电视胸腔镜在胸腔积液诊治中的临床应用

目的 探讨电视胸腔镜在胸腔积液诊治中的临床作用。方法 对英德市人民医院134例术后证实为胸腔积液的患者分别进行经皮穿刺活检及电视胸腔镜胸膜活检及治疗,观察2组检查方法的敏感性及电视胸腔镜诊治的作用。结果 经皮穿刺取材成功率为91.9%,诊断的敏感性为82.8%,电视胸腔镜下取材成功率为100%,活检结果肺癌97例,其中腺癌55例,鳞癌30例,小细胞肺癌12例;恶性间皮瘤7例;乳腺癌术后胸腔内转移并胸腔积液8例;结核性胸腔积液22例,诊断敏感性为100%,电视胸腔镜下活诊断胸腔积液诊断敏感度显著高于经皮穿刺,差异有统计学意义（χ2=25.159,P〈0.001）。134例经由电视胸腔镜诊治后患者均治愈出院,胸腔引流管放置时间（5.6±1.9）d,术后随访12~26月,未发现死亡病例。结论 电视胸腔镜诊断胸腔积液敏感性、特异性高,并可针对性对胸腔积液进行有效治疗,为后续的放化疗支持。

Objective To explore the clinical application of VATS in the diagnosis and treatment of pleural effusion.Methods 134 cases patients with postoperative pleural effusion were confirmed and cured by separately percutaneous biopsy and video-assisted thoracoscopic pleural biopsy, sensitivity and the role of video-assisted thoracoscopic were observed.Results Percutaneous obtain material success rate was 91.9%,the diagnostic sensitivity was 100%. VATS obtain material success rate was 100%,lung was 97 cases,and 55 cases adenocarcinoma, 30 cases squamous cell carcinoma, 12 cases small cell lung cancer,7 cases malignant mesothelioma,8 cases breast cancer metastasis and pleural effusion, 22 cases tuberculous pleural effusion,the sensitivity was 100% . the Pleural effusion diagnostic sensitivity of VATS was significantly highly than Percutaneous （χ2=25.159,P〈0.001）.134 patients were cured after treatment by VATS,the placement time of chest tube was （5.6 ＆#177; 1.9） d,it does not appear deaths by Postoperative follow-up 12-26 months.Conclusion It has high specificity and sensitivity that VATS was used in the diagnose of pleural effusionwhich is purposiveness for the treatment of pleural effusion, and was provided support t for subsequent chemotherapy.