胸膜活检在渗出性胸腔积液中的诊断价值

目的:探讨胸膜活检在渗出性胸腔积液中的诊断价值及安全性。方法:对不明原因引起胸腔积液患者183例行胸膜活检190例次，同时取胸腔积液送涂片查抗酸杆菌、脱落细胞检查。结果:患者经皮胸膜活检取标本成功率为90.0%（171/190），病检结果显示112例患者有明确病因诊断，阳性率65.5%，其中40.9%的患者确诊为结核性胸膜炎，肿瘤阳性率24.6%；190例次穿刺发生胸膜反应8例（4.2%），气胸17例，无严重的并发症（如胸腔感染或严重出血等）。结论:胸膜活检术具有操作简单、安全、有效、并发症少的特点，尤其适用于基层医院。

Clinical value of pleural biopsy in the diagnosis of exudative pleural effusion

Objective:To explore the clinical value and safety of the pleural biopsy in the diagnosis of exudative pleural effusion. Methods:One hundred and eighty-three patients with pleural effusion of unknown reasons were treated with pleural biopsy, and the acid-fast bacillus and exfoliated cells in pleural effusion were detected. Results:The success rate of the taking sample though pleural biopsy was 90%. The pathological examination results showed that the obvious etiology in 112 patients were identified,the positive rate of which was 65. 5%. Among 112 patients,the 40. 9% of patients with tuberculous pleurisy was diagnosed,and the positive rate of tumor was 24. 6%. During the 190 times of puncture,the pleural reactions in 8 cases(4. 2%),and pneumothorax in 17 cases and no severe complications( such as chest infection or severe bleeding) were found. Conclusions:Pleural biopsy is simple,safe and effective, especially suitable for county hospitals.