CAJ | 학술논문

目的：探讨电视胸腔镜(VATS)治疗不明原因胸腔积液的临床效果。方法回顾性分析我院收治的184例不明原因胸腔积液患者的临床资料，所有患者均给予VATS检查，其中117例患者同时接受胸膜剥离手术。观察患者的临床效果以及并发症发生情况。结果184例不明原因胸腔积液患者中170例获得了明确诊断，诊断率为92.4%，其中恶性胸腔积液109例(64.1%)，结核性胸膜炎40例(23.5%)，肺炎旁组织积液10例(5.9%)，非特异性炎症11例(6.5%)。接受胸膜剥离手术的患者术后胸痛及发热比例高于单纯接受VATS检查的患者，差异具有统计学意义(P<0.05)；但两者咳嗽、胸闷、2个月内死亡率及其它并发症相比则无显著差异(P>0.05)。结论电视胸腔镜在不明原因胸腔积液的诊断中具有诊断阳性率高的特点，胸膜剥离手术是治疗不明原因胸腔积液的有效手段，与仅进行胸腔镜检查比较，不会明显增加术后咳嗽、胸闷及死亡等并发症发生率。
목적：탐토전시흉강경(VATS)치료불명원인흉강적액적림상효과。방법회고성분석아원수치적184례불명원인흉강적액환자적림상자료，소유환자균급여VATS검사，기중117례환자동시접수흉막박리수술。관찰환자적림상효과이급병발증발생정황。결과184례불명원인흉강적액환자중170례획득료명학진단，진단솔위92.4%，기중악성흉강적액109례(64.1%)，결핵성흉막염40례(23.5%)，폐염방조직적액10례(5.9%)，비특이성염증11례(6.5%)。접수흉막박리수술적환자술후흉통급발열비례고우단순접수VATS검사적환자，차이구유통계학의의(P<0.05)；단량자해수、흉민、2개월내사망솔급기타병발증상비칙무현저차이(P>0.05)。결론전시흉강경재불명원인흉강적액적진단중구유진단양성솔고적특점，흉막박리수술시치료불명원인흉강적액적유효수단，여부진행흉강경검사비교，불회명현증가술후해수、흉민급사망등병발증발생솔。
Objective To explore the clinical effect of video-assisted thoracoscopy (VATS) in the treatment of unexplained pleural effusion. Methods Clinical data of 184 patients with unexplained pleural effusion were retrospectively analyzed, all patients were checked by VATS, and 117 patients among them received pleura decollement. The clinical effect and complications were observed. Results Of 184 patients, 170 cases got a definite diagnosis, the diagnosis rate was 92.4%, with malignant pleural effusion in 109 cases (64.1%), tuberculous pleurisy in 40 cases (23.5%), parapneumonic effusion in 10 cases (5.9%) and non-specific inflammatory in 11 cases (6.5%). The incidence of chest pain and fever in patients received pleura decollement were higher than those in patients only received VATS, with statistical difference (P<0.05);but the incidence of cough and chest distress, mortality within two-month and other complications of two groups had no statistical difference (P >0.05). Conclusions VATS has high diagnosis rate in unexplained pleural effusion. Pleura decollement is an effective mean for treating unexplained pleural effusion, which does not significantly increase the incidence of complications like postoperative cough, chest distress and death compared with VATS alone.