经脐腹腔内镜探查术在不明原因腹水诊断中的应用  

Transumbilical peritoneoscopy in the diagnosis of ascites of unknown origin

作　　者：蔡建群[1] 白杨[1] 智发朝[1] 王震[1] 邢同印[1] 黄颖[1] 刘思德[1] CAI Jian-qun;BAI Yang;ZHIFa-chao;WANG Zhen;XING Tong-yin;HUANG Yin;LIU Si-de(Guangdong Provincial Key Laboratory of Gastroenterology,Department of Gastroenterology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院消化内科,510515

出　　处：《现代消化及介入诊疗》2020年第7期847-850,855,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：广东省科技计划项目《广东省消化系统疾病临床医学研究中心》(2017B02029003);2020年度大学生创新创业训练计划项目课题(S202012121090)。

摘　　要：目的探讨经脐腹腔内镜探查术对不明原因腹水的诊断价值,评估该方法的安全性和有效性。方法回顾性分析我院29例通过经脐腹腔内镜探查术诊断不明原因腹水的病例,记录术中探查情况、术后诊断率及术中术后并发症发生情况。结果28例患者成功完成操作,1例因术中肠穿孔中转外科手术。29例患者均获得明确诊断,其中结核性腹膜炎11例,转移性腺癌9例,腹膜间皮瘤3例,转移性恶性间质瘤2例,腹膜假性黏液瘤2例,Burkitt淋巴瘤1例,嗜酸细胞性胃肠炎1例。术后均未发生出血、穿孔、腹膜炎、腹腔脓肿等手术相关并发症。结论经脐腹腔内镜探查术对不明原因腹水的诊断率高,是一种安全和有效的方法。Objective The aim of this study is to investigate the diagnostic value of transumbilical peritoneoscopy for ascites of unknown origin.Methods A total of 29 patients with ascites of unknown origin who undertook transumbilical peritoneoscopy procedures in our hospital were retrospective investigated,intraoperative exploration,postoperative diagnostic rate and operative-related complications were carefully recorded.Results Transumbilical peritoneoscopy was successfully performed in 28 patients except 1 patient was converted to open surgery due to intraoperative bowel perforation.Definite diagnoses were established in all the 29 patients.The most common causes of ascites was tuberculosis peritonitis(11 cases),followed by peritoneal metastatic adenocarcinoma(9 cases),peritoneal mesothelioma(3 cases),metastatic malignant stromal tumor(2 cases),and pseudomyxoma peritonei(2 cases).Postoperative complications such as bleeding,perforation,peritonitis,intraabdominal abscesses were not observed.Conclusion Transumbilical peritoneoscopy has a high diagnostic rate for ascites of unknown origin,and is a safe and effective method.

关 键 词：经脐腹腔内镜探查术 不明原因腹水 诊断 

分 类 号：R442.5[医药卫生—诊断学] R572[医药卫生—临床医学]