胸腔镜在老年胸腔积液中的诊断价值及安全性分析

Analysis of the value and safety of medical thoracoscopy in the diagnosis of elderly patients with complicate pleural effusion

目的探讨胸腔镜在不同年龄人群中渗出性胸腔积液诊断中的价值。方法选择就诊于我院符合纳入标准的69例胸腔积液患者,根据胸水检验结果均为不明原因的渗出液,其中老年组30例,非老年组39例。结果老年组病理确诊率为93.3%(28/30),肿瘤和结核确诊率为66.7%(20/30),非老年组病理确诊率100%(39/39),肿瘤和结核确诊率为87.2%(34/39),肿瘤和结核确诊率两组有显著性差异。老年组术中及术后不良反应总的发生率为46.7%(14/30),非老年组不良反应总的发生率为28.2%(11/39),两组无显著性差异。结论内科胸腔镜检查对老年疑难性胸腔积液的诊断确诊率较高,对肿瘤及结核的诊断缺乏特异性,不良反应较非老年患者多,对不明原因的疑难性胸腔积液应在积极评估患者一般状况后值得推广。

Objective To investigate the diagnostic value of medical thoracoscopy in different ages of pleural effusion. Methods The clinical data of 69 patients with unexplained pleural effusion were retrospectively analyzed,including 30 cases of senile patients and 39 cases of non-senile patients. Results The pathological diagnostic rate was 93. 3%（ 28 /30）,and the diagnostic rate of tumor and tuberculosis was 66. 7%（ 20 /30） in the senile group.The pathological diagnostic rate was 100%（ 39 /39）,and the diagnostic rate of tumor and tuberculosis was 87. 2%（ 34 /39） in the non-senile group. The incidence of adverse reactions was 46. 7%（ 14 /30） in the senile group and28. 2%（ 11 /39） in the non-senile group. Conclusion Medical thoracoscopy has high diagnostic rate for elderly patients with difficult pleural effusion and unexplained exudation.