结核性胸膜炎不同分型的彩色多普勒超声表现

目的 探讨彩色多普勒超声在结核性胸膜炎分型及治疗中的价值,进一步提高结核性胸膜炎的诊治水平.方法 收集2009年2月至2013年4月在西安市结核病胸部肿瘤医院行胸腔镜检查或手术治疗的结核性胸膜炎患者165例,术前均行超声检查,以开胸手术或胸腔镜手术检查为标准,分析超声分型结果与手术病理分型的一致性;超声分型与胸腔镜分型一致性采用SPSS 19.0统计学软件卡方检验中的Kappa检验,以P＜0.05为差异有统计学意义.结果 165例患者彩色多普勒超声分型诊断发现工型18例（与胸腔镜或手术分型一致13例）、Ⅱ型28例（与胸腔镜或手术分型一致28例）、Ⅲ型43例（与胸腔镜或手术分型一致43例）和76例Ⅳ型（与胸腔镜或手术分型一致75例）,与胸腔镜或病理分型一致率96.4％（159/165）,Kappa值为0.946,具有很好的一致性.结论 彩色多普勒超声在结核性胸膜炎的临床分型和指导治疗方面有重要价值.

Ultrasonogram features in patients with different types of tuberculous pleurisy

Objective To investigate the value of color Doppler ultrasound in the diagnosis and treatment of tuberculous pleuritis （TBP） which progressed to the different periods,to further improve the diagnosis of tuberculous pleuritis.Methods A total of 165 patients who received thoracoscope or operation in the Xi＇an Tuberculosis and Thoracic Tumor Hospital from February 2009 to April 2013 were involved in this study.Ultrasound was performed in all recruited patients before they received thoracoscope or operation.The pathologic result obtained through operation or thoracoscope was regarded as the standard.The results of ultrasound were compared with the pathologic results and the consistency of the classifications were analyzed by Kappa using SPSS 19.0.Results Among 165 patients with TBP,by using color Doppler ultrasound examination,18 cases were diagnosed as type Ⅰ （13 cases were diagnosed as the same classifications by thoracoscope or operation）,28 cases were type Ⅱ （all of them were diagnosed as the same classifications by thoracoscope or operation）,43 cases were type Ⅲ （all of them were diagnosed as the same classifications by thoracoscope or operation） and 76 cases were type Ⅳ （75 cases were diagnosed as the same classifications by thoracoscope or operation）.So the consistency rate of the classifications by using colorDoppler ultrasound was 96.4％ （159/165） and the Kappa value was 0.946,which meant the consistency was good.Conclusion Color Doppler ultrasound is a convenient and rapid examination method.It is valuable in clinical classification and treatment guidance for the patients with TBP.