腹腔镜腹腔探查用于诊断不明原因腹水的临床研究  

Clinical research of laparoscopic peritoneal exploration in diagnosis of unknown origin ascites

作　　者：克力木[1] 李梅[1] 张成[1] 陈勇[1] 牛伟亚[1] 王志[1] 凯塞尔[1] 艾克拜尔[1] 王自立[1] 

机构地区：[1]新疆维吾尔自治区人民医院,新疆乌鲁木齐830001

出　　处：《腹腔镜外科杂志》2010年第5期352-356,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜探查用于诊断不明原因腹水的价值。方法:回顾分析1993年3月至2009年12月为102例不明原因腹水患者行腹腔镜腹腔探查活检术的临床资料。结果:97例经腹腔镜腹腔探查活检术明确病因,其中结核性腹膜炎41例(40.2%)。发生肠管损伤2例,切口二期缝合1例,术后一过性发热7例。不同常规影像学检查诊断符合率差异无统计学意义(P>0.05)。常规检查费用之和较腹腔镜探查费用多(P<0.05),花费时间之和明显长于腹腔镜检查(P<0.01)。发病入院时结核性腹膜炎与腹腔内广泛转移癌患者血清糖类抗原125(carbohydrate antigen 125,CA125)值差异无统计学意义(P>0.05);结核性腹膜炎患者入院时血清CA125值与正规抗痨治疗3个月后相比差异有统计学意义(P<0.01)。结论:腹腔镜探查诊断不明原因腹水效率高,安全可行,经济,省时。血清肿瘤标记物CA125值的变化可作为评判结核性腹膜炎治疗效果的一种指标。Objective：To assess the value of laparoscopic exploration in diagnosing unknown origin ascites.Methods：A total of 102 patients with unknown origin ascites underwent diagnostic laparoscopic abdominal exploration and biopsy from Mar.1993 to Dec.2009.Results：The etiological factor of 97 cases were identified by laparoscopic abdominal exploration and biopsy,there were 41 cases of tuberculous peritonitis.Surgical complications included 2 cases of bowel injury,1 case of secondary suture,and 7 cases of postoperative transient fever.There was no difference in diagnosis rate among different routine conventional imaging examinations（P0.05）.Summation fee of routine examinations was more than laparoscopic exploration（P0.05）,and the summation time of routine examinations was obviously longer than laparoscopic exploration（P0.01）.There was no significant difference of serum carbohydrate antigen 125（CA125） concentrations between the cases of tuberculous peritonitis and abdominal extensive metastatic carcinoma on admission（P0.05）.There were significant differences of serum CA125 concentrations between the patients with tuberculous peritonitis after 3 months treatment and their first serum CA125 test on admission（P0.01）.Conclusions：The laparoscopic exploration in diagnosing unknown origin ascites is efficient,safe,feasible,economic and time-saving.Serum CA125 can be used as performance monitor in the patients with tuberculous peritonitis and an indicator of therapeutic effect.

关 键 词：腹腔镜检查 腹水 诊断 

分 类 号：R656[医药卫生—外科学]