纤维支气管镜代胸腔镜在胸腔积液诊断中的应用

Application of fibrobrochoscope instead of thoracoscope in diagnosing pleural effusion

目的探讨纤维支气管镜代胸腔镜检查术对胸腔积液病因诊断的应用价值。方法回顾性总结187例经常规检查未明确病因的胸腔积液患者接受经纤维支气管镜代胸腔镜检查术资料。结果 187例胸腔积液患者中,171例明确病因,确诊率91.4%。其中,胸膜转移性腺癌61例(32.6%),转移性鳞癌4例(2.1%),恶性肿瘤未分型14例(7.5%),胸膜间皮瘤20例(10.7%),结核性胸膜炎53例(28.3%),非特异性胸膜炎15例(8.0%),化脓性胸膜炎2例(1.1%),尿毒症性胸水2例(1.1%),原因未明16例(8.6%)。无一例出现严重并发症。结论纤维支气管镜代胸腔镜用于胸腔积液的病因诊断为一种安全、有效、诊断率高的检查方法。

Objective To evaluate the value and feasibility of fibrobrochoscope instead of thoracoscope in the diagnosis of pleural effusion.Methods The clinical data of 187 patients with pleural effusion of unknown reasons after routine examinations were summarized.All patients were examined with fibrobrochoscope under local anesthesia.Results Of 187 cases,etiology was confirmed in 171 cases with a positive rate of 91.4%,among whom pleura metastatic adenocarcinoma was diagnosed in 61 cases（32.6%）,squamous carcinoma in 4 cases（2.1%）,unclassified malignancy in 14 cases（7.5%）,mesothelioma of pleura in 20 cases（10.7%）,tuberculous pleurisy in 53 cases（28.3%）,nonspecific pleurisy in 15 cases（8.0%）,purulent pleurisy in 2 cases（1.1%）,uremia pleural fluid in 2 cases（1.1%）,with unknown reasons in 16 cases（8.6%）.No serious complication was found in this group.Conclusion Fibrobrochoscope instead of thoracoscope is a safe and effective tool for the diagnosis of pleural effusion with a higher positive diagnostic rate.