内科胸腔镜在合并胸腔积液肺癌患者分期诊断中的价值  

The value of medical thoracoscopy in staging diagnosis of lung cancer with pleural effusion

作　　者：薛克营[1] 柯明耀[1] 吴雪梅[1] 雍雅智[1] 罗炳清[1] 陈玲玲[1] 

机构地区：[1]福建医科大学教学医院厦门市第二医院厦门市呼吸中心,福建厦门361021

出　　处：《中国内镜杂志》2012年第9期955-957,共3页China Journal of Endoscopy

摘　　要：目的探讨可弯曲内科胸腔镜在合并胸腔积液的肺癌患者临床分期中的应用价值。方法采用Olympus LTF-240型可弯曲内科电子胸腔镜,对病理已确诊的合并中小量胸腔积液的24例肺癌患者,在分期诊断中行内科胸腔镜检查。24例包括腺癌15例、鳞癌7例、小细胞肺癌2例。结果内科胸腔镜下可见胸膜病变17例,包括结节13例、扁平隆起2例、胸膜弥漫性充血2例,经内科胸腔镜检查证实为胸膜转移12例,排除胸膜转移12例。15例腺癌有11例确诊为胸膜转移,7例鳞癌1例确诊胸膜转移,2例小细胞肺癌未发现胸膜转移。24例胸腔镜检查均未见严重并发症。结论内科胸腔镜检查能提高肺癌分期诊断的准确性且安全微创,建议在合并胸腔积液的肺癌患者分期诊断中积极行内科胸腔镜检查。[ Objective ] To investigate the value of flexi-rigid medical thoracoscopy in staging diagnosis of lung cancer with pleural effusion. [Methods] 24 lung cancer patients with medium and minimum pleural effusion diag- nosed by pathology were examined with the Olympus LTF-240 flexi-rigid medical thoracoscopy for staging diagno- sis, which included 15 cases of adenocarcinoma, 7 cases of squamous cell carcinoma and 2 cases of small cell lung cancer. [Results] 17 cases had found pleural lesion, which included 13 cases of nodule, 2 cases of flat protrusion and 2 cases of diffused pleural congestion. 12 cases were confirmed as pleuralmetastasis by thoracoscopy, which in- cluded 11 cases of adenocarcinoma and 1 case of squamous cell carcinoma, 12 cases were excluded pleuralmetasta- sis, which included small cell lung cancer 2 cases. No severe complication was observed in all patients. [ Conclu- sion ] Medical thoracoscopy could increase the accuracy of staging diagnosis of lung cancer. It also was a safe and minimally invasive method. So it should be applied to the staging diagnosis of lung cancer with pleural effusion.

关 键 词：内科胸腔镜术 肺癌 胸腔积液 分期诊断 

分 类 号：R734.2[医药卫生—肿瘤]