女性结核性腹膜炎36例临床分析

Clinical Analysis of 36 Women with Tuberculous Peritonitis

目的:分析结核性腹膜炎的临床特征及易误诊为卵巢癌的原因。方法:回顾性分析36例结核性腹膜炎患者的临床特征、诊断和治疗结果。结果:腹胀、腹水、盆腔包块是结核性腹膜炎患者的主要临床特征。36例中13例(36.1%)术前误诊为卵巢癌,35例血清CA125值升高,平均值为400.2 U/ml。3例术前明确诊断经抗结核治疗治愈。33例经手术明确诊断,6例行患侧附件切除术,5例行患侧输卵管切除术,5例行脓肿引流术,其余17例行病变活检术。患者术后均接受了抗结核治疗。结论:结核性腹膜炎的临床表现与体征和卵巢癌极为相似,临床很容易误诊为卵巢癌,手术可以明确诊断与清除结核病灶,缩短药物治疗时期,有利于结核病的痊愈。

Objective：To analysis the clinical features of tuberculous peritonitis and the reason that misdiagnose as ovarian cancer, Methods：36 cases of tuberculous peritonitis were retrospectively reviewed clinical manifestation, diagnosis, and treatment, Results： The main clinical features of tuberculous peritonitis included abdominal distention, ascites, and pelvic mass. There were 13（36.1%） cases preoperatively misdiegnosed as ovarian cancer. The serum CA125 levels （ mean value 400.2 u/ml） elevated in 35 cases of total 36 cases. The final diagnosis was made in 3 preoperation and 33 post-operation. Surgical approach included 6 affected lateral adnexectomy,5 affected lateral salpingectomy,5 abscess drainage, and 17 biopsy. All patients received antituberculosis therapy after operation. Conclusions：The clinical manifestation of tuberculous peritoneal is extremely similar to that of ovarian cancer which results in misdiagnosis in clinical practice. Surgery is a good way to distinguish them and get final diagnosis, and it can also remove tuberculous lesion with shorten medicine regimen,and improve curing.