不明原因腹水患者266例病因及临床特点分析

Analysis of etiology and clinical features of 266 patients with unexplained ascites

目的:探讨不明原因腹水患者的病因及临床特点。方法:收治腹水原因待查患者266例,回顾性分析其临床资料。结果:病因构成中,恶性肿瘤所占比例最高。男性恶性腹水中以消化系统肿瘤占首位,较女性更常见(P<0.01);女性恶性腹水以妇科恶性肿瘤占首位;男性结核性腹水较女性更常见(P<0.01)。青年组腹水主要以结核性为主,明显高于中年组及老年组(P<0.01);中年组和老年组腹水以恶性为主,明显高于青年组(P<0.05)。体重减轻在恶性腹水组及结核性腹水组中显著高于肝硬化组(P<0.01);纳差症状在恶性腹水组中高于肝硬化组和结核组(P<0.05);肝硬化腹水组出现浮肿症状显著高于恶性腹水组及结核性腹水组(P<0.01);结核性腹水组出现发热症状显著高于肝硬化组和恶性组(P<0.01)。结论:以不明原因腹水起病的患者要注意排查恶性肿瘤,男性尤其要注意排查消化系统肿瘤,女性要注意排查妇科肿瘤;青年患者,尤其是男性要注意排除结核。

Objective:To explore the etiology and clinical features of266patients with unexplained ascites.Methods:266patients with unexplained ascites were selected,and the clinical data were retrospectively analyzed.Results:Among the causes of the disease,the proportion of malignant tumors was the highest.In men with malignant ascites,the digestive system tumors were the first,and it was more common than women(P<0.01).In women with malignant ascites,gynecologic malignancies was the leading cause of malignancy.Tuberculous ascites in men was more common than in women(P<0.01).Tuberculous ascites was the most common in the young group,and it was significantly higher than that in the middle-aged group and the elderly group(P<0.01).In the middle-aged group and the old group,malignant ascites was the most,and it was significantly higher than that in the young group(P<0.05).In the malignant ascites group and the tuberculous ascites group,the weight loss was significantly higher than that in the cirrhosis group(P<0.01).In the malignant ascites group,symptoms of anorexia was higher than that in liver cirrhosis group and tuberculosis group(P<0.05).In the cirrhotic ascites group,the swelling symptom was significantly higher than that in the malignant ascites group and the tuberculous ascites group(P<0.01).In the tuberculous ascites group,the fever symptom was significantly higher than that in the cirrhosis group and the malignant group(P<0.01).Conclusion:In patients with unexplained ascites,we should pay attention to the investigation of malignant tumors.In men,we should pay special attention to the investigation of digestive system tumors.In women,we should pay attention to the investigation of gynecological tumors.In young patients,especially men,we should pay attention to the removal of tuberculosis.