超声检查在肺结核致胸腔积液中的诊断价值研究

The diagnostic value of ultrasonography in pleural effusion caused by pulmonary tuberculosis

目的探讨超声检查在肺结核致胸腔积液中的诊断及对治疗的价值。方法将2022年1月至2023年6月在廊坊市第三人民医院治疗的97例肺结核患者作为研究对象,均采用超声及X线检查判定有无胸腔积液,以胸腔穿刺病理检查结果作为金标准,收集超声和X线对肺结核致胸腔积液的诊断效能、对不同胸腔积液分型检出率及有无胸腔积液的超声征象。结果超声对肺结核致胸腔积液诊断的灵敏度为96.55%,特异度97.44%;CT对肺结核致胸腔积液诊断的灵敏度为77.59%,特异度71.79%。超声和X线患者胸腔积液Ⅰ型、Ⅱ型、ⅢA型、ⅢB型、ⅢC型、Ⅳ型比例比较,差异无统计学意义(P>0.05);有无胸腔积液患者胸膜不均匀增厚、胸膜厚度<5mm、透声、无回声区光点或肿块比例比较,差异有统计学意义(P<0.05);58例患者中,显效32例,有效21例,无效5例,有效率为91.38%(53/58)。结论超声检查在肺结核致胸腔积液中的诊断价值显著,诊断效能高,并能指导临床胸腔穿刺及治疗。

Objective:To investigate the value of ultrasound in the diagnosis and treatment of pleural effusion caused by pulmonary tuberculosis.Methods:97 patients with pulmonary tuberculosis treated in the Third People's Hospital of Langfang City from January 2022 to June 2023 were selected as the study objects.Ultrasound and X-ray examination were used to determine whether there was pleural effusion,and the results of thoracic puncture pathology were used as the gold standard.The diagnostic efficacy of ultrasound and X-ray on pleural effusion caused by pulmonary tuberculosis,the detection rate of different pleural effusion types and the ultrasonic signs of pleural effusion were collected.Results:The sensitivity and specificity of ultrasound in the diagnosis of pleural effusion caused by pulmonary tuberculosis were 96.55%and 97.44%.The sensitivity and specificity of CT in the diagnosis of pleural effusion caused by pulmonary tuberculosis were 77.59%and 71.79%.There was no significant difference in the proportion of pleural effusion typeⅠ,typeⅡ,typeⅢA,typeⅢB,typeⅢC and typeⅣbetween ultrasound and X-ray patients(P>0.05).There was statistical significance in the proportion of patients with or without pleural effusion with uneven pleural thickening,pleural thickness<5mm,spot or mass in the echoless and echoless areas(P<0.05).Among the 58 patients,32 were effective,21 were effective,and 5 were ineffective,with an effective rate of 91.38%(53/58).Conclusion:Ultrasonography has significant diagnostic value and high diagnostic efficiency in pulmonary tuberculosis induced pleural effusion,and can guide clinical thoracopuncture and treatment.