渗出性胸腔积液行胸膜刷检操作失败的原因分析

Analysis the reason for failed pleural brushing operation in exudative pleural effusions

目的:分析渗出性胸胸腔积液行胸膜刷检,部分操作失败,分析其原因,总结教训以提高胸膜刷检成功率。方法:对87例渗出性胸腔积液患者,进行闭式胸膜活检术联合胸膜刷检术。结果:87例患者,胸膜活检113次,成功率92.9%(105/113),胸膜刷检112次,成功率仅73.2%(82/112),胸膜刷检操作成功率明显低于胸膜活检,差异有统计学意义(0.05)。30次未成功的胸膜刷检中,19次因细胞刷未能紧贴胸壁,未取到胸膜组织细胞而致操作失败;6次因胸水量大,操作时无法一次将胸水放干净,而致操作失败;另有5次刷检结果仅见红细胞。结论:胸膜刷检在临床中有操作简单、病人耐受性好、取材范围广等优势,在操作中应不断总结经验教训,逐渐提高胸膜刷检操作成功率,从而发挥它在渗出性胸腔积液病因诊断中的价值。

Objective：To analyse reasons for failed pleural brushing in exudative pleural effusions,And summarize lessons to improve success rate of pleural brushing.Methods：The pleural biopsy and pleural brushing was performed in 87 patients suffering from exudative pleural effusions.Results：Total 113 times pleural biopsy were completed in 87 patients, the puncture success rate was 92.9%（105/113）. Total 112 times pleural brushing were also completed in this group, brushes examines success rate was 73.2%（82/112）, the differences of success rate between pleural biopsy and pleural brushing was statistical significance （P＆lt;0.05）. Pleural brushing operation failed 30 times, including 19 times for cells brush failed to close the chest , 6 times for a lot of pleural effusion,and other 5 times for only red blood cells.Conclusion： Pleural brushing has a lot of advantages in clinical practice, such as simple operation, good tolerance, wide operation range.We should constantly sum up experience and lessons, and gradually improve the success rate of pleural brushing ,playing it diagnosis value in exudative pleural effusion.