内科胸腔镜在不明原因单侧胸腔积液诊断中的应用

Application of internal medicine thoracoscopy in diagnosis of unilateral pleural effusions of unknown cause

目的探讨内科胸腔镜在不明原因单侧胸腔积液诊断中的应用价值。方法选择我院2007年1月至2011年9月因不明原因单侧胸腔积液行内科胸腔镜检查的患者74例,对其诊断方法和诊断结果进行回顾性分析。结果经过胸腔镜检查和病理活组织检查,74例中有65例得到明确诊断,确诊率87.8%。其中结核性胸膜炎33例,肺癌胸膜转移21例,乳腺癌胸膜转移2例,鼻咽癌胸膜转移、甲状腺癌胸膜转移、腮腺癌胸膜转移各1例,胸膜间皮瘤3例,淋巴瘤1例,漏出液2例。全部病例术中和术后均未出现严重并发症。结论内科胸腔镜操作简单、安全,对不明原因单侧胸腔积液诊断阳性率高,是一种有效的、值得推广的检查手段。

Objective To investigate the application value of internal medicine thoracoscopy in diagnosis of unilateral pleural effusions of unknown cause. Methods 74 eases of unilateral pleural effusions of unknown cause examined by medical thoracoscopy in our hospital from Jan. 2007 to Sep. 2011 were selected, and the diagnostic methods and results were retrospectively analyzed in these cases. Results Through thoracoscopy and pathological biopsy, 65 eases were definitely diagnozed, the diagnostic rate was 87.8%, which included tuberculous pleurisy 33 cases, pleural metastasis tumors from lung cancer 21 eases, from breast cancer 2 cases, from nasopharyngeal carcinoma, thyroid eaneer,careinoma of parotid gland 1 case separately, pleural mesothelioma 3 cases, lymphoma 1 ease, transudate 2 cases. No serious complication occurred in all cases. Conclusion Medical thoracoscopy can be easily and safely performed with high diagnostic rate in patients of unilateral pleural effusions, and is worth widely developing and applying in the clinic.