内科胸腔镜与经皮穿刺胸膜盲检对渗出性胸腔积液诊断价值的对比研究

Evaluation of medical thoracoscopy and percutaneous puncture biopsy in the diagnosis of eachability pleural effusions

目的对比研究内科胸腔镜和经皮穿刺胸膜盲检方法对渗出性胸腔积液的病因诊断价值。方法选取符合入选标准的渗出性胸腔积液患者100例,随机分为胸腔镜组和胸膜盲检组,胸腔镜组50例行内科胸腔镜直视下胸膜活检术;胸膜盲检组50例行经皮穿刺胸膜盲检术。然后分析两组病例资料,对两种检查方法的病理确诊率进行比较。结果胸腔镜组的病理确诊率为84%,胸膜盲检组的病理确诊率为58%,胸腔镜组病理确诊率显著高于胸膜盲检组(P<0.01);其中,对于恶性肿瘤的诊断,胸腔镜组病理确诊率为28%,胸膜盲检组病理确诊率为4%,胸腔镜组恶性肿瘤的病理确诊率显著高于胸膜盲检组(P<0.01);对于结核的诊断,胸腔镜组病理确诊率为56%,胸膜盲检组病理确诊率为54%,两组比较差异无统计学意义(P>0.05)。结论经皮穿刺胸膜盲检可作为确诊结核性胸膜炎的首选活检方法,而内科胸腔镜的病理确诊率更高,对于不明原因胸水(尤其是恶性肿瘤)具有更高的诊断价值。

Objective To compare the effect of medical thoracoscopy and percutaneous puncture biopsy of pleura in the diagnosis of leachability pleural effusions. Methods One hundred leachability pleural effusion cases were selected and divided randomly. Biopsy of pleura were carried out by medical thoracoscopy for 50 cases, while