胸膜活检对胸腔积液的病因诊断价值

目的：探讨胸膜活检对胸腔积液病因诊断的价值。方法：对127例胸腔积液患者行首次胸膜活检术。结果：127例患者获取胸膜组织125例,穿刺成功率98.4%,经病理检查有41例为正常胸膜组织,特异性病理诊断84例,病理诊断阳性率（67.2%）。恶性胸腔积液胸膜活检阳性38例（45.2%）,结核性胸腔积液胸膜活检阳性31例（36.9%）,非特异性炎15例（17.9%）。38例恶性肿瘤经免疫组织化学和特殊染色分类,腺癌27例,小细胞肺癌2例,鳞癌2例,恶性间皮瘤2例,转移癌3例,淋巴瘤1例,未分化癌1例。发生并发症者4例（3.1%）,全部为气胸,肺压缩均小于15%,未做特殊处理数日后自行吸收。结论：胸膜活检是一项安全、简单、有效的胸膜疾病的重要的内科确诊手段。

The Value of Pleural Biopsy in the Etiological Diagnosis of Pleural Effussion

Objective：To explore the value of pleural biopsy in the etiological diagnosis of pleural effusion.Methods：We performed the first time pleural biopsy in 127 patients suffering from pleural effusion.Results：One-hundred and twenty-five pleural tissues were obtained while 127 patients were performed pleural biopsy.The success rate of puncture was 98.4%.The positive rate of pathological diagnosis was 67.2%（84/125）.Among these were 38 cases malignant pleural effusion（45.2%）,31 cases tuberculous pleural effusion（36.9%） , 15 cases non-specific inflammarion （17.9%）. It was confirmed that 27 cases adenocarcinoma, 2 cases small cell lung cancer, 2 cases of squamous cell carcinoma, 2 cases malignant mesothelioma, 3 cases metastatic carcinoma, 1 case lymphoma, and 1 cases undifferentiated carcinoma were among the 38 cases malignant tumors by immunohistochemical and special staining classification. Complications occurred in 4 patients （3.1%）, all as pneumothorax, and lung compression were less than 15%. It was absorbed by itself without any treatment after a few days. Conclusion： The pteural biopsy is a safe, simple, effective mean of medical diagnosis in pleural disease.