临床肺科杂志
臨床肺科雜誌
림상폐과잡지
Journal of Clinical Pulmonary Medicine
2015年
10期
1794-1797
,共4页
党焱%朱波%李敏%马玉娟%高亭%刘小伟%王利%何小鹏
黨焱%硃波%李敏%馬玉娟%高亭%劉小偉%王利%何小鵬
당염%주파%리민%마옥연%고정%류소위%왕리%하소붕
胸腔积液%内科胸腔镜%诊断
胸腔積液%內科胸腔鏡%診斷
흉강적액%내과흉강경%진단
pleural effusion%medical thoracoscopy%diagnosis
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.
目的 探討內科胸腔鏡對胸腔積液的診斷應用價值及安全性. 方法 迴顧性分析我科2011年1月至2015年1月住院及門診明確診斷為胸腔積液併行內科胸腔鏡檢查的160例患者的確診率及不良事件髮生率,併于同期住院的300例行閉式胸膜活檢的胸腔積液患者比較. 結果 胸腔鏡組確診率88. 7%,腫瘤77例(48. 1%),其中肺腺癌62例,鱗癌2例,小細胞癌4例,胸膜肉瘤3例,胸膜間皮瘤2例,淋巴瘤1例,遠處髒器胸膜轉移3例;結覈性65例( 40. 6%);慢性非特異性炎18例( 11. 25%) ,明顯高于閉式胸膜活檢組;不良事件髮生率胸腔鏡組略低于閉式胸膜活檢組(無統計學意義) ,無一例髮生嚴重併髮癥. 總結160例胸腔鏡組患者的鏡下錶現及病理結果,髮現腫瘤多為血性胸水,鏡下常錶現為多髮大小不等的結節;結覈性胸膜炎的特徵性錶現為胸膜瀰漫分佈的大小均勻的鹽粒樣結節伴有胸膜水腫、增厚,胸膜粘連多見. 結論內科胸腔鏡對胸腔積液尤其是原因不明的胸腔積液確診率高,安全性高,創傷小,且操作簡單,非常值得臨床廣汎推廣.
목적 탐토내과흉강경대흉강적액적진단응용개치급안전성. 방법 회고성분석아과2011년1월지2015년1월주원급문진명학진단위흉강적액병행내과흉강경검사적160례환자적학진솔급불량사건발생솔,병우동기주원적300례행폐식흉막활검적흉강적액환자비교. 결과 흉강경조학진솔88. 7%,종류77례(48. 1%),기중폐선암62례,린암2례,소세포암4례,흉막육류3례,흉막간피류2례,림파류1례,원처장기흉막전이3례;결핵성65례( 40. 6%);만성비특이성염18례( 11. 25%) ,명현고우폐식흉막활검조;불량사건발생솔흉강경조략저우폐식흉막활검조(무통계학의의) ,무일례발생엄중병발증. 총결160례흉강경조환자적경하표현급병리결과,발현종류다위혈성흉수,경하상표현위다발대소불등적결절;결핵성흉막염적특정성표현위흉막미만분포적대소균균적염립양결절반유흉막수종、증후,흉막점련다견. 결론내과흉강경대흉강적액우기시원인불명적흉강적액학진솔고,안전성고,창상소,차조작간단,비상치득림상엄범추엄.
Objective To analyze and study the application value of medical thoracoscopy in the diagnosis of pleural 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 pleural 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 pleural metastases. 65 cases were tuberculosis pleurisy, and18 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.