腹膜活检对腹水患者病因诊断的价值  

The Significance of Biopsy of Peritoneum in Diagnosis of The Patients with Unknown Etiological Ascites

作　　者：刘文斌[1] 段丽平[1] 缪应雷[1] 张海蓉[1] 南琼[1] 张瑜[1] 

机构地区：[1]昆明医学院第一附属医院消化内科,650032

出　　处：《中国消化内镜》2009年第2期29-33,共5页Digestive Disease and Endoscopy

摘　　要：目的研究腹膜活检对腹水患者的病因诊断,分析腹水病因、指导临床诊治,并对该研究进行价值评价。方法原因不明腹水患者75例(A组)使用多功能腹膜活检针行腹膜活检并行组织病理学检查,与同期常规检查腹水病因的40例(B组)患者从确诊率、平均确诊时间、诊断费用等方面进行对比;并使用灵敏度、特异度及准确度评价该诊断方法的价值。结果A组67例经病理检查明确诊断(确诊率89.33%);B组25例经腹水细胞病理学或试验性抗痨治疗明确诊断(确诊率62.50%)(P<0.05);平均诊断时间、诊断费用等两组对比均有显著差异(P<0.05)。该诊断方法的灵敏度为81.5%,特异度为80%,准确度81.33%。结论腹膜活检对不明原因腹水的确诊率高,价格低,确诊时间快;该方法灵敏度、特异度及准确度高,具有较高的临床指导意义,可广泛推广应用。Objective： To evaluate the value of percutaneous biopsy of peritoneum in diagnosis of the patients with unknown etiological ascites. Methods： 75 cases （group A） with unknown etiological ascites underwent the detection by multifunctional Peritoneal Biopsy Needle and histopathology. Meanwhile, another 40 cases （group B） with unknown etiological ascites underwent the routine examination. The two groups were compared in accuracy, mean diagnostic time and diagnostic cost. The sensitivity and specificity of the percutaneous biopsy of peritoneum in diagnosis of the patients with unknown etiological ascites was evaluated. Results： 67 cases （89.33%） in group A was diagnosed definitely by multifunctional Peritoneal Biopsy Needle and histopathology. 25 cases （62.5%） in group B was diagnosed definitely by histopathology and experimental antituberculous therapy. The two groups showed significant difference in mean diagnostic time and diagnostic cost （P〈0.05）. The sensitivity of dectection of multi functional Peritoneal Biopsy Needle and histopathology was 81.5%, the specificity was 80% and the accuracy was 81.33%. Conclusions： The higher accuracy, lower cost, shorter dignostic time, higher sensitivity and specificity were obtained by the detection of multi functional Peritoneal Biopsy Needle and histopathology compared with the routine examination in diagnosis of the patients with unknown etiological ascites. This technique showed importance in clinic dignosis and treatment of the patients with unknown etiological ascites.

关 键 词：腹膜活检 诊断 腹水 

分 类 号：R442.5[医药卫生—诊断学] R441.7[医药卫生—临床医学]