胸膜活检对原因不明的渗出性胸腔积液的诊断价值

Diagnostic value of pleural biopsy to unknown causes of exudative pleural effusions

目的观察胸膜活检术在渗出性胸腔积液诊断中的价值。方法对146例渗出性胸腔积液患者行胸膜活检,同时取胸水及痰送检抗酸杆菌及癌细胞。结果146例胸膜活检第一次活检成功率71.9%,特异性病理诊断92例,病理诊断阳性率63%。恶性胸腔积液胸膜活检阳性率58%,胸水细胞学检查阳性率22%,痰找癌细胞阳性率16%。结核性胸腔积液胸膜活检阳性率66.6%,痰找抗酸杆菌阳性率5.2%。结论胸膜活检是一项安全、简单、有效的胸膜疾病的重要的内科确诊手段。

Objective To investigate the diagnostic value of pleura biopsy to exudative pleural effusions. Methods 146 patients with exudative pleural effusion were performed with pleural biopsy, checking pleural effusion and acid-fast bacilli in sputum examination and cancer cells. Results The rate of 146 cases of pleural biopsy success was 71.9% for the first time, with specificity of 92 cases of pathological diagnosis, and pathology positive rate being of 63 %. Malignant pleural effusion pleural biopsy positive rate was 58%, pleural effusion cytology positive rate was 22% ,identifying cancer rate cells in sputum was 16%. The tuberculous pleural effusion pleural biopsy positive rate was 66% ,and pleural effusion for AFB positive rate was 5.2%. Conclusion Pleural biopsy is safe,simple,clear and effective, in diagnosing the pleura/disease. Combined with the sputum cytology,it can increase the positive rate of malignant pleural effusion in the diagnosis. Pleural biopsy is an important means of medical diagnosis in the tuberculosis pleurisy.