电子胸腔镜在不明原因的胸腔积液诊断中的应用

Application of electronic-assisted thoracoscopic surgery for diagnosis of pleural effusions of unknown causes

目的：探讨局部麻醉下电子胸腔镜检查能否提高胸膜疾病的诊断准确性和患者的顺应性。方法：对36例不明原因胸腔积液患者在局部麻醉下进行电子胸腔镜肉眼观察和病理检查，统计诊断准确性、患者的不良反应和顺应性。结果：电子胸腔镜下肉眼观：多发、单发结节最为常见（21例），占58．3％，其次为胸膜充血、水肿（8例），占22．2％。病理检查结果：36例患者中胸膜肿瘤为22例（61．2％），胸膜结核7例（19．4％），不明原因1例（2．8％），诊断准确性达97．2％。所有患者术中、术后生命体征均稳定；36例患者中仅6例在壁层胸膜活检时轻度疼痛，术后有4例伤口疼痛，无1例出现严重并发症；所有患者都乐意接受此项检查，97．2％的患者对检查结果满意。结论：局部麻醉下电子胸腔镜检查术，操作简单，视野清晰，可以观察整个胸膜腔，也易于取活检，而且费用低，风险小，患者依从性和耐受性好。

Odjective： To explore whether electronic-assisted thoracoscopic surgery could raise the diagnosis accuracy rate and patients＇compliance in patients with pleural disease under local anaesthesia, nthods： Thirty-six patients with pleural effusion of unknown causes accepted visual aspect and pathologic examination by electronic-assisted thoracoscopic surgery under local anaesthesia, and their diagnosis accuracy rate and side effecitive rate and patients＇compliance were observed . Results： There were 21 patients with one or more sarcoidosis（58.3%）and 8 patients with pleural congestive and edema（22.2%）in 36 patients by visual aspect under electronic-assisted thoracoscopic surgery. While 22 patients with pleural tumor （61.2%） and 7 patients with pleural tuberculosis（19.4%）were diagnosed by pathologic examination afterward, but the cause of one case was unknown yet, The diagnosis accuracy rate of electronic-assisted thoracoscopic surgery was 97.2% and no serious complication was found. Patients＂ complication to accept electronic-assisted thoracoscopic surgery was 97.2%. Conclusion： Electronic-assisted thoracoscopic surgery could examine whole pleural, from which bio very high and patients＇compliance is very well under local anaesthesia is easily operated and psy is available. Its diagnosis accuracy rate is in patient＇s with pleural disease.