电视胸腔镜诊治胸腔积液的临床体会

Application of video-assisted thoracoscopic surgery in diagnosis and treatment of pleural effusion

目的:探讨电视胸腔镜手术诊治胸腔积液的应用价值。方法:回顾分析2006年3月至2012年8月为152例胸腔积液患者行电视胸腔镜手术的临床资料。双腔气管插管全麻后置入胸腔镜及活检钳,取胸膜组织送病理检查,并根据病理检查结果决定治疗方案。结果:152例患者中肺癌胸膜转移83例,恶性胸膜间皮瘤18例,胸腺瘤3例,恶性肿瘤胸膜转移16例,来源不明的转移肿瘤4例,结核性胸水25例,3例未明确诊断。恶性胸腔积液患者行滑石粉胸膜固定,根据病理类型术后予以规范化抗肿瘤治疗。结核性胸腔积液患者,术后予以正规抗结核治疗。余者均根据病理回报结果进行相应后续治疗。结论:电视胸腔镜手术诊治胸腔积液微创,确诊率高,疗效确切,为进一步治疗疾病提供了有力证据。

Objective：To study the application value of video-assisted thoracoscopic surgery（VATS） in the diagnosis and treatment of pleural effusion.Methods：The clinical data of 152 patients who suffered from pleural effusion and underwent VATS from May 2006 to Aug.2012 were retrospectively analyzed.After general anesthesia,thoracoscope and biopsy forceps were intubed in.Some pleural was taken for biopsy and the management was made according to the result of the pathologic examination.Results：Of the 152 cases,83 patients were diagnosed of lung cancer with pleura metastasis,18 patients were diagnosed of malignant pleual celiothelioma,3 patients were diagnosed of thymic carcinoma,16 patients were diagnosised of metastatic neoplasms,4 patients were diagnosised of metastatic pleual tumor of unknown source,25 patients were diagnosed of tubercular effussion,the rest 3 patients were acatalepsia.Malignant pleural effusion was treated with pleuropexy and routine anti-tumor therapy was made according to the pathologic results.Regular antituberculosis therapy was made on the patients with tubercular pleural effusion.The follow-up treatments was made according to the pathologic results.Conclusions：VATS has advantages of mini-invasion,high definite diagnostic rate,good efficacy,and could provide good proofs for the follow-up therapy.