| Tuberculous Peritonitis is a kind of chronic and diffused peritoneum infection caused by Mycobacterium tuberculosis. It is 5% of tuberculosis, less than pulmonary tuberculosis and intestine tuberculosis. In these 10 years the morbidity is increasing. Mycobacterium tuberculosis infection develop by direct intraperitoneum expansion mianly, others by blood and lymph cycle. Tuberculous Peritonitis has no specific symptoms and signs. Lab test and others inspection can find all changes, but each test has its shortcomings. Meantime, recently because antituberculotic treatment is incorrect and drug resistant bacterium is increasing, Tuberculous Peritonitis can not be treated well.Objective: To review the clinical characteristics of Tuberculous Peritonitis in the past 7 years and improve the diagnosis and treatment methods. Methods: The 102 cases of Tuberculous Peritonitis from January 1999 to December 2005 in the First Hospital of Jilin University which were diagnosed denifinitely and have complete data were analyzed retrogradely according to the etiology, clinical manifestations, diagnosis and treatment methods. Results: Tuberculous Peritonitis morbidity rate is 1:1.08 according to male versus female, and medium age is 40.7±17.6. Less than 10% patients have extraperitoneal tuberculosis, but patients combined with decompensate cirrhosis of alcoholic cirrhosis is about 6.9%. Less than 40% patients have fever, night sweat and thin,et al . 98% patients haveabdominal swell, ascites 49% and abdominal soft feeling 42.2%. Ascites biochemistry test of 80% patients indicated extravasate fluid, and mononuclear cells is more than polynuclear cells.Serum and ascites anti-tubercle antibody of 60 patients is 45% positive rate. Ascites Mycobacterium tuberculosis of 16 cases is 12.5% positively. 31 patients underwent classical antituberculotic treatment for 2 weeks, serum CA125 level were 382.1±148.3 and 104.5±58.3 before and after treatment respectively, and ESR were 70.2±32.3 and 15±11.4 respectively. Misdiagnosis rate of 102 cases is 12.7%. The effective rate of advanced group is 96.7%, and conventional group is 63.3%. Conclusion: (1) Tuberculous Peritonitis is increasing recently, and male versus female is 1:1.08, aged from 30 and 50. (2) People who live poorly and have high pressure is apt to get the disease. (3) In this investigation less than 10% patients have extraperitoneal tuberculosis. (4) Less patients have tuberculous toxic symptoms, such as fever, night sweat and thin , but most patients have abdominal swell and pain. Abdominal soft feeling can not work as a specific sign to diagnosis Tuberculous Peritonitis. (5) Blood cell count, ESR, ascites biochemistry test, X ray and sonography are not specific diagnosis methods. To diagnosis Tuberculous Peritonitis is synthesize all tests and trial antituberculotic treatment. (6) ESR and serum CA125 can work as a marker to examine treatment effectiveness. (7) Treatment outcoming with drug, regular celiac discharge fluid and celiac drug injection is better than conventional drug treatment only. |
