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在中心静脉导管辅助下通过腹腔镜检查诊断结核性腹膜炎。

Tuberculous peritonitis diagnosed using laparoscopy with assistance of a central venous catheter.

作者信息

Zhang Ru, Xu Zhenglei, Yao Jun, Shi Ruiyue, Zhang Dingguo, Mei Yi, Zhong Yunlian, Lai Mingguang, Wang Lisheng

机构信息

Department of Gastroenterology, Shenzhen People's Hospital, The Second Affiliated Hospital of Jinan University, Shenzhen, Guangdong 518020, P.R. China.

出版信息

Exp Ther Med. 2018 Dec;16(6):5265-5271. doi: 10.3892/etm.2018.6854. Epub 2018 Oct 12.

Abstract

Laparoscopy with peritoneal biopsy is a tool for rapid and accurate diagnosis of tuberculous peritonitis (TBP). However, laparoscopic procedures are not risk-free; complications include injuries to the gastrointestinal tract and major blood vessels. The purpose of the present study was to introduce a novel method for safe and straightforward laparoscopic diagnosis of TBP. A case series of 12 patients with TBP diagnosed between October 2012 and November 2013 at our hospital is presented. The patients underwent a novel method of laparoscopy involving the use of a central venous catheter (CVC). The diagnosis was confirmed by biopsy and histology. The efficacy of the method for TBP diagnosis was evaluated by the time taken for the procedure and the rate of successful completion. The safety of the method was evaluated by recording all intra- and post-operative adverse events encountered. The mean age of the patients was 41 years and 33% were male. The mean operation time was 50.6 min and the median duration of hospital stay was 7 days. In all cases, diagnostic laparoscopy was successfully performed. Targeted biopsies were taken from all of the patients and revealed caseous granulomatous inflammation. All patients tolerated the procedure without significant bleeding or digestive tract perforation. In conclusion, the present case series demonstrated a novel method of diagnostic laparoscopy with CVC that is a feasible and straightforward procedure for TBP diagnosis.

摘要

腹腔镜检查联合腹膜活检是快速准确诊断结核性腹膜炎(TBP)的一种手段。然而,腹腔镜手术并非毫无风险;并发症包括胃肠道和主要血管损伤。本研究的目的是介绍一种安全、简便的腹腔镜诊断TBP的新方法。本文报道了2012年10月至2013年11月在我院确诊的12例TBP患者的病例系列。这些患者接受了一种使用中心静脉导管(CVC)的新型腹腔镜检查方法。通过活检和组织学检查确诊。通过手术所需时间和成功完成率评估该方法对TBP诊断的有效性。通过记录所有术中及术后遇到的不良事件来评估该方法的安全性。患者的平均年龄为41岁,33%为男性。平均手术时间为50.6分钟,中位住院时间为7天。所有病例均成功进行了诊断性腹腔镜检查。对所有患者进行了靶向活检,结果显示为干酪样肉芽肿性炎症。所有患者均耐受该手术,无明显出血或消化道穿孔。总之,本病例系列展示了一种使用CVC的诊断性腹腔镜新方法,这是一种可行且简便的TBP诊断方法。

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