可弯曲式内科胸腔镜在恶性胸膜间皮瘤中的诊断价值

The application of flexirigid thoracoscopy in the diagnosis of pleural efusions with unknown aetiology

目的探讨可弯曲式胸腔镜对恶性胸膜间皮瘤的诊断价值。方法对30例不明原因胸腔积液患者进行胸腔镜检查。全麻下于腋部胸壁第6～7肋间置入胸腔镜套管,吸去大部分胸腔积液后按照内、前、上、后、侧、下的顺序观察胸膜腔并进行胸膜活检。结果 30例患者中有6例经直视下取活检病理证实为恶性胸膜间皮瘤。结论胸膜间皮瘤,单纯依靠影像学诊断较为困难,通过内科胸腔镜可在直视下取到理想的胸膜组织,提高了诊断阳性率。

Objective Medical thoracoscope is a kind of minimally invasive skill which could realize the direct observation of lesions in pleural cavity.This thesis investigates the significance of flexible thoracoscope in the diagnosis of malignant pleural mesothelioma.Methods Thoracoscopy were performed on 30 in-patients with cryptogenic pleural effusion.Firstly,routine pre-surgery examination was accomplished.A thoracoscope cannula was then put into the thoracic cavity through entering point between the sixth and seventh rib at chest wall near axilla under general anesthesia.After that,most pleural effusion was pumped out.The pleural cavity was observed from top to bottun and pleural biopsy was carried out.Results 6 cases in 30 cases were diagnosed as malignant mesothelioma through pleural biopsy under thoracoscope.Conclusion Pleural mesothelioma is a kind of malignant tumor in pleural cavity.It is difficult to diagnose purely depending on imaging studies.Under medicine thoracoscope,ideal pleural organization can be obtained under direct vision,thus it can improve the positive rate of diagnosis significantly.