NOTES经胃入路诊断不明原因腹水的临床研究

发布时间：2018-05-11 07:21

本文选题：经自然腔道内镜外科 + 经胃　；参考：《重庆医学》2017年12期

【摘要】：目的探讨经自然腔道内镜外科(NOTES)经胃入路对不明原因腹水的病因诊断的临床价值。方法回顾该院2015年11月至2016年7月采用经胃入路NOTES诊断12例不明原因腹水患者进行腹腔探查及腹膜活检的临床资料,通过对术后有无并发症发生及疾病诊断率进行分析统计,评估该手术风险及临床应用价值。结果通过腹腔探查、腹膜活检后病理学证实,确诊率达100%,其中结核性腹膜炎8例(66.7%)、肝硬化2例(16.7%)、腹膜间皮瘤1例(8.3%)、转移性腹膜癌1例(8.3%);术后出现腹痛2例,其中1例中性粒细胞比值升高,症状及实验室指标异常持续时间均未超过24h,发生率为8.3%;无术后腹腔感染、切口出血、穿刺口瘘等并发症发生。结论 NOTES经胃入路腹腔探查及腹膜活检诊断不明原因腹水,具有创伤小、并发症少、术后恢复快等优势,具有重要的临床应用价值。
[Abstract]:Objective to evaluate the clinical value of transgastric approach in the diagnosis of unexplained ascites. Methods the clinical data of 12 patients with unexplained ascites diagnosed by transgastric NOTES from November 2015 to July 2016 were reviewed. To evaluate the risk and clinical value of the operation. Results by abdominal exploration, pathology after peritoneal biopsy, the diagnosis rate was 100%, including tuberculous peritonitis (n = 8), liver cirrhosis (n = 2, n = 16), peritoneal mesothelioma (n = 1), metastatic peritoneal carcinoma (n = 1), abdominal pain (n = 2), peritoneal mesothelioma (n = 1) and metastatic peritoneal carcinoma (n = 1). In one case, the ratio of neutrophil was increased, the duration of symptoms and laboratory indexes was not more than 24 hours, the incidence was 8.3, no postoperative complications such as abdominal infection, incision bleeding, puncture fistula and so on. Conclusion the diagnosis of unexplained ascites by abdominal exploration and peritoneal biopsy by NOTES via gastric approach has the advantages of less trauma, less complications and quick postoperative recovery. It has important clinical application value.
【作者单位】：重庆市涪陵中心医院消化科;
【分类号】：R442.5

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