内科胸腔镜在结核性胸膜炎中的作用

Role of medical thoracoscopy in the diagnosis of tuberculous pleurisy

目的观察结核性胸膜炎胸腔镜下形态表现,探讨结核性胸膜炎形态特征对诊断的价值。方法回顾分析216例确诊结核性胸膜炎患者胸腔镜下形态表现,与其他结核诊断方法及最终疗效的相关性。结果216例结核性胸膜炎患者镜下表现为胸腔积液,胸膜充血、水肿,渗液、渗血,糜烂,纤维素及粘连,粟粒样分散结节、多发结节、结节融合,胸膜肥厚。结论胸腔镜下结核性胸膜炎形态多样,其特征不具有结核性病变特异性,但对结核性胸膜炎的诊断具有较高临床价值。

Objective To investigate the morphological features of tuberculous pleurisy under thoracoscope and evaluate the diagnostic significance of thoracoscope for patients with tuberculous pleurisy.Methods Retrospectively analyzed of the morphological features under thoracoscope and pathological results of 216 patients who had been diagnosed as tuberculous pleurisy,compared thoracoscopy and other diagnostic methods,and its correlation with good curative effect.Results Thoracoscopic presentations of 216 patients with tuberculous pleurisy were hydrothorax,membrana pleuralis hyperaemia,hydrops,effusion,errhysis,anabrosis,formation of fibrous septa or adhesion,diffuse miliary nodules,multiple nodules,nodus coalesce,pachynsis pleurae.Conclusion The morphological features of tuberculous pleurisy are（variable）diversiform,and tuberculosis lesions are non-specific of tuberculous.Thoracoscopy is of great value in the diagnosis for patients with tuberculous pleurisy.