胸膜活检在渗出性胸腔积液中的诊断价值

Clinical value of pleural biopsy in the diagnosis of exudative pleural effusion

目的:探讨胸膜活检在渗出性胸腔积液中的诊断价值及安全性。方法:对不明原因引起胸腔积液患者183例行胸膜活检190例次,同时取胸腔积液送涂片查抗酸杆菌、脱落细胞检查。结果:患者经皮胸膜活检取标本成功率为90.0%(171/190),病检结果显示112例患者有明确病因诊断,阳性率65.5%,其中40.9%的患者确诊为结核性胸膜炎,肿瘤阳性率24.6%;190例次穿刺发生胸膜反应8例(4.2%),气胸17例,无严重的并发症(如胸腔感染或严重出血等)。结论:胸膜活检术具有操作简单、安全、有效、并发症少的特点,尤其适用于基层医院。

Objective： To explore the clinical value and safety of the pleural biopsy in the diagnosis of exudative pleural effusion.Methods： One hundred and eighty-three patients with pleural effusion of unknown reasons were treated with pleural biopsy,and the acid-fast bacillus and exfoliated cells in pleural effusion were detected. Results： The success rate of the taking sample though pleural biopsy was 90%. The pathological examination results showed that the obvious etiology in 112 patients were identified,the positive rate of which was 65. 5%. Among 112 patients,the 40. 9% of patients with tuberculous pleurisy was diagnosed,and the positive rate of tumor was 24. 6%. During the 190 times of puncture,the pleural reactions in 8 cases（ 4. 2%）,and pneumothorax in 17 cases and no severe complications（ such as chest infection or severe bleeding） were found. Conclusions： Pleural biopsy is simple,safe and effective,especially suitable for county hospitals.