内科电子胸腔镜诊断不明原因胸腔积液的临床观察

目的探讨内科胸腔镜对于不明原因胸腔积液诊治中的临床应用价值。方法我科2008年10月至2011年5月期间203例经过胸腔积液细胞病理和胸膜活检术仍不能确诊的胸腔积液患者进行胸腔镜检查。结果经内科胸腔镜明确诊断的病例数为172,占84．73％,其中确诊为肿瘤82例,占40．39％,其中肺腺癌75例,占36．95％,小细胞肺癌2例,占0．99％,鳞癌1例,占0．49％,肾癌胸膜转移1例,占0．49％,乳腺癌胸膜转移2例,占0．99％,非何杰金氏淋巴瘤1例,占0．49％,胸膜间皮瘤为20例,占9．85％,结核70例,占34．48％,慢性非特异性炎伴或不伴间皮细胞增生31例,占10．34％,同时本组病例未见严重并发症。结论内科胸腔镜对于不明原因胸腔积液的诊断是一种安全、简便、诊断率阳性高的方法,值得临床推广。

Clinical observed by medical thoracoscope in diagnosis of unexplained pleural effusion

Objective To evaluate the value of medical thoracoscope for unexplained pleural effusion.Methods Two hundred and three cases with undiagnosed pleural effusion were examined by medical thoracoscope from Oct.2008 to May.2011,one hundred and eighty-eight patients were diagnosed,and examination by Medical thoracoscope has proved safe, and no significant complication was associated in present series.Results The diagnostic accuracy rate was 84.73%(172/203),including tumour 82(40,39%),lung adenocarcinoma 75(36.95%),small cell lung cancer 2(0.99%)SqCa 1(0.49%),pleural metastasis of renal cell carcinoma 1(0.49%),pleural metastasis of breast cancer 2(0.99%),Non-Hodgkin's lymphomal 1(0.49%),pleural metastasis 20 (9.85%),tuberculosis 70(34.48%),cloronic non-specific inflammation with or without mesothelial cell proliferation 31(10.34%),and there were fewer significant complications.Conclusion In patients with unexplained pleural effusion,medical thoracoscopy is simple and safe.It has lower complications ratio,with a high positive rate.Physicians should extend its application in clinical practice.