摘要
目的 探讨内科胸腔镜在胸膜疾病中的诊疗价值. 方法 对76例不明原因胸腔积液病人、3例自发性气胸病人行内科胸腔镜检查、活检及治疗,分别统计胸腔积液的确诊率及气胸的治愈率,并统计其不良反应及病人的顺应性. 结果 76例不明原因胸腔积液病人中,确诊75例,占98.7%,病理结果分别为:结核性胸膜炎43例(56.6%),恶性肿瘤31例(40.8%),炎症1例(1.3%),不明原因1例(1.3%).3例自发性气胸病人中发现肺大泡1例,胸膜粘连2例,经处理肺大泡或钳断粘连带后,气胸全部治愈.所有病人均无严重并发症发生. 结论 内科胸腔镜技术的介入,使胸膜疾病的诊断及治疗提高到了一个新的水平,且操作相对简单、安全性高,具有肯定的临床价值.
Objective To explore the role of medical thoracoscopy in the diagnosis and therapy in the pleural diseases. Methods 76 cases with pleural effusion of unknown causes and 3 cases with spontaneous pneumatothorax received the examination、biopsy and therapy of medical thoracoscopy. Then the diagnosis accuracy rate of pleural effusion and the cure rate of pneumatothorax were added up, while the side effects and the compliance of patients were observed. Results Among 76 cases with pleural effusion of unknown causes, 75 cases were diagnosed definitely, with the accuracy rate of 98.7%. And the pathological results: 43 cases with tuberculous pleuritis (56.6%), 31 cases with malignant tumors (40.8%), 1 case with inflammation (1.3%) and 1 case with unknown causes (1.3%). Among 3 cases of spontaneous pneumatothorax,1 case with emphysematous bullae while 2 cases with conglutination of pleural cavity. Pneumatothorax were all cured after the therapy of emphysematous bullae and cut out the conglutination. No serious complications occurred in all cases. Conclusions Medical thoracoscopy improved the diagnosis and therapy levels of pleural diseases. It was easily operated with little severe complications and warranted to use widely.
关键词
胸腔镜
胸膜疾病
诊断
治疗
Thoracoscopy
Pleural diseases
Diagnosis
Therapy
