胸腔镜在恶性胸腔积液诊断和治疗上的应用

目的　探讨胸腔镜在恶性胸腔积液诊断和治疗上的价值。方法　对15例原因不明的胸腔积液患者作胸腔镜检查,并经胸腔镜喷入滑石粉及顺铂治疗。结果　所有病例经胸腔镜行活检均确诊为恶性病变,总诊断率为100%。经滑石粉喷入和顺铂局部治疗后14例获得完全的胸膜固定,持久的成功率为93.3%。结论　胸腔镜对胸腔积液病因诊断有较高临床实用价值,滑石粉胸膜固定加顺铂治疗是控制恶性胸腔积液、治疗晚期癌症的一种有效方法。

The role of thoracoscopy in diagnosis and management of malignant pleural effusions.

Objective To assess the value of thoracoscopy in malignant pleural effusions.Methods Fifteen patients with pleural effusions of unknown causes were examined by thoracoscope and were treated by intrapleural spraying with talcum powder suspension and cisplatin under thoracoscopy.Results All patients were proved as malignant cases through lung biopsy. The overall diagnostic rate was 100%. Fourteen cases obtained complete pleurodesis and the persistent success rate was 93.3%.Conclusion Thoracoscopy is a simple, safe, reliable, and practical method in the diagnosis of pleural effusions, and talc pleurodesis is an effective management for controlling malignant pleural effusions.