摘要
目的:探讨胸腔镜检查术对不明原因胸腔积液的诊断价值。方法:85例不明原因的胸腔积液患者行胸腔镜检术,取病变组织行病理检查。结果:镜下表现可以分为5种,分别是乳白色、鲜红色弥漫性粟粒样结节38例(44.7%),单发或多发菜花样、乳突状结节34例(40%),胸膜充血、水肿6例(7.1%),胸膜增厚及纤维分隔或粘连带形成4例(4.7%),无明显异常3例(3.5%)。胸腔镜检术确诊率91.7%。确诊病例中恶性肿瘤32例(37.6%),其中肺癌转移24例(腺癌20例,鳞癌3例,小细胞肺癌1例),恶性胸膜间皮瘤2例,胃癌胸膜转移3例,肝癌2例,淋巴瘤1例。良性疾病共50例(58.8%),其中结核性胸膜炎46例(54.1%),慢性炎症4例(4.7%)。无严重并发症。结论:胸腔镜检查术对不明原因的胸腔积液是一种安全、确诊率高的诊断方法。
objective: To evaluate the diagnostic value of thoracosocopy in pleural effusion of unknown reason. Methods: Eighty-five patients with plural effusion of unknown reason underwent thoracoscopy and for histopathologic examination. Results: Thoracoscopic presentations could be divided into 5 types, ivory, bright red miliary nodules in 38 cases (44. 7%), single or multi cauliflower or papillary nodules in 34 cases (40%), pleural congestion and edama in 6 cases (7. 1%), pleural thickness and formation of fibrous septa or adhesion in 4 cases (4. 7%), no obvious abnormalities in 3 cases (3.5%). The accurate diagnostic rate of thoracoscopy was 91.7%. Among 32 malignant cases (37. 6%), there were 24 cases with metastasis of lung cancer (adenocarcinoma 20 cases, squamous cell lung cancer 3 cases, small cell lung cancer 1 case), 2 cases with malignant mesothelioma, 3 cases with pleural metastasis from stomach cancer, 2 cases with pleural metastasis from liver cancer, 1 case with lymphoma. Among 50 benign cases (58. 8%), there were 46 cases (54. 1%) with tuberculous pleurisy, 4 cases (4. 7%) with chronic inflammation. There was no severe complication. Conclusion: Thoracoscopy is safe and with high diagnostic rate in pleural effusions of unknown reason.
出处
《内科急危重症杂志》
2006年第6期275-276,F0003,共3页
Journal of Critical Care In Internal Medicine
关键词
胸腔镜
胸腔积液
病理检查
分析
Thoracoscopy
Heural effusion
Pathologic examination
Analysis