超声引导下大网膜穿刺活检诊断结核性腹膜炎

Ultrasound-guided needle biopsy of greater omentum in diagnosis of tuberculosis peritonitis

目的探讨超声引导下大网膜穿刺活检诊断结核性腹膜炎的临床价值。方法回顾性分析129例接受超声引导下大网膜穿刺活检且最终经临床确诊为结核性腹膜炎的患者,评价超声引导下大网膜穿刺活检对结核性腹膜炎的诊断率、安全性及其临床应用价值。结果对129例结核性腹膜炎患者共行343针超声引导下大网膜穿刺活检;病理明确诊断93例结核性腹膜炎,21例高度提示结核性腹膜炎,总诊断率为88.37%(114/129),15例病理未能明确诊断。不同穿刺针数诊断率间差异无统计学意义(χ2=0.073,P=0.964)。未发生严重并发症。结论超声引导下大网膜穿刺活检对结核性腹膜炎诊断率高、安全性好,可作为临床高度怀疑结核性腹膜炎时的常规检查。

Objective To explore the clinical value of ultrasound-guided needle biopsy of greater omentum in diagnosis of tuberculosis peritonitis （TBP）. Methods Totally 129 patients who underwent ultrasound-guided greater omentum needle biopsy and ultimately diagnosed as TBP were retrospectively analyzed. The diagnostic rate, safety and clinical application value of ultrasound-guided needle biopsy of greater omentum for TBP were evaluated. Results Ultrasound-guided needle biopsy of greater omentum was performed in 129 patients with 343 punctures, among them 93 patients were pathologically diagnosed as TBP, 21 were highly suggested of TBP, the total diagnostic rate was 88.37% （114/129）. No clear pathological diagnosis was obtained in 15 cases. There was no statistical difference of diagnostic rate patients underwent different puncture times （X^2=0. 073, P=0. 964）. No serious complication occurred. Coneluslon Ultrasound-guided needle biopsy of greater omentum has high diagnostic rate and safety for diagnosing TBP, which can be used as a routine examination of clinical suspected TBP.