内科胸腔镜对不明原因胸腔积液患者的诊断评价  

Diagnostic value of medical thoracoscopy for unknown pleural effusion

作　　者：马龙艳[1] 孙昕[1] 梁春宝[1] 范勇[1] 杜钟珍[1] 

机构地区：[1]天津市海河医院呼吸内科,天津300350

出　　处：《中国内镜杂志》2009年第12期1320-1322,共3页China Journal of Endoscopy

摘　　要：目的探讨内科胸腔镜在诊断不明原因胸腔积液中的价值。方法采用OlympusBF-240可弯曲式内科电子胸腔镜对21例不明原因胸腔积液患者进行胸腔镜检查,术中对可疑病变部位进行直视下多点活检,比较镜下表现与病理结果相关性,评价手术的安全性。结果21例不明原因胸腔积液患者中病理确诊19例,诊断阳性率90%,其中结核病9例(43%),转移性腺癌6例(28%),恶性胸膜间皮瘤4例(19%),2例未确诊病例中病理提示纤维素性渗出,所有病例均未发生严重并发症。结论内科胸腔镜检查对不明原因胸腔积液诊断阳性率高、微创、有效,可作为临床常规诊断手段进行推广。[ Objective ] To approach the value of the medical thoracoscopy in diagnosis of unknown pleural effusion. [Methods] Retrospective study of 21 patients referred for thoracoscopy between June 2007 and October 2008. Multiple punch biopsy was taken in the questionable diseased regions under direct vision, the correlation between the thoraeoscopic manifestations and pathological results was investigated. The safety of the operation was evaluated. [Results] Of the 21 cases, 19 （90%） were finally diagnosed by pathology, including tuberculosis in 9 cases （43%）, metastatic adenocarcinoma in 6 cases （28%）, malignant pleural mesothelioma in 4 cases （19%）, 2 cases with undetermined diagnosis. None of the cases had serious complication. [ Conclusion] Medical thoracoscopy has a high diagnostic rate, and can be easily and safely performed.

关 键 词：胸腔镜 诊断 治疗 

分 类 号：R561.3[医药卫生—呼吸系统]