210例针刺胸膜活检分析

Analysis of 210 Cases of Pleural Needle Biopsy

目的研究针刺胸膜活检在胸腔积液病因诊断中的价值和安全性。方法对2000年12月至2007年12月间诊断明确且做过1次以上胸膜活检的210例胸腔积液患者的临床资料进行回顾分析。结果210例胸腔积液中结核性胸膜炎102例,恶性胸膜炎60例,两者胸膜活检的阳性率分别为66.7(68/102)和69.7(60/86)。术后并发症主要为:气胸34.9(105/301)、出血11.6(35/301)、术后发热12.3(37/301)、胸膜反应7.3(22/301)、肿瘤细胞针道种植1.0(3/301),未出现致命并发症。结论在结核性及恶性胸腔积液的诊断中,针刺胸膜活检是一种有效而又安全的手段,多次活检可提高确诊率。

Objective To evaluate the safety and clinical significance of using pleural needle biopsy in diagnosis of pleural effusion. Methods 210 cases of established pleural effusion with receiving at least one pleural needle biopsy in The First People＇s Hospital of Changzhou City, Jiangsu province from December 2000 to December 2007 were retrospectively analyzed. Results There were 102 cases of tuberculous pleurisy and 60 cases of malignant pleurisy. The positive rate of tuberculous pleurisy and malignant pleurisy were 66.7% （68/102） and 69.7% （60/ 86）, respectively. Complications associated with pleural needle biopsy were pneumothorax （34.9%, 105/301）, bleeding （11.6%, 35/301）, fever （ 12.3%, 37/301）, pleural reaction （7.3%, 22/301） and seeding of malignant cells （1.0%, 3/301 ）. Conclusion Pleural needle biopsy is a safe, simple and effective method for diagnosis of tuberculous and malignant pleural effusion. The sensitivity in diagnosis of pleural effusion can be increased by repeated pleural needle biopsy.