A Clinical Feature Analysis Of98Cases Of Gerontic Tuberculous Peritonitis

Objective: Through the analysis of the clinical features of the tuberculous peritonitisaged60and above in patients in affiliated hospital of Zunyi Medical University and thefirst people’s Hospital of Zunyi in9years, to explore the methods of diagnosis andtreatment, in order to prompt diagnosis, reduce the rate of misdiagnosis and misseddiagnosis.Methods: A total of98cases（aged60and above） were entered into the study fromFebruary2005to February2014diagnosis of tuberculous peritonitis in the affiliatedhospital of Zunyi Medical University（45cases）and the first people’s Hospital of Zunyi（53cases），the clinical manifestation, auxiliary examination has been analyzed andsummarized, and the misdiagnosis, missed diagnosis were reviewed analysis.Results: Of gerontic tuberculosis peritonitis，patients with abdominal pain, abdominaldistension were more, the pain is occupied about83.67%, abdominal distension accountedfor about81.63%, about37.75%different degrees of fever, anorexia, fatigue accounted forabout77.55%, only8.16%-21.43%of patients with diarrhea, constipation, nausea, nightsweats, weight loss.Signs：abdominal wall flexible sense about33.67%, the shiftingdullness positive accounted for about76.53%, abdominal tenderness accounted for about83.67%, abdominal mass in about3.06%. Auxiliary examination: ascites routine,biochemical examination indicates that appearance is yellow turbid or colorless liquid,leucocyte number>500×106/L accounted for95.58%, lymphocytes accounted for86.76%, Rivalta test positive accounted for91.18%, ascitic fluidADA＞45U/L accountedfor85.29%，ascitic fluid protein>30g/L accounted for82.35%，over the same period ofascitic fluid protein/blood albumin>0.5accounted for82.35%, over the same period ofascites serum LDH/blood LDH>0.6accounted for82.35%. ESR faster accounted forabout60.20%, hemoglobin decreased about66.32%, hypoproteinemia accounted for about82.65%, and serum CA125increased about81.63%, anti tuberculosis antibody positiveabout2.04%. Through anti-tuberculosis treatment，the total effective rate as high as95.59%. Among the98cases,13cases were misdiagnosed and missed diagnosis of2 cases，accounting for about15.31%. Among the98cases，the male to female ratio is1:1.08,60-69years （62cases,）70-79（28cases）, aged80years and above（8cases）,25cases with peritoneal tuberculosis，accounting for about25.51%..Conclusion:(1) Tuberculosis peritonitis people (aged60and above) is not common,gender differences is no significant, male: female is1:1.08.(2)Gerontic tuberculosisperitonitis with extraperitoneal TB cases accounted for about25.51%, of which themajority is pulmonary tuberculosis.(3) The old suffering from tuberculous peritonitis withlow fever, night sweats typical symptoms of tuberculosis is not common, this kind ofpatients with abdominal pain, abdominal distension is more often as the first or mainsymptom. More than90%patients with varying degrees of ascites.(4) Peritoneal bacterialculture and peritoneal effusion biopsy has the value in the diagnosis of tuberculousperitonitis in the elderly population, but the detection rate is low, ascites routine,biochemical examination, ESR and serum ADA examination is a comprehensive judgmentdiagnosis，commonly used effective auxiliary examination.(5)Of senile tuberculosisperitonitis，the rate of misdiagnosis, missed diagnosis rate is high, is not easy to bedifferentiated from other diseases, we can take anti-tuberculosis treatment trial, so as not todelay the disease or illness.(6)The changes of ascites, serum CA125, blood sedimentationcan be used to judge the efficacy of the treatment.(7) The combined use of oral anti-TBdrugs remains to be the more effective treatment in treatment of senile tuberculosisperitonitis.