超声诊断在结核性腹膜炎中的临床应用  

Clinical value of ultrasound examination in diagnosis of tuberculous peritonitis

作　　者：于德林[1] 刘彬[1] 王昱[1] 

机构地区：[1]天津市环湖医院超声科,天津300060

出　　处：《中华医院感染学杂志》2013年第18期4413-4414,共2页Chinese Journal of Nosocomiology

摘　　要：目的探讨结核性腹膜炎的超声声像图特点及其诊断价值,以提高结核性腹膜炎超声诊断水平。方法选取医院2011年12月-2013年2月经大网膜穿刺活检、腹水穿刺检查确诊为结核性腹膜炎患者50例,利用彩色超声诊断仪分析50例结核性腹膜炎患者的超声声像图特征。结果 50例患者中,超声诊断符合率94.0%,误诊3例,误诊率6.0%;49例患者可探及腹水占98.0%,其中少量腹水4例占8.2%,中等量腹水40例占81.6%,大量腹水5例占10.2%;腹水无回声区即单纯性腹水28例占55.1%,非均质性腹水22例占44.9%,在免疫反应的早期阶段,腹水声像图一般表现为单纯性腹水,随着病情进展,腹水声像图转化为非均质性腹水,因此超声声像图可显示病情的进展情况;大网膜增厚47例占94.0%,壁腹膜增厚13例占25.1%,肠系膜增厚9例占18%,其中有8例属肠管聚集征占16.0%;淋巴结肿大7例占14.0%,其中有5例位于肠系膜根部,另外两例分别位于肝门部及胰腺周围。结论超声检查具有操作简便、敏感性好、准确率高,并且可以了解疾病进展以及引导进一步的检查,在结核性腹膜炎的诊断中具有重要的价值,值得推广。OBJECTIVE To study the sonographic characteristics of ultrasound examination and its clinical value in diagnosis of tuberculous peritonitis so as to improve its diagnosis level. METHODS A total of 50 cases of patients with tuberculous peritonitis confirmed by omental biopsy and ascites puncture examination from Dec 2011 to Feb 2013 were enrolled in the study, then the sonographic characteristics of ultrasound examination were analyzed by using color ultrasonic diagnostic apparatus. RESULTS Of the 50 cases of patients investigated, the accordance rate of the ultrasound examination was 94.0 %, 3 cases were misdiagnosed with the misdiagnosis rate of 6.0 %. There were 49 （98.0%） patients with ascites detectable, 4（8.20%） cases of patients with small amount of ascites, 40 （81.6 % ） cases of patients with medium amount of ascites, and 5 （10.2 %） cases of patients with massive ascites. There were 28 cases with echo-lucent ascites and 22 cases with heterogeneity ascites. In the early stage of immune response, the sonogram of ascites was generally characterized by echo-lucent ascites ultrasonography, as the disease progressed, the sonogram of ascites transferred into heterogeneity ascites ultrasonography, so ultrasonic ultrasonogram could show the progress of disease. There were 47 （94.0%） cases with thickend greater omentum, 13 （25.1 % ） cases with thickend peritoneum, and 9 （ 18 % ） cases with thickend mesenterium, including 8 （16.0 %） cases with bowel gathered levy; there were 7（14.0%） cases with swoiien lymph nodes,including 5 cases with the swollen lymph nodes located in mesenteric root and 2 cases with the swoiien lymph nodes located around the hepatic portal vein and the pancreas. CONCLUSION Ultrasounds examination has such advantages as the simple operation, good sensitivity, and high accuracy, and can help to understand the progression of disease so as to guide the further examination, it is of great clinical significance in the diagnosis of tuberculous peritonitis and worthy t

关 键 词：结核性腹膜炎 超声检查 声像图 

分 类 号：R181.32[医药卫生—流行病学]