可弯曲内科胸腔镜诊断胸腔积液临床应用  

Application of flexible t medical horacoscopy in the diagnosis of pleural effusion

作　　者：范勇[1] 梁春宝[1] 孙昕[1] 吴万鹏[1] 吴琦[1] 李玉萍[1] 沈淑敏[1] 李萍[1] 于蕾[1] 赵崇法[1] 王咏梅[1] 韩炳森[1] 

机构地区：[1]天津市海河医院,天津300350

出　　处：《中国实用内科杂志》2009年第1期73-74,77,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的探讨可弯曲内科胸腔镜检查术对不明原因胸腔积液的诊断价值。方法选择天津市海河医院2007年5月至12月行胸腔镜检查术的20例胸腔积液患者,16例胸腔镜直视下取病变组织行病理检查,4例术前已明确诊断。结果胸腔镜检查术确诊率93.75%(15/16)。转移性腺癌8例,转移性鳞癌1例,转移性腺鳞癌1例,恶性胸腔积液未分型1例,结核病4例,恶性胸膜间皮瘤3例,化脓性炎症1例,未确诊1例。镜下表现弥漫性粟粒样结节10例(50%),多发肿块7例(35%),纤维分隔或粘连带形成9例(45%),无严重并发症。结论可弯曲内科胸腔镜检查术对胸腔积液是一种安全、确诊率高的诊断方法。Objective To evaluate the application of flexible thoracoscopy in the diagnosis of pleural effusion. Methods Thoracoscopy was performed in 20 pleural effusion patients in our hospital from May to December 2007. Biopsies were performed in 16 patients, not in the other 4 patients since difinite diagnosis had been reached before thoracoscopy. Results Rate of accurate diagnosis via thoracoscopy was 93.75% （15/16）. Results Of biopsy were as follows ： adenocarcinoma 8 cases, squamous carcinoma 1 case, adenosquamous carcinoma 1 case, malignant pleural effusion 1 case, tuberculous pleuritis 4 cases, malignant mesothelioma 3 cases, chronic suppurative pleuritis 1 case, failed diagnosis 1 case. Presentations of lesions under thoracoscope were as follows ： diffused miliary nodules 10 cases（10/20） , multiple mass 7 cases （7/20） , fibrous compartmentation or conglutination 9 cases （9/20）. There were no severe complications. Conclusion Flexible medical thoracoscopy is a safe and efficient method of etiologic diagnosis of pleural effusion.

关 键 词：胸膜疾病 胸腔积液 内科胸腔镜检查术 

分 类 号：R5[医药卫生—内科学]