内科胸腔镜在结核性胸膜炎中的诊治作用分析

目的探讨内科胸腔镜对结核性胸膜炎的诊断及治疗过程中的价值。方法回顾2004年1月至2008年2月在本科住院诊断为结核性胸膜炎的患者共41例。其中治疗组18例，入院后行内科胸腔镜检查术，术后予闭式引流。对照组23例行胸膜活检术，反复多次胸腔穿刺抽液，或留置一次性深静脉导管引流胸腔积液。结果治疗组中所有患者均得到病理确诊，检出率为100％。对照组12例得到病理确诊，检出率为52．17％，两组对比有统计学意义（P〈0．05）。胸水控制时间，两组患者比较有显著性差异（P〈0．01）。但在住院时间两组比较无显著性差异（P〉0．05）。结论早期行内科胸腔镜检查对结核性胸膜炎，可以达到早期诊断和治疗，是一种简便、快速、有效的方法。

Analysis of medical thoracoscopy in the diagnosis and treatment of tuberculous pleuritis effusion

Objective To explore the value of medical thoracoscopy in the diagnosis and treatment of tuberculous pleuritis. Metheda 31 patients with tuberculous pleuritis in our hospital were analyzed retrospectively from January 2004 to December 2008. Of the those 10 patients were given medical thracoscopy with closed thoracic drainage as treatment group and 21 patients were given conventional pleuracentesis repeatedly after pleuralbiopsy or given pleural fluid drainage with deep venous catheter as the control group. Results All patients (100%) in the treatment group and 11 patients(52.38%) in the control group obtained the pathological final diagnosis. There was significant difference between the two groups in the detection rates(P< 0.05) and the time required for controlling pleural fluid(P < 0.01) ,except the days for hospital stay(P > O.05).Conclusion Medical thoracoscopy is a simple,fast effective method in the diagnosis and treatment of the patients with tuberculous plerritis in the earlier period.