结核及恶性胸腔积液患者胸膜活检次数与病理阳性率分析

目的研究结核及恶性胸腔积液胸膜活检时各次活检获得病理阳性结果的特点。方法对确诊的103例结核性胸腔积液及124例恶性胸腔积液患者行胸膜活检的临床资料进行分析。结果结核胸腔积液首次、第2次、第3次胸膜活检的病理阳性率分别为42.7%(44/103)、26.0%(12/46)、19.4%(6/31)。第3次活检的阳性率同第一次比较差异有统计学意义(χ2,P<0.05);恶性胸腔积液首次、第2次、第3次胸膜活检的病理阳性率分别为33.9%(42/124)、22.9%(16/70)、34.2%(13/38)。两者前3次活检后病理阳性者均已达到行胸膜活检阳性患者总阳性的94%以上。结论 3次胸膜活检已可达到较高阳性率,提示单次多部位活检可能提高阳性率,利于早期诊断。

The positive rate of pathological diagnosis of pleural biopsy in different times in patients with tuberculous pleurisy or malignant pleural effusion

Objective To explore the features of the positive rate of pathological diagnosis in different times in patients with tuberculous pleural effusion or malignant pleural effusion.Methods Clinical data of biopsy of pleura in 103 patients with tuberculous pleural effusion and 124 patients with malignant pleural effusion were studied.Results The positive rate of the first,second and third pleural biopsy in tuberculous pleural effusion was respectively 42.7%(44/103),26.0%(12/46) and 19.4%(6 /31).There was significant difference between the third and first pleural biopsy(P<0.05).The positive rate of the first,second and third pleural biopsy in malignant pleural effusion was respectively 33.9%(42 /124),22.9%(16 /70) and 34.2%(13 / 38).The total positive rate of pleural biopsy was above 94% in tuberculous pleural effusion or malignant pleural effusion after the forward three times.Conclusions Three times pleural biopsy almost gains the highest positive rate of pathological diagnosis.It suggests that biopsy of multi-positions in one time may be useful.