摘要
目的探索可弯曲内科电子胸腔镜诊治胸膜疾病的价值及可行性。方法采用Olympus LTF-240型可弯曲内科胸腔镜对114例胸膜疾病患者在局麻下行开放式胸腔镜术,包括诊断组(含不明原因胸腔积液者及肺癌分期诊断者)、气胸组、胸膜固定术组及脓胸组。结果72例不明原因胸腔积液中确诊58例(80.1%),包括胸膜转移癌39例(肺癌胸膜转移38例、食管癌胸膜转移1例),胸膜间皮瘤3例,结核性胸膜炎15例,矽肺累及胸膜1例;未确诊的病例包括12例病理示非特异性炎症、2例胸腔镜检查未见异常。6例肺癌分期诊断者2例证实胸膜转移。13例气胸治愈7例(53.8%),胸膜固定术28例胸水均得到控制,脓胸6例均得到治愈。无1例出现严重并发症。结论可弯曲内科电子胸腔镜术容易耐受、安全、微创、费用低,是诊断疑难胸膜疾病及治疗难治性胸腔积液、脓胸的有效而实用的方法。
Objective To evaluate the value and feasibility of semirigid thoracoscopy in diagnosis and treatment of pleural diseases. Methods Semirigid thoracoscopy on 114 patients were performed under local anesthesia with Olympus LTF-240 thoracoscope. Results Etiologic causes were determined in 80. 1% （58/72 cases） of pleural effusion cases, and the diagnosed cases included pleural metastasis tumor from lung cancer 38 cases, from esophageal cancer 1 case, malignant mesothelioma 3 cases, tuberculous pleurisy 15 cases, silicosis 1 case. The undetermined cases included nonspecific inflammation 12 cases and no abnormal 2 cases. 2 cases of pleural metastasis were confirmed in the staging of 6 lung cancer cases. The cure rate of pneumothorax was 53.8% （7/13 cases） and for empyema,the cure rate was 100% （6/6 cases）. The achievement ratio was 100% （28/28 cases） in talc pleurodesis for the treatment of pleural effusion. There was no serious complication. Conclusions Semirigid thoracoscopy is an easy tolerance, safe,less invasive and low expension examination. It is effective and practical to diagnose pleural diseases of unknown etiology and to treat refractory pleural effusion and empyema.
出处
《临床肺科杂志》
2008年第8期990-992,共3页
Journal of Clinical Pulmonary Medicine
关键词
内科胸腔镜术
胸膜疾病
胸腔积液
medical thoracoscopy
pleural diseases
pleural effusion
