内科胸腔镜在胸腔积液中的临床应用价值

Clinical application value of medical thoracoscopy in pleural effusion

目的探讨内科胸腔镜在胸腔积液中的临床应用价值。方法对行内科胸腔镜检查诊断的96例胸腔积液患者的临床资料进行分析、总结,通过与临床常用鉴别良恶性胸腔积液的影像学、胸腔积液细胞病理和胸膜活组织检查术等比较,评估内科胸腔镜检查在胸腔积液中的应用价值。结果 96例患者中经胸腔镜直视下多部位取材病理活组织检查的确诊率为94.8%(91/96):结核性胸膜炎65例(67.7%),肺腺癌10例(10.4%),腺鳞癌4例(4.2%),胸膜间皮瘤7例(7.3%),小细胞癌1例(1.0%),肾透明细胞癌肺转移腺鳞癌1例(1.0%),脓胸2例(2.1%),慢性非特异性炎症1例(1.0%)。内科胸腔镜检查常见并发症为疼痛、出血、发热、皮下气肿等,均未引起严重后果。结论内科胸腔镜是一种安全、简便、诊断率高的微创诊疗技术,在胸腔积液的诊疗中具有重要的临床应用价值。

Objective To investigate the clinical application value of medical thoracoscopy in the pleural effusion. Methods The analysis, summary of medical thoxacoscopy in diagnosis of pleural effusion were conducted in 96 cases of clinical data,compared with the commonly used clinical differential diagnosis of benign and malignant pleural effusion,pleural effusion cell imaging and pathology and pleural biopsy, to evaluate the value of clinical application of medical thoracoscopy in the pleural effusion. Results The diagnosis rate in 96 cases of patients with multiple sites of video-assisted thoracoscopic biopsy pathology was 94.8%,（91/96） ：65 cases of tuberculous pleurisy （67.7%）, 10 cases of lung adenocarcinoma （10.4%）, 4 cases of adenosquamous carcinoma （4.2%.）, 7 cases of pleural mesothelioma （7.3%）, 1 case of small cell carcinoma （!： 0%）, renal clear cell carcinoma metastasis to the lung adenosquamous carcinoma in 1 case （1.0%）,2 cases of empyema （2.1%）, t case of chronic nonspecific inflammation （1.0%）. The common complications of medical thoracoscopy including pain, fever, bleeding, subcutaneous emphysema and others, did not cause serious consequences. Conclusion Medical thoracoscopy is a safe, simple, minimally invasive diagnosis and treatment technology which has important clinical value in the diagnosis and treatment of pleural effusion.