纤支镜检和胸膜活检在中老年人胸水病因诊断中的应用

目的:通过对46例中老年胸水患者同时行纤支镜检和胸膜活检,以探讨其联合应用在良恶性胸水鉴别中的意义.方法分析46例胸水患者的纤维支气管镜检、胸膜活检的分别诊断阳性率及两者联合诊断的阳性率.结果:纤支镜对胸水病因的诊:断阳性率为30.4%(其中肺内有病变者19例,确诊为肺癌11例、肺结核1例,确诊率为63%.肺内无病变者27例.确诊为肺癌2例.确诊率为7.4%).胸膜活检对胸水病因诊断的阳性率为56.5%(其中肺内有病变者19例.确诊为肺癌5例、肺结核2例、其它1例,确诊率为42.1%.肺内无病变者27例,确诊为肺癌4例、肺结核10例、其它4例,确诊率为66.6%).两项联合应用对胸水病因的诊断阳性率为84.7%.结论:纤支镜检对肺内有病变的胸水尤其是肺癌所至的胸水诊断率较高,胸膜活检总阳性率较纤支镜高.而联合应用纤支镜及胸膜活检可明显提高对胸水的病因诊断.

Diagnostic Application of Fibrobronchoscopy and Pleural Biopsy in Middle and Elder Patients with Pleural Effusion

Objective: To evaluate the diagnostic application of combination of fibrobronchoscopy with pleural biopsy in middle and elder aged patients with pleural effusion. Methods: All cases were examined with chest radiograph, fibrobronchoscopy, and pleural biopsy. Results:14 (30.4%) of 46 cases with pleural effusion were diagnosed with fibrobronchoscopy, while 26 (56.5%) of the 46 cases were diagnosed with pleural biopsy. 8 of 19 cases with pathological changes were diagnosed with chest radiograph.However, 18 of 27 cases without pathological changes were diagnosed with chest radiograph.Conclusion:The diagnostic rate of pleural biopsy for pleural effusion is higher than that of fibrobronchoscopy.Fibrobronchoscopy, however,shows a higher diagnostic rate for pathological changes of pulmonary in pleural effusion cases.Combining pleural biopsy with fibrobronchoscopy would be favorable to diagnosis in pleural effusion.