内科胸腔镜诊断180例胸腔积液临床分析

Clinic Evaluation of Medical Thoracoscopy in the Diagnosis of 180 Cases of Pleural Sffusions

目的评价用内科胸腔镜诊断不明病因胸腔积液的临床价值．方法回顾性分析接受胸腔镜检查的180例不明病因渗出性胸液患者的临床资料，评价该诊断试验的真实性、有效性和适用性．结果180例胸腔积液中，经胸腔镜检查178例患者明确诊断，其中结核性胸膜炎87例，恶性肿瘤28例，（其中恶性胸膜间皮瘤2例，肺癌24例，胆管癌1例，宫颈癌1例）肺炎58例，脓胸5例，2例患者未能明确诊断．确诊率98．88％，95％CI为97．78％-99．98％，具有较高可信度．无检查失败及终止检查者．结论内科胸腔镜诊断不明病因胸腔积液安全高效，尽早合理应用有利于正确制定下一步的治疗方案．

Objective To evaluate the clinical value of medical thoracoscopy in the diagnosis of exudative pleural effusions with unknown etiology. Methods We analyzed retrospectively the clinical data of 180 patients with undiagnosed pleural effusions who underwent medical thoracoscopy and appraised clinical value regarding validity, effectivity and applicability of thoracoscopy. Result In 180 cases of pleural effusion, there were 178 cases of patients with a clear diagnosis, including 87 cases of tuberculous pleurisy, 28 cases of malignant tumor, malignant breast bildes mesothelioma in 2, lung cancer in 24, bile duct carcinoma in 1, cercival cancer in 1） , pneumonia 58 case fo pyothorax, 5 caseso of pyothorax, and 2 cases withou clear diagnosis.No check failure and terminate, the 95%CI was 5 cases of 97.78%-99.98%. Conclusions Medical thoracoscopy is a safe and effective method in the diagnosis of exudative pleural effusions with unknown aetiology .The early application of this method is very helpful for the management of the pleural diseases in suitable patients.