CT检查在鉴别结核性腹膜炎与感染性腹膜炎中的作用  

Role of CT examination in differential diagnosis of tuberculous peritonitis and septic peritonitis

作　　者：尤国庆[1] 刘蕾[1] 许禹[1] 

机构地区：[1]南阳市中心医院CT室,河南南阳473006

出　　处：《中华医院感染学杂志》2014年第4期926-927,930,共3页Chinese Journal of Nosocomiology

基　　金：河南省自然科学基金资助项目(0511041900)

摘　　要：目的探讨CT检查在鉴别结核性腹膜炎与感染性腹膜炎中的作用,为临床结核性腹膜炎与感染性腹膜炎的鉴别诊断提供更可靠的方法。方法回顾性分析医院2010年12月-2012年12月收治的经手术病理、穿刺活检证实的32例结核性腹膜炎患者和34例感染性腹膜炎患者临床资料,观察比较各种CT征象在两种病变中的阳性率,所有数据均采用SPSS17.0软件分析。结果腹水量结核性腹膜炎表现为少量腹水,占12.50%,而感染性腹膜炎则有大量腹水,占76.47%,两组比较,差异有统计学意义(P<0.05);结核性腹膜炎以壁层腹膜均匀增厚、肠系膜污迹样改变为主,而感染性腹膜炎以壁层腹膜以结节、块样增厚为主,两组相比,差异有统计学意义(P<0.05);两组患者大网膜及淋巴结CT征象差异无统计学意义。结论通过腹水量、壁腹膜及大网膜CT征象,可以很好鉴别结核性腹膜炎与感染性腹膜炎,提高诊断的准确度。OBJECTIVE To investigate the role of CT examination in differential diagnosis of tuberculous peritonitis and septic peritonitis so as to offer more reliable method for the clinical differential diagnosis of tuberculous peritonitis and septic peritonitis. METHODS Totally 32 patients who were confined as tuberculous peritonitis and 34 patients who were confirmed as septic peritonitis through surgical pathology and puncture biopsy were enrolled in the study, then the incidence of CT findings of the subjects with two types of lesions was observed and compared, and the statistical analysis of all the data was performed with the use of SPSS17.0 software. RESULTS In the amount of ascites, the tuberculous peritonitis showed a small amount of ascites（12. 50~）, and the infectious peritonitis showed a large amount of ascites （76.47~）, the difference between the two groups was statistically significant （P~ 0. 05） ~ the tuberculous peritonitis was characterized by evenly thickened parietal peritoneum and mesentery stains like changes, while the infectious peritonitis was manifested by parietal peritoneum with nodules and block-like thickening, the difference between the two groups was statistically significant~ the difference in the CT sign of greater omentum or lymph node between the two groups was not statistically significant. CONCLUSION The tuberculous peritonitis and septic peritonitis can be well distinguished through the amount of ascites, parietal peritoneum, and CT signs of great omentum, which can improve the accuracy of diagnosis.

关 键 词：CT检查 结核性腹膜炎 感染性腹膜炎 

分 类 号：R526[医药卫生—内科学]