内科胸腔镜对不明原因胸腔积液的诊断价值及安全性分析

The analysis of diagnostic value and safety of medical thoracoscopy in unexplained pleural effusion

目的探讨内科胸腔镜在不明原因胸腔积液中的诊断价值并评价其安全性。方法回顾分析本科26例行内科胸腔镜检查不明原因胸腔积液患者的临床资料。结果26例患者中恶性肿瘤16例（61．5％），腺癌13例，小细胞癌3例，结核性胸膜炎10例（38．5％）；恶性积液主要表现为胸膜结节样改变，部分病灶融合成团块，结核性主要为胸膜充血肿胀，可见纤维黏连，结节细小；常见不良反应为疼痛及局部出血，无严重并发症发生。结论内科胸腔镜检查对不明原因胸腔积液的敏感性、确诊率高，具有创伤小、安全高的优点。

Objective To analyze the application value and safety of medical thoracoscopy in the diagnosis of unexplained pleural effusion. Method The clinical data of 26 patients with unexplained pleural effusion who underwent medical thoracoscopy was analyzed retrospectively. Results Among the 26 cases, there were 16 patients diagnosed as malignant tumor metastases （13 cases diagnosed as adenocarcinoma, 3 cases diagnosed as small cell carcinoma）, and 10 patients diagnosed as tuberculous pleuritis. Malignant pleural effusion performancedas nodular changes mainly, what＇s more, some lesions fused into mass. Tuberculous effusion mainly performancedas uniform pleural congestion and edema, small nodular or fiber adhesion. The common adverse reactions were pain and local bleeding, there were no serious complications. Conclusion Medical thoracoscopy has high sensitivity and diagnosis rate in the diagnosis of unexplained pleural effusion, relatively safe, with high security.