CAJ | 학술논문

目的探讨绝经后老年女性结核性腹膜炎与晚期卵巢癌的临床特点,并对相关文献进行复习.方法回顾性分析了2003年1月至2009年9月卫生部北京医院收治的60岁以上老年女性被确诊为结核性腹膜炎的3例患者临床资料.并进行文献复习,探讨结核性腹膜炎的误诊原因及诊断方法.结果 3例患者均表现出类似晚期卵巢癌的临床症状:胸水、腹水、盆腹腔包块及腹胀,进行性消瘦,肿瘤抗原125(CA125)升高.其中2例患者接受了剖腹探查术,均未发现恶性肿瘤.3例患者均接受了抗结核治疗.其中2例患者在治疗中胸水、腹水消失.结论结核性腹膜炎老年女性患者易被误诊为卵巢癌,从而接受手术治疗.腹腔镜活检是诊断结核性腹膜炎安全有效的方法.剖腹探查是不能行腹腔镜手术患者的另一选择.
목적 탐토절경후노년녀성결핵성복막염여만기란소암적림상특점,병대상관문헌진행복습.방법 회고성분석료2003년1월지2009년9월위생부북경의원수치적60세이상노년녀성피학진위결핵성복막염적3례환자림상자료.병진행문헌복습,탐토결핵성복막염적오진원인급진단방법.결과 3례환자균표현출유사만기란소암적림상증상:흉수、복수、분복강포괴급복창,진행성소수,종류항원125(CA125)승고.기중2례환자접수료부복탐사술,균미발현악성종류.3례환자균접수료항결핵치료.기중2례환자재치료중흉수、복수소실.결론 결핵성복막염노년녀성환자역피오진위란소암,종이접수수술치료.복강경활검시진단결핵성복막염안전유효적방법.부복탐사시불능행복강경수술환자적령일선택.
Objective To document peritoneal tuberculosis mimicking ovarian malignancy in elderly post-menopausal women and to review pertinent literature.Methods The records of 3 women with peritoneal tuberculosis who were managed at Beijing Hospital from January 2003 to September 2009 were reviewed.Results Three patients with peritoneal tuberculosis mimicking ovarian malignancy all presented with the classical symptoms of advanced-stage ovarian carcinoma,including ascites,abdominopelvic masses,elevated serum CA125,bloating and progressive emaciation.Two patients received laparotomy revealing peritoneal tuberculosis but no malignancy.All the patients were treated with anti-tuberculosis chemotherapy.Conclusions Medical awareness of peritoneal tuberculosis is still lacking and many women with this disease are initially thought to have ovarian malignancy and undergo unnecessary extended surgery.Laparoscopy including biopsies seems to be a sufficient and safe method to provide diagnosis of peritoneal tuberculosis.If laparoscopy is not feasible,laparotomy should be performed.Ascites and high level of CA125 do not necessarily indicate that the clinical picture is malignant in post-menopausal women.