留置导管气体造影下胸膜活检在胸腔疾病诊断中的应用价值

Application valuation by pleural biopsy under gasgraphy reserved intubation for diagnosis of thoracic disease

目的 探讨留置导管气体造影下胸膜活检在胸腔疾病诊断中的价值。方法 4 4例在常规B超定位下胸膜活检未能明确病因的住院病人 ,采用中心静脉导管留置于胸腔 ,抽胸水 ,注入气体后在X线透视下胸膜增厚部分 ,进行活检。结果 4 4例B超发现胸膜增厚 30例 ,胸膜增厚部位活检阳性率为 0 ;而气体造影X线透视转位发现增厚 4 0例 ,发现胸膜增厚 ,4 0例增厚胸膜活检阳性率97.5 % ,其中肺腺癌胸膜转移 12例 ,恶性胸膜间皮瘤 5例 ,结核 2 2例。无并发症发生。结论 留置导管气体造影易发现胸膜病变部位 ,活检准确可靠 ,阳性率高、安全、费用低 ,值得推广。

Objective To explore the valuation of pleural biopsy under gasgraphy by intubation for thoracic disease.Methods 44 inpatients which were no confirmed diagnosis by biopsy in the position pointed by routine ultrasonic,were placed a reserved catheter through central vein in thoracic cavity.Gas was injected through the catheter after pleural fluid was pumped out from the cavity.Then biopsy were done in the area of thickening pleural,which was pointed by X ray.Results The pathological positive rate of biopsy was 0 in the pleural specimens of the positions pointed by routine ultrasonic of 44 cases.The positive rate of thickening pleural by gasgraphy under X ray was 90.9%,and the pathological rate of biopsy was 97.5%.There were 12 cases with adenocarinoma,5 cases with malignant mesothelioma,22 cases of pulmonary tuberculosis.112 times of biopsy at the same site and different direction was taken,and there was no complication occurred.Conclusion The pleural lesion was easy to be found by gasgraphy through reserved intubation.The results of biopsy was credibility and the positive rate was high.The method was safe,economical and could be popularized.