纤维支气管镜在原因不明胸腔积液诊断中的应用

Application of fiberoptic bronchoscopy in the diagnosis of unknown reason pleural effusion

目的探讨纤维支气管镜替代胸腔镜在原因不明胸腔积液诊断中的临床应用价值。方法对45例原因不明胸腔积液患者在局部麻醉下用纤维支气管镜行开放式胸腔检查术,全面检查胸膜腔和肺,并在电视直视下取病变组织行病理学检查。结果胸腔积液患者被确诊42例,确诊率为93.3%(42/45),包括胸膜转移癌24例,胸膜间皮瘤3例,胸膜结核12例,脓胸3例。所有患者发生不良反应少,经对症处理后缓解和恢复正常,无严重并发症发生。结论局部麻醉下纤维支气管镜诊断原因不明的胸腔积液,诊断率高,创伤小,操作安全、简便,并发症少。

Objective To explore the clinical application values of thoraeoscope substituted for fiberoptic bronchoscopy in the diagnosis of unknown reason pleural effusion. Methods Forty-five patients of unknown reason pleural effusion were performed thoraeoseope with fibernptie bronchoscopy under local anesthesia. Pleural cavity and lungs were examined comprehensively,and lesion tissues were taken out to have a pathological examination under direct vision on television. Results Forty-two patients with pleural effusion were diagnosed,the rate of diagnosis was 93.3% （42/45） ,including 24 patients of pleural metasta- ses ,3 patients of pleural mesothelioma, 12 patients of pleural tuberculosis ,3 patients of pyothorax. Adverse reaction was small and it was easy to relief and recovery after cure,no serious complications. Conclusion The rate of diagnosis of unknown reason pleu- ral effusion with fiberoptic bronchoseopy under the local anesthesia was high,and the operation was safe and simple and less com- plications.