内科胸腔镜对348例不明原因胸腔积液的诊断价值

目的研究内科胸腔镜在原因不明胸腔积液诊断方面的价值,了解不明原因胸腔积液的疾病谱,评估手术的安全性。方法筛选通过胸水检查及其他临床情况综合判断病因不明的渗出性胸腔积液的患者,行内科胸腔镜检查。结果共348例患者,以最终临床诊断为金标准,内科胸腔镜诊断不明原因胸腔积液敏感性为99.2%,特异性为95.3%。不同年龄组间,胸腔积液病因构成比差异有统计学意义。胸腔镜检查术后发热(52例,15.0%)及大面积皮下气肿(49例,14.1%)常见,严重不良反应少见(3例,0.9%)。结论内科胸腔镜检查对原因不明胸腔积液诊断敏感性及特异性均较高,严重并发症发生率较低,安全、有效。

Medical thoracoscopy in diagnosis of pleural effusion of unknown aetioloty (348 cases)

Abstract: Objective To study the value and evaluate the safety of medical thoracoscopy in diagnosing pleural effusion of unknown aetioloty and identify the disease spectrum. Methods We performed medical thoracoscopy on these patients who were considered diagnosed as pleural effusion of unknown aetioloty which was defined by hydrothorax and other clinical examinations. Results 348 patients were involved. Diagnosis sensitivity of medical thoracoscope was 99.2%, and specificity was 95.3%. Diagnosis were significant different among different age groups. Complications of the patients underwent medical thoracosopy were fever (n = 52, 15.0 %), subcutaneous emphysema (n = 49, 14.1 %), severe complications (n = 3, 0.9 %) were pleural reaction, heart arrest and myocardial infarction. Conclusion Medical thoracoscopy is an standard option for diagnosing pleural effusion of unknown aetiology for its high sensitivity and specificity, but low incidence of severe complications.