双部位闭式胸膜活检与电子胸腔镜的阳性率研究

Study on Positive Rate of Closed Pleural Biopsy and Electronic Thoracoscopy

目的分析双部位闭式胸膜活检术与内科电子胸腔镜在活检阳性率的差异。方法方便选取该院2016年1月—2017年1月时间内收治的60例中等量以上胸腔积液患者,随机分成双部位闭式胸膜活检组(试验组)及电子胸腔镜组(对照组)。应用χ2检验,分析两组患者在活检阳性率及并发症发生率等指标。结果试验组30例,其中第一部位阳性患者19例,第二部位阳性患者18例,第一部位、第二部位的阳性率分别为63.30%(19/30)、62.10%(18/29),双部位病理阳性总例数为25例,诊断的总阳性率83.33%(25/30),双部位阴性5例,阴性率16.67%(5/30),均为肿瘤病例。对照组阳性患者数28例,总阳性率为100.00%(28/28),阴性率为0.00%(0/28)。试验组中2个患者出现胸膜反应。对照组2例患者胸部CT见明显粘连,退出试验。试验组与对照组组间差异有统计学意义(P=0.046)。结论双部位胸膜活检能够提高活检阳性率,可作为胸腔镜外的另一种选择。

Objective This paper tries to analyze the differences in the positive rate of biopsies between closed pleural biopsy and internal thoracoscopy. Methods 60 patients with moderate pleural effusion admitted to this department from January 2016 and January 2017 were randomly divided into two-part closed pleural biopsy group（experimental group） and electronic thoracoscopic group（control group）. The χ^2 test was used to analyze the positive rate of biopsy and the incidence of complications in the two groups. Results There were 30 patients in the experimental group, of which 19 were positive in the first site and 18 were positive in the second site. The positive rates of the first site and the second site were 63.30%（19/30） and 62.10%（18/29） respectively. The total number of pathological positive cases in both sites was 25 cases. The total positive rate of diagnosis was 83.33%（25/30）, and there were 5 cases with double sites negative. The negative rate was16.67%（5/30）. Both cases were tumor cases. The number of positive patients in the control group was 28 cases, with a total positive rate of 100.00%（28/28） and a negative rate of 0.00%（0/28）. The pleural reaction occurred in 2 patients in the experimental group. In the control group, 2 patients had obvious adhesions on chest CT and they withdrew from the trial.There was a statistically significant difference between the experimental group and the control group（P=0.046）. Conclusion Two-site pleural biopsy can increase the positive rate of biopsy and can be used as an alternative to thoracoscopy.