内科胸腔镜在不明原因胸腔积液诊断中的应用

Value of medical thoracoscopy in diagnosis of pleural effusion of unknown causes

目的 分析内科胸腔镜在不明原因胸腔积液诊断中的价值及其安全性.方法 对我院呼吸内科及重症医学科2010年4月至2013年4月收治的92例不明原因胸腔积液患者行内科胸腔镜检查,观察胸膜病变,直视下病变处多部位活检并行病理检查.结果 92例胸腔积液患者确诊84例,诊断阳性率为91.3％,其中恶性胸腔积液48例,结核性胸腔积液29例,非特异性炎症4例,化脓性胸膜炎2例,结节病1例,病因不明8例,术后疼痛11例,发热3例,出血1例.结论 内科胸腔镜检查有助于进一步明确不明原因胸腔积液的病因,且患者耐受性好、安全、有效,值得临床推广应用.

Objective To analyse the value of medical thoracoscopy in the diagnosis of unknown pleural effusion and its safety.Methods 92 cases of unknown pleural effusion treated in our department of respiratory medicine and intensive medicine from April 2010 to April 2013 were examined through medical thoracoscopy,pleural lesion was observed,and the abnormal parts were made biopsy and pathologic examination.Results In 92 patients with pleural effusion,84 cases were diagnosed,the positive rate of diagnosis was 91.3 ％,in which 48 cases were malignant pleural effusion,29 cases were tuberculous pleural effusion,four cases were nonspecific inflammation,two cases were purulent pleuritis,one case was sarcoidosis,8 cases had unknown etiology,11 cases had postoperative pain,three cases had fever,and one case had bleeding.Conclusions Medical thoracoscopy is helpful to further clarify the causes of unexplained pleural effusion with superior tolerability,safety,and effectivity,it is worth clinical application.