胸膜活检对胸腔积液病因诊断的临床价值

The Value of Pleural Biopsy in the Etiological Diagnosis of Pleural Effussion

目的:探讨胸膜活检对胸腔积液病因诊断的价值。方法:对268例胸腔积液患者行经胸壁胸膜活检术。结果:268例患者共行胸膜活检289次,二次及以上活检者19例,获取胸膜组织244例,穿刺成功率91%,经病理检查有18例为正常胸膜组织,阳性诊断者为226例,阳性率92.6%(226/244),其病理诊断为结核104例(46%)、肿瘤54例(23.9%)、慢性炎症68例(30.1%);发生并发症者19例(6.6%),全部为气胸,肺压缩均小于30%,未做特殊处理数日后自行吸收。结论:从本组资料可以看出,经胸壁胸膜活检术对于胸腔积液的病因诊断具有非常好的效果,相比胸水涂片或病理检查具有更高的阳性率。因此经胸壁胸膜活检术由于它的简单、安全、高效等特点,目前在胸腔积液病因诊断方面仍是一项重要的手段。

Objective：To evaluate the value of pleural biopsy in the etiological diagnosis of pleural effussion.Methods：The pleural biopsy through thoracic wall was perfomed in 268 patients suffering from pleural effussion.Results：Total 289 times of pleural biopsy were completed on 268 patients.Nineteen cases of them were done twice and more.Two hundred and forty-four pleural tissues were gained.The puncture success rate was 91%.The positive rate of pathological diagnosis was 92.6%（226/244）.Among these were 104 cases tuberclosis,54 cases tumor and 68 cases chronic inflammation.All complicantion was 19 cases pneumothorax（6.6%）.Conclusion：Pleura biopsy through thoracic wall has the extremely good effect to the diagnosis of pleural effussion.It is more positive rate than pleural fluid film and pathology.Because simple,safe and fast,it is also a important method to make the etiological diagnosis of pleural effusion.