微创技术在不明原因胸腔积液诊断中的应用

Applicationof Minimally Invasive Technique in the Diagnosis of Pleural Effusion of Unknown Origin

目的:探讨微创技术在不明原因胸腔积液诊断中的应用。方法:选取胸腔积液患者216例的临床资料。其中,结核性胸腔积液106例,恶性胸腔积液110例。均行改良胸膜活体组织检查(活检)术检查,胸水细胞学检查,胸水ADA、CEA及LDH检测以及血CEA检测。比较检测结果。结果:首次穿刺取材成功205例,成功率94.9%,首次穿刺成功的胸膜活检材料病理结果显示有诊断价值的127份,占58.8%,总确诊率65.3%。恶性胸腔积液组胸水CEA、胸水LDH、血CEA以及胸水CEA/血CEA水平以及阳性率均显著高于结核胸水组;结核性胸腔积液组胸水ADA水平以及阳性率显著高于恶性胸腔积液组,差异均有统计学意义(P<0.01)。结论:临床上可联合多种指标明确胸腔积液病因,指导治疗。

Objective：To investigate the application of minimally invasive technique in the diagnosis of pleural effusion of unknown origin.Methods：Clinical data of 216 patients with pleural effusion.Of which 106 cases of tuberculous pleural effusion,malignant pleural effusion in 110 cases.underwent modified pleural biopsy,pleural fluid cytology,pleural fluid ADA,CEA and LDH detection and blood CEA detection.Comparison of test results.Results：The success rate of the first puncture was 94.9%.The biopsy results of the first biopsy showed that there were 127 diagnoses,accounting for 58.8%and 65.3%respectively.The levels of pleural effusion CEA,pleural effusion LDH,CEA and CEA / blood CEA in pleural effusion were significantly higher than those in tuberculous pleural effusion group.The ADA level and positive rate of pleural effusion in tuberculous pleural effusion group were significantly higher than that in malignant pleural effusion Group,the difference was statistically significant（P〈0.01）.Conclusion：A variety of clinical indicators can be combined with a clear cause of pleural effusion,guiding treatment.