可弯曲电子内科胸腔镜在不明原因胸腔积液诊断中的应用

目的了解可弯曲电子内科胸腔镜在不明原因胸腔积液诊断中的应用价值。方法自2005年7月至2007年3月，应用可弯曲电子内科胸腔镜对我院呼吸科病房中60例不明原因的胸腔积液患者进行胸腔镜检查，其中男36例，女24例。对所有通过胸腔积液常规、生化、微生物学及细胞学等实验室检查或通过诊断性抗结核治疗仍不能明确其积液原因的患者进行内科胸腔镜检查。结果经检查，60例不明原因的胸腔积液患者中恶性肿瘤32例（53％），结核16例（27％），阴性结果或慢性炎症5例（8％），肺炎合并胸膜炎4例（7％），粘连严重未能看到胸壁者3例（5％）。恶性肿瘤中肺腺癌最常见。术后并发症中伤口疼痛最常见，对症治疗可缓解。未出现肺水肿、感染、拔管延迟等并发症。结论可弯曲电子内科胸腔镜是一项简单、安全、有效的检查方法。在临床上，可帮助我们进一步明确胸腔积液的病因，特别是对于不明原因的胸腔积液。

The application of flexirigid thoracoscopy in the diagnosis of pleural effusions with unknown aetiology

OBJECTIVE: To investigate the application of Flexirigid thoracoscopy in the diagnosis of pleural effusions with unknown aetiology. METHODS: Sixty patients (male 36, female 24) with pleural effusions of unknown aetiology, were examined with Flexirigid thoracoscopy from July 2005 to March 2007 in our hospital. Routine examinations of the pleural effusions, including biochemistry and cytology, as well as sputum cytology and bronchoscopy had failed to reach a definite diagnosis. RESULTS: Of the 60 cases, malignancy was confirmed in 32 (53%), tuberculosis in 16 (27%), negative or chronic inflammations in 5 (8%), and parapneumonic effusions in 4 (7%) cases; while in 3 cases (5%), the pleural cavity could not be examined thoroughly because of severe adherence. Pulmonary adenocarcinoma was most common in malignancy. The most common complication was pain of the wounds after operations, which was relieved by symptomatic treatment. There were no complications of pulmonary edema, infection, and delay of extubation. CONCLUSION: Flexirigid thoracoscopy is a relatively simple, safe, and effective examination for a definite diagnosis of pleural effusion of unknown aetiology.