经胃腹腔内镜检查对原因不明腹水的诊断价值

Transgastric peritoneal endoscopy in diagnosis of ascites with unknown origin

目的探讨经自然腔道进行腹腔内镜检查对渗出性腹水病因的诊断价值。方法23例不明原因渗出性腹水患者经口腔穿胃壁行腹腔内镜检查及病理活检。结果23例中22例获得明确诊断，确诊率95．7％。明确病因诊断22例中，腹腔恶性肿瘤12例（54．6％），结核性腹膜炎8例（36．4％），肝硬化合并自发性腹膜炎1例（4．5％），嗜酸性小肠炎1例（4．5％）。结论经自然腔道腹腔内镜检查及病理活检对原因不明渗出性腹水患者是一种安全、确诊率高的诊断方法。

Objective To investigate the diagnostic value of transgastric peritoneal endoscopy in diagnosis of ascites with unknown origin. Methods Endoscopy was introduced into peritoneal cavity through gastric wall in 23 patients with exudative ascites which was able to be diagnosed by routine methods and biopsy was made through endoscopy to get pathological diagnosis. Results Definite diagnosis was made in 22 patient （95.7%）, of which 12 （54. 6% ） were malignant tumors, 8 （36.4%） were tuberculosis peritonitis, 1 （4. 5% ） was spontaneous peritonitis associated with liver cirrhosis and 1 （4. 5% ） was eosinophilic enteritis. Conclusion Natural orifice transluminal endoscopy combined with biopsy is an effective and accurate procedure for diagnosis of ascites of unknown causes.