摘要
目的探讨内科胸腔镜下结核性胸膜炎与恶性胸膜肿瘤的不同表型特征,提高对此两种胸膜疾病镜下形态差异的认识。方法回顾性分析该院2007年8月～2010年8月诊断结核性胸膜炎39例、恶性胸膜肿瘤36例的内科胸腔镜下胸膜形态特征的差异。结果两种疾病胸膜的镜下形态变化集中在5个方面:胸膜肿胀光滑度、结节大小及形态、白斑样改变、病变范围及胸膜粘连。结核性胸膜炎患者约87.2%(34/39)胸膜呈均匀光滑充血水肿,约51.3%(20/39)伴多发小结节或弥漫粟粒结节,全部患者均无白斑样改变。而恶性胸膜肿瘤患者约80.6%(29/36)胸膜呈明显不均匀增厚、粗糙,约44.4%(16/36)伴大结节甚至肿块样突起,约38.9%(14/36)伴弥漫白斑样改变。两种疾病在此三方面的发生率比较差异具显著性,两种疾病的上述改变均呈多发性或弥漫性分布,粘连程度相当。结论内科胸腔镜下结核性胸膜炎与恶性胸膜肿瘤的形态特征存在差异,结合最终的病理学诊断,有助于提高对此两种疾病胸膜表型的认识。
【Objective】To study the difference of appearance in pleura between tuberculous pleurisy and malignant pleural tumor under thoracoscope, for improving the cognition of the character in pleura of the two diseases. 【Methods】A retrospective study on appearance in pleura under thoracoscope in 39 tuberculous pleurisy patients and 36 malignant pleural tumor patients in our hospital from August 2007 to August 2010 was conducted.【Results】 There are five forms of appearances in pleura under thoracoscope： The degree of smoothness and homogeneity, the diameter and shape of the nodules, with or without white patch, the distribution of lesions, the degree of adhesions. In the pleura of tuberculous pleurisy group, there were about 87.2% （34/39） of patients who showed even and smooth edema, about 51.3% （20/39） of patients with many small or miliary nodules, but none of patients with white patch. In the pleura of malignant pleural tumor group, there were about 80.6% （29/36） of patients who showed uneven thickening and rough, about 44.4% （16/36） of patients with large nodules or bumps, about 38.9% （14/36） of patients with white patch. The result in comparing the ratio of the three aspects above between two groups was remarkably different. The distribution of lesions and the degree of adhesions in the two groups were similar. 【Conclusion】There are significant difference in appearance in pleura between tuberculous pleurisy and malignant pleural tumor under thoracoscope. Combining the biopsy pathology of pleura and appearance under thoracoscope can improve the cognition of the character in pleura of the two diseases.
出处
《中国内镜杂志》
CSCD
北大核心
2011年第10期1039-1042,共4页
China Journal of Endoscopy
关键词
内科胸腔镜
结核性胸膜炎
恶性胸膜肿瘤
medical thoracoscopy
tuberculous pleurisy
malignant pleural tumor
