结核分枝杆菌感染性腹膜炎超声诊断的分析

Value of ultrasonography in diagnosis of infective peritonitis caused by Mycobacterium tuberculosis

目的分析超声检查在结核分枝杆菌感染性腹膜炎患者诊断中的临床价值,为结核分枝杆菌感染性腹膜炎的诊断提供参考。方法调查2009年1月-2012年12月于医院经超声检查初步诊断为结核分枝杆菌感染性腹膜炎患者病历资料,对其超声检查结果进行分析。结果在92例患者中经诊断性治疗、临床表现、体检、超声等辅助检查明确诊断为结核分枝杆菌感染性腹膜炎患者83例,超声诊断符合率为90.22%;超声检查主要表现为腹水、网膜肠管粘连、腹膜壁增厚、淋巴结肿大、肠管聚集;发生腹水89例占96.74%,腹膜壁增厚63例占68.48%,网膜肠管粘连33例占35.87%,肠管聚集23例占25.00%,淋巴结肿大19例占20.65%。结论在进行结核分枝杆菌性腹膜炎诊断与鉴别时,超声检查具有无创、高效、便捷的优点,值得临床推广使用。

OBJECTIVE To analyze the clinical value of ultrasonography in diagnosis of infective peritonitis caused by Mycobacterium tuberculosis so as to provide guidance for the diagnosis of M. tuberculosis infective peritonitis. METHODS The patients who were primarily diagnosed as the M. tuberculosis infective peritonitis in the hospital from Jan 2009 to Dec 2012 were enrolled in the study, then the clinical data of the subjects were investigated, and the results of the ultrasonography were analyzed. RESULTS Totally 83 of 92 patients have been conformed with M. tuberculosis infective peritonitis through the auxiliary examinations including＇the diagnostic treatment, clinical manifestations, physical examination, and ultrasonography, and the accordance rate of the ultrasonography was 90.22%. The ultrasonography result showed that the main manifestations were the ascites, omentum and intesti- nal adhesion, peritoneal wall thickening, swollen lymph nodes, and intestinal gathering~ there were 89 （96.74 %） cases of ascites, 63 （68.48%） cases of peritoneal wall thickening, 33 （35.87%） cases of omentum and intestinal adhesion, 23 （25.00%） cases of intestinal gathering, and 19 （20.65%） cases of swollen lymph nodes. CONCLUSION The ultrasonography has such advantages as the noninvasive, high effectiveness and convenience in diagnosis and identification of the M. tuberculosis infective peritonitis, and it is worthy to be promoted in the hospital.