摘要
目的探讨内科胸腔镜对胸腔积液的诊断应用价值及安全性。方法回顾性分析我科2011年1月至2015年1月住院及门诊明确诊断为胸腔积液并行内科胸腔镜检查的160例患者的确诊率及不良事件发生率,并于同期住院的300例行闭式胸膜活检的胸腔积液患者比较。结果胸腔镜组确诊率88.7%,肿瘤77例(48.1%),其中肺腺癌62例,鳞癌2例,小细胞癌4例,胸膜肉瘤3例,胸膜间皮瘤2例,淋巴瘤1例,远处脏器胸膜转移3例;结核性65例(40.6%);慢性非特异性炎18例(11.25%),明显高于闭式胸膜活检组;不良事件发生率胸腔镜组略低于闭式胸膜活检组(无统计学意义),无一例发生严重并发症。总结160例胸腔镜组患者的镜下表现及病理结果,发现肿瘤多为血性胸水,镜下常表现为多发大小不等的结节;结核性胸膜炎的特征性表现为胸膜弥漫分布的大小均匀的盐粒样结节伴有胸膜水肿、增厚,胸膜粘连多见。结论内科胸腔镜对胸腔积液尤其是原因不明的胸腔积液确诊率高,安全性高,创伤小,且操作简单,非常值得临床广泛推广。
Objective To analyze and study the application value of medical thoracoscopy in the diagnosis of pleura] effusion caused by, unknown reasons. Methods The diagnostic rate and the incidence of adverse events of 160 cases of pleural effusion underwent medical thoracoscopy were retrospectively analyzed, and they were compared with another 300 cases of pleura] effusion underwent closed-style pleural biopsy. Results The positive diagnostic rate of medical thoracoscopy was 88.7% , and 77 cases were malignant tumors （48.1% ） , including 62 cases of ade- nocarcinoma, 2 cases of squamous carcinoma, 4 cases of small cell carcinoma, 3 cases of pleural-sarcoma, 2 cases of mesothelioma, 1 cases of lymph adenoma, and 3 cases of pleura] metastases. 65 cases were tuberculosis pleurisy, andl8 cases of chronic non-specific inflammation. The diagnostic rate of the medical thoracoscopy group was higher than that of the biopsy group （ P 〈 0. 05 ） , and the incidence of adverse events was lower in the medical thoracoscopy group than in the biopsy group （ P 〈 0. 05 ）. Conclusion Medical thoracoscopy is a relatively safe procedure and has an important application value in the diagnosis of unexplained pleural effusion.
出处
《临床肺科杂志》
2015年第10期1794-1797,共4页
Journal of Clinical Pulmonary Medicine
关键词
胸腔积液
内科胸腔镜
诊断
pleural effusion
medical thoracoscopy
diagnosis
