可弯曲内科胸腔镜在不明原因胸腔积液中的应用分析

目的评价可弯曲内科胸腔镜在不明原因胸腔积液诊断中的应用价值。方法回顾性总结了该科自2005年5月～2006年12月间采用可弯曲内科电子胸腔镜诊断不明原因胸腔积液的临床资料。共有51例经过一系列常规检查仍不能明确诊断的胸腔积液患者进行了胸腔镜检查。结果51例患者均成功实施了胸腔腔检查,胸腔镜下病理组织活检确诊恶性肿瘤37例、结核性胸膜炎7例、慢性炎症6例、未见异常1例。肿瘤和结核病理结果确诊率为86.3%。恶性肿瘤主要表现为结节样改变,部分病灶融合成肿块;而结核性胸膜炎主要为胸膜弥漫性充血肿胀,结节病灶细小呈卵石样改变,可见坏死物覆盖。51例胸腔镜检查仅1例出现粘连带撕裂出血,1例术中血压下降,经处理均恢复正常,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确诊率高,具有安全创伤小的优点。

Retrospective analysis of flexirigid thoracoscopy for diagnosing difficult pleural effusion

Objective] To evaluate the use of flexirigid thoracoscopy for diagnosing difficult pleural effusion.Methods] Fifty-one patients with difficult pleural effusion diagnosed through flexirigid thoracoscopic pleural biopsy were retrospectively studied on its visual aspect under thoracoscopy.Results] All patients finished flexirigid thoracoscopy examination,thirty-seven malignant tumor and seven tuberculous pleurisy were diagnosed by pathological analysis,only six chronic inflammation,and one case had no problem to be found.Under thoracoscopy:malignant tumor display one or more sarcoidosis,even some sarcoidosis fused into mass;and tuberculous pleurisy showed as small sarcoidosis with diffused pleural congestive and edema,sphacelus might be seen covering the pleura.Haemorrhage was seen in one patient because of tearing up pleural adherent ribbon,and one patient showed blood pressure decreasing to be abnormal transiently,and there was no serious complication.Conculusions] Flexirigid thoracoscopy pleural biopsy is relatively safe and has very important value in diagnosis of difficult pleural effusion.