老年结核性胸膜炎的内科胸腔镜表型分析

目的探讨老年结核性胸膜炎内科胸腔镜下表型的特征。方法回顾性分析2006年10月至2010年1月,在本院结核科病房通过内科胸腔镜确诊的老年结核性胸膜炎24例(≥60岁)和非老年结核性胸膜炎52例(<60岁)的临床资料和胸腔镜下表现特征。结果两组结核性胸膜炎患者均有胸膜粟粒或结节样改变,伴有或不伴有黏连。老年组胸膜呈弥漫粟粒样改变或多发白色结节改变(66.67%)显著低于非老年组(90.38%,P<0.05)。两组发生胸膜黏连的概率无显著性差异(P>0.05)。结论老年结核性胸膜炎胸膜上粟粒或结节分布减少,闭式胸膜活检的意义有限,对于老年不明原因胸腔积液患者,建议尽早行胸腔镜检查。

Thoracoscopic appearance of senile tuberculous pleurisy

Objective To study the thoracoscopic appearance of senile tuberculous pleurisy.Methods Seventy-six patients,pathologically diagnosed with tuberculous pleurisy by medical thoracoscopy in our hospital from October 2006 to January 2010,were divided into a senile group(≥60 years old;n=24) and a non-senile group(<60 years old;n=52).A retrospective analysis was conducted on their clinical data and thoracoscopic appearance.Results Both groups developed miliary or nodular lesions in the pleura,with or without adhesion.The incidence of diffuse miliary lesions or multiple white nodular lesions in the pleura of the senile group was significantly lower than that of the non-senile group(66.67% vs 90.38%,P<0.05).There was no significant difference between the incidences of pleural adhesion in the two groups(P>0.05).Conclusion The senile patients with tuberculous pleurisy have reduced distribution of miliary or nodular lesions in the pleura,and the diagnostic significance of closed pleural biopsy is limited.Therefore,thoracoscopic examination is suggested for senile patients with unknown pleural effusion.