CAJ | 학술논문

目的：探讨结核性胸膜炎患者胸膜病变在胸腔镜下表现及与临床之间关系。方法对我院临床诊断结核性胸膜炎的447例患者作内科电子胸腔镜检查，将胸腔镜下表现与病程、病理及临床特点作回顾性分析。结果447例结核性胸膜炎患者在胸膜腔内均发现明显病灶，早期表现为充血水肿、肉芽结节；晚期主要表现为纤维粘连包裹、胸膜肥厚等。各期不同形态的病变可单独或同时存在。病理确诊率70.2%。胸水及胸腔清除物结核菌培养阳性率46.3%。结论结核性胸膜炎在胸腔镜下可表现为多种形态，胸膜病变表现与病程关系密切，胸腔内纤维包裹形成是导致胸水吸收排出困难的主要原因，内科胸腔镜对诊断治疗结核性胸膜炎及判断预后有较高价值。
목적：탐토결핵성흉막염환자흉막병변재흉강경하표현급여림상지간관계。방법대아원림상진단결핵성흉막염적447례환자작내과전자흉강경검사，장흉강경하표현여병정、병리급림상특점작회고성분석。결과447례결핵성흉막염환자재흉막강내균발현명현병조，조기표현위충혈수종、육아결절；만기주요표현위섬유점련포과、흉막비후등。각기불동형태적병변가단독혹동시존재。병리학진솔70.2%。흉수급흉강청제물결핵균배양양성솔46.3%。결론결핵성흉막염재흉강경하가표현위다충형태，흉막병변표현여병정관계밀절，흉강내섬유포과형성시도치흉수흡수배출곤난적주요원인，내과흉강경대진단치료결핵성흉막염급판단예후유교고개치。
Objective To explore the manifestations and clinical characteristics of pleural lesions of patients with tuberculous pleurisy via thoracoscopy. Methods 447 patients with tuberculous pleurisy were given medical e-lectronic thoracoscopy. Their manifestations, pathology, and clinical characteristics were retrospectively analyzed. Results Significant lesions were found in all patients. Congestion, edema, and granulation nodules occurred in early stages, and intrathoracic fibronectin encapsulated, pleural thickening, etc resulted in later stage. Different forms of lesions in different stages could exist alone or in combination. The correct diagnosis rate was 70. 2%. Pleural effusion and pleural clearance's mycobacterium tuberculosis cultivation positive rate was 46. 3%. Conclusion Tuberculous pleurisy could be manifested in many forms via thoracoscopy. These manifestations are closely related to the severity of the inflammation. The formation of encapsulated intrathoracic fiber is the major cause of the difficulty in absorption and excretion of pleural effusion. Medical thoracoscopy is valuable in diagnosis, treatment, and estimate prognosis for tuberculosis pleurisy.