疑难性腹部疾病诊断性腹腔镜下常见与罕见病变的特征  

Characteristics of diagnostic laparoscopy on rare and common pathological changes of complicated abdominal diseases

作　　者：周曾芬[1] 秦兴陆[2] 崔蓉[1] 何青雯[1] 马永福[1] 李树安[1] 

机构地区：[1]昆明医学院第一附属医院消化内科,云南昆明650032 [2]昆明医学院第一附属医院肝胆外科,云南昆明650032

出　　处：《罕少疾病杂志》2001年第1期1-3,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨疑难性腹部疾病诊断性腹腔镜下常见与罕见病变的特征。方法对 31例临床难以诊断的腹痛、腹水和腹块患者进行了电视腹腔镜检查以及窥视下多部位、多点和块状组织活检病理组织学检查。结果① 31例腹腔镜检查均获成功，经活检病理组织学检查 30例明确诊断，确诊率达 96.77％ (30/31)。其中良性病变 17例 (54.84％ )，恶性病变 14例 (45.16％ )，并发现罕见腹部疾病 11例 (35.48％ )(肠系膜淋巴管囊性扩张 1例，腹膜转移性透明细胞癌 2例，腹腔恶性淋巴瘤 3例，腹膜恶性间皮瘤 3例，大网膜恶性间叶肿瘤 1例和腹膜假粘液瘤 1例 )。②本组不同罕见病变各有其特征。结论腹腔镜检查是疑难性腹部疾病 (不明原因腹痛、腹水和腹块 )病因诊断的一种确诊率高、安全、快速的方法，能及时发现罕见病；腹腔镜窥视下块状组织活检可显著提高确诊率，在众多检查中，对疑难性腹部疾病诊断率最高。Objective To explore characteristics of diagnostic laparoscopy on rare and common pathological changes of the complicated abdominal diseases. Methods 31 complicated cases of abdominal pain,ascites and abdominal mass underwent video laparoscopy and multi－ piece biopsy from multi－ position. Results① All cases underwent laparoscopy successfully and 96.77％ (30/31) cases(benignancy 17,malignancy 14)were diagnosed clearly by biopsy and histology diagnosis in which the 11(35.48％ )cases(mesenteric lymphangiectasia 1,metastatic peritoneal malignant transparent cytoma 2,malignant lymphoma 3,peritoneal mesothelioma 3,malignant omentum majus mesothelioma 1 and peritoneal pseudomyxoma 1)were rare.② Characteristic of various rare diseases was shown. Conclusion Diagnostic laparoscopy on complicated abdominal diseases(abdominal pain,ascites and abdominal mass of unknown origin)is a safe,rapid,sensitive and special method on the etiological diagnosis and can find the rare diseases timely.diagnostic rate of video laparoscopy on complicated abdominal diseases is the highest among varied examinations and could be improved significantly by multi－ piece biopsy from multi－ position.

关 键 词：腹腔镜检查 腹部罕见疾病 诊断 临床特征 

分 类 号：R572[医药卫生—消化系统]