闭式胸膜刷检术对恶性胸腔积液的诊断价值  

Diagnostic value of close percutaneous pleural brushing in suspected malignant pleural effusion

作　　者：蒋德升[1] 尚宁[1] 姜静[1] 陈小凤[1] 

机构地区：[1]解放军第四五四医院呼吸科,南京210002

出　　处：《临床肺科杂志》2007年第12期1355-1356,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的评价闭式胸膜刷检术对恶性胸腔积液的诊断价值。方法临床疑诊的48例恶性胸腔积液行胸膜刷检、胸膜活检和胸水细胞学检查,比较各种方法和组合对肿瘤细胞的阳性率。结果43例确诊为恶性胸腔积液,胸膜刷检阳性率为62.8%,胸水细胞学检查阳性率为55.8%,胸膜活检阳性率为37.2%,以胸膜刷检最高,明显高于胸膜活检(P<0.05),但与胸水细胞学检查比较无显著性差异(P>0.05)。联合胸膜活检和胸膜刷检,阳性率提高为76.7%,3种方法联合应用阳性率为83.7%。结论胸膜刷检是一种简单、安全、有效的检查手段,对诊断恶性胸腔积液有较大的应用价值。Objective To investigate diagnostic value of close percutancous pleural brushing in suspected malignant pleural effusion （SMPE）. Methods 48 cases of SMPE underwent thoracenesis, pleural brushing and pleural biopsy. All the samples were sent for pathological and cytological studies in order to compare the positive rate of malignancy. Results 43 cases were finally documented to have malignancy. Pleural brushing was positive in 27（62.8% ） of cases. This were superior to that achieved by pleural biopsy （37.2%） （P 〈 0.05） and pleural fluid cytology （55.8%） （P 〉 0.05 ）. The positive rate of the combination of pleural brushing and pleural fluid cytology was raised to 76. 7%. The positive rate of the combination of the three methods was 83.7%. No pneumothorax or other major complications were encountered. Conclusion Closed pleural brushing is a safe and simple tchnique with a high diagnostic yield for patients with malignant pleural effusion.

关 键 词：胸膜刷检 胸膜活检 疑恶性胸腔积液 

分 类 号：R730.4[医药卫生—肿瘤]