CAJ | 학술논문

目的：探讨闭式胸腔穿刺胸膜活检同时胸膜刷检在渗出性胸腔积液中的诊断价值。方法对87例渗出性胸腔积液患者，同时行闭式胸膜活检术与胸膜刷检术。结果87例患者，胸膜活检113次，成功率92.9%(105/113)，病因诊断阳性率为70.1%(61/87)。胸膜刷检112次，成功率73.2%(82/112)，病因诊断阳性率为60.0%(52/87)。胸膜活检病因诊断阳性率虽高于胸膜刷检，但差异无统计学意义(P>0.05)。有11例患者胸膜活检病因诊断阴性，胸膜刷检阳性；有20例患者胸膜刷检病因诊断阴性，但胸膜活检阳性。胸膜活检同时胸膜刷检，病因诊断阳性率提高至82.8%(72/87)，高于单独胸膜活检及单独胸膜刷检(均P<0.05)。87例患者胸膜检查时发生胸膜反应3例(2.7%)，气胸4例(3.5%)。结论经皮胸膜活检与胸膜刷检均是渗出性胸腔积液病因诊断的重要手段，相对安全。胸膜活检同时胸膜刷检有更高的病因诊断阳性率，在渗出性胸腔积液的临床诊断中具有重要价值。
목적：탐토폐식흉강천자흉막활검동시흉막쇄검재삼출성흉강적액중적진단개치。방법대87례삼출성흉강적액환자，동시행폐식흉막활검술여흉막쇄검술。결과87례환자，흉막활검113차，성공솔92.9%(105/113)，병인진단양성솔위70.1%(61/87)。흉막쇄검112차，성공솔73.2%(82/112)，병인진단양성솔위60.0%(52/87)。흉막활검병인진단양성솔수고우흉막쇄검，단차이무통계학의의(P>0.05)。유11례환자흉막활검병인진단음성，흉막쇄검양성；유20례환자흉막쇄검병인진단음성，단흉막활검양성。흉막활검동시흉막쇄검，병인진단양성솔제고지82.8%(72/87)，고우단독흉막활검급단독흉막쇄검(균P<0.05)。87례환자흉막검사시발생흉막반응3례(2.7%)，기흉4례(3.5%)。결론경피흉막활검여흉막쇄검균시삼출성흉강적액병인진단적중요수단，상대안전。흉막활검동시흉막쇄검유경고적병인진단양성솔，재삼출성흉강적액적림상진단중구유중요개치。
Objective To evaluate the diagnostic value of pleural biopsy combined with pleural brushing in exudative pleural effusion. Methods The pleural biopsy and pleural brushing were performed in 87 patients suffer-ing from exudative pleural effusions. Results 113 times pleural biopsy were completed in 87 patients, and the punc-ture success rate was 92. 9% (105/113). The positive rate of pathological diagnosis was 70. 1% (61/87). 112 times pleural brushing were also completed in this group, and brush examining success rate was 73. 2% (82/112). The positive rate of pathological diagnosis was 60. 0% ( 52/87 ) . There were 11 patients having negative etiological diagnosis by pleural biopsy but positive etiological diagnosis by pleural brushing. There were 20 patients having nega-tive etiological diagnosis by pleural brushing but positive etiological diagnosis by pleural biopsy. The combination of pleural biopsy and pleural brushing improved the positive rate of pathological diagnosis to 82. 8% (72/87) ( P<0. 05). Conclusion Both pleural biopsy and pleural brushing are important means of diagnosis of exudative pleural ef-fusions. The combination of pleural biopsy and pleural brushing can improve the positive rate of pathological diagnosis.