超声引导下改良胸膜活检术对诊断原因不明胸腔积液的临床观察(附49例临床分析)

Diagnostic value of modified pleura biopsy in unknown pleural effusion under ultrasonic guidance:Analysis of 49 clinical cases

目的观察超声引导下改良胸膜活检术对原因不明胸腔积液诊断中的价值。方法使用改良胸膜活检术对49例不明原因胸腔积液患者进行胸膜活检术。结果所有患者胸膜活检均成功,其中间皮瘤3例,低分化癌6例,腺癌7例,未分型4例,结核18例,慢性炎症11例(经治疗最终证实为结核),病理确诊率77.6%,仅2例出现胸膜反应,未出现局部出血及气胸。结论超声引导下改良胸膜活检术安全、方便,对胸腔积液确诊率高、并发症少。

Odjective To observe the clinical value of the modified pleura biopsy in the diagnosis of pleural effusion under ultrasonic guidance. Methods Forty-nine patients with unknown pleural effusion were subjected to the modified pleura biopsy. Results The pleura biopsy was performed on patients successfully. Among them, 3 cases were diagunsed as mesothelioma, 6 cases as poorly differentiated carcinoma, 7 cases as adcnocarcinoma, 4 cases as unclassified tumor, 18 cases as tuberculous pleurisy, and 11 cases were chronic inflammation （ confirmed tuberculous pleurisy after treatment）. The positive rate was 57.6% in pathological diagnosis, and only two patients had pleural reaction, and no one appeared pneumothorax or local bleeding. Conclusion Pleural biopsy is a simple, safe and effective method in the diagnosis of pleural diseases and it is an important method to make the etiological diagnosis of pleural effusion. Ultrasonicguided pleur＇al biopsy can be performed easily, safely with increased diagnostic sensitivity and few complications are reported indiagnosing pleural effusion.