结核性胸腔积液B超引导下穿刺与研究

目的 探讨病程长短对积液量、胸膜厚度、抽液难度的影响,以及测量距体表深度与实际进针深度的关系。方法 76例结核性胸腔积液患根据病程分为3组：A组（病程≤1个月)、B组（1个月＜病程＜3个月）、C组（病程≥3个月）,在B超引导下穿刺,测量穿刺前后暗区深度、抽出液体量、胸膜厚度、距体表深度与实际进针深度。结果 3组病例穿刺前暗区深度无明显差异（P＞0．05）;穿刺后暗区深度A组小于B组和C组（P＜0．05）,B组与C组无明显差异（P＞0．05）;抽出量A且与B组无明显差异（P＞0．05）,A组和B组大于C组（P＜0．05）;距体表深度、胸膜厚度以及进针深度A组小于B组（P＜0．05）,B组小于C组（P＜0．05）。3组病例B超测量距体表深度均小于实际进针深度（P＜0．05）,当B超测量深度均为5mm后,B超测量与实际深度无明显差异（P＞0．05）,且有显相关性（r=0.97)。结论 病程与积液量无关,病程越长胸膜越厚,液体距体表越深、抽出液体的难度越大,测量距体表深度加5mm能准确估计进针深度。

Study of Ultrasound GuidedThoracentesis for Tuberculous Hydro thorax

Objective To explore the influence of clnical c o urse tothoracic effusion quantity,pleura thickness and difficulty of drawing li quid,and the relation between the distance measured with ultrasound and actual d epth.Methods 76 cases divided into three groups according to cl inical course.group A(≤1 month),group B(＜3months and ＞1 month),group C(≥3 mo nths).Thoracentesis was guided through ultrasound and the depth of hydrothorax,d rawn liquid quantity,pleurs thickness,the distance away from body surface and ac tual depth confirmed by thoracentesis was measured.Results The difference of depth before thoracentesis among three groups were not considered significant(P＞0.05),the depth after thoracentesis group A i s smaller in contrast with group B and group C(P＜0.05),but there is no significant difference between group B and group C([ WTBX P＞0.05);And there is no significant difference of drawn liquid qu antity between group A and group B(P＞0.05),the quantity both gr oup A and group B are greater in contrast with group C(P＜0.05); In terms of distance away from body surface,pleura thickness,and actual depth th rough thoracentesis,group A is smaller than group B(P＜0.05),gro up B is smaller than group C(P＜0.05);the distance away from bod y surface measured with ultrasound is smaller than actual depth confirmed by tho racentesis in all the three groups(P＜0.05),when each distance m easured with ultrasound adds 5mm,the data have no significant difference in cont rast with actual depth(P＞0.05),and they have significant correl ativity(r＝0.97).Conclusions There is no relati on between thorac ic effusion quantity and clinical course;the longer the clinical course,the thic ker the pleura,the more distant the liquid away from body surface,the more diffi cult the liquid drawn from the pleural cavity;Distance from body surface added 5 mm can evaluate accurately the actual depth.