可弯曲内科胸腔镜联合肿瘤标志物诊断恶性胸腔积液的价值分析

Analysis of the value of flexible thoracoscopy combined with tumor mark-ers in the diagnosis of malignant pleural effusion

目的分析可弯曲内科胸腔镜联合肿瘤标志物诊断恶性胸腔积液的价值分析。方法将140例胸腔积液患者纳入研究,按诊断方法分为观察组(可弯曲内科胸腔镜联合肿瘤标志物诊断)和对照组(肿瘤标志物诊断)。比较两组恶性胸腔积液诊断正确率和总体诊断正确率,观察组各类恶性胸腔积液诊断正确率;观察胸腔镜下良恶性胸腔积液特征;比较两组的诊断灵敏度、特异性、准确度;记录观察组的并发症。结果观察组恶性胸腔积液诊断正确率(95.65%)、总体诊断正确率(97.14%)均高于对照组;观察组诊断灵敏度、特异度、准确度(96.56%、97.20%、98.01%)均高于对照组(P均<0.05)。恶性胸腔积液主要特征包括白色或灰黑色小结节、蜂窝样、胸膜粘连、胸膜肿物增生、脓性胸积液、脏层胸膜表面脓胎样病变等。观察组并发症发生率为14.29%。结论可弯曲内科胸腔镜是方便、快捷、安全的微创诊疗技术,联合肿瘤标志物能提高恶性胸腔积液诊断准确度、特异性和灵敏度,值得推广。

Objective To analyze the value of flexible thoracoscopy combined with tumor markers in the diagnosis of malignant pleural effusion. Methods A total of 140 patients with pleural effusion were included in the study. According to diagnostic methods, the patients were divided into the observation group（diagnosis with flexible thoracoscopy combinet with tumor markers） and the control group（diagnosis with tumor markers）. The diagnostic accuracy and overall diagnostic accuracy of malignant pleural effusion were compared between the two groups. The diagnostic accuracy of malignant pleural effusion was observed in the observation group; the characteristics of benign and malignant pleural effusion were observed under thoracoscopy; the diagnostic sensitivity, specificity and accuracy of the two groups were compared; complications were recorded in observation group. Results The diagnostic accuracy of malignant pleural effusion was 95.65%, and the total diagnostic accuracy was 97.14% in the observation group, which were both higher than those in the control group; the diagnostic sensitivity, specificity and accuracy in the observation group（96.56%, 97,20%, 98.01%） were all higher than those in the control group （P a11〈0.05）. The main characteristics of malignant pleural effusion in- cluded white or gray-black nodules, honeycomb-like shape, pleural .adhesions, pleural tumor hyperplasia, purulent pleural effusion, pus-like lesions on the visceral pleural surface, etc. The incidence rate of complications in the obser- vation group was 14.29%. Conclusion The flexible tboracoscopy is a convenient, fast and safe minimally invasive diag- nostic and therapeutic technique. Combined tumor markers can improve the diagnostic accuracy, specificity and sensi- tivity of malignant pleural effusion, which is worthy of promotion.