胸膜疾病纤维支气管镜胸腔诊治的应用价值

目的　探讨纤支镜代胸腔镜诊治胸膜疾病的临床应用价值。方法 对25例自发性气胸和22例胸腔积液患者在局麻下用纤支镜行开放式胸腔检查治疗术。结果 胸腔积液患者的诊断率为95.4%(21/22),包括胸膜转移癌11例,胸膜间皮瘤1例,胸膜结核6例,脓胸3例,气胸患者中13例寻找到肺大疱或胸膜破口,而48%(12例)镜下未见明显异常。结论 局麻下纤支镜代胸腔镜术安全、简便,可直视下观察胸腔病变并进行活检,有利明确积液病因,对脓胸和自发性气胸的诊治也有较大的意义。

The value of thoracoscope examination in disease of pleura with fiberoptic bronchoscope

Objective To evaluate the clinical value of thoracoscope examination in disease of pleura with fiberoptic bronchoscope.Methods Twenty-two patients of pleural effusion and 25 patients of spontaneous pneumothorax were performed thoracoscope with fibrobronchoscope under local anesthesia.Results The diagnostic rate of patients with pleural effusion with thoracoscope was 95.4%(21/22),including 11 cases of pleural carcinomatosis,1 case of pleural malignant mesothelioma,6 cases of pleural tuberculosis and 3 cases of empyema.Twenty-five patients of pneumothorax,bullas or fistulae were seen in 13 patients,48%(12/25)of pneumothorax cases,etiologic causes have not been determined with thoracoscope.Conclusions It is safe and simple to apply the thoracoscope under local anesthesia.Through fiberbronchoscope,the pleural cavities could be observed clearly and biopsy specimen could be taken easily.In pleural effusions,the thoracoscopy provides the proof or exclusion of malignancy and tuberculosis.The thoracoscopy has proved also to be successful in the management of empyema and of spontaneous pneumothorax.