胸腔镜下结核性胸膜炎的镜下特征及临床特点  

Characteristics of tuberculous pleurisy under thoracoscopy and clinical features

作　　者：胡绳[1] 田坤[1] 张定涛[1] 田德兴[1] 李小玉[1] 肖贞良[1] 

机构地区：[1]成都军区总医院呼吸科,成都610083

出　　处：《西南国防医药》2015年第3期273-275,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的：探讨胸腔镜下结核性胸膜炎的镜下特征及临床特点。方法收集我科2011年9月～2014年1月经胸腔镜病理活检明确诊断的36例结核性胸膜炎患者的临床资料，对其年龄、性别及镜下病变特点等进行回顾性分析。结果胸腔镜下表现为：胸膜弥漫性充血、水肿5例，胸膜粟粒样、白色结节14例，胸膜腔内纤维苔素沉积及粘连带12例，胸膜肥厚呈多房性5例。发病1个月以内的结核性胸膜炎镜下多见于2、3期，病理抗酸阳性率高，经过抗结核治疗后预后均较好，未出现明显的胸膜增厚、粘连。发病＞1个月的结核性胸膜炎镜下多见于3、4期。病理结果以肉芽肿性炎并干酪样坏死为主，经过抗结核治疗后部分患者出现胸膜增厚、粘连。结论胸腔镜是尽早诊断结核性膜炎的有效方法之一。Objective To explore the characteristics of tuberculous pleurisy （ TP） under thoracoscopy and clinical features . Methods The clinical data of 36 patients with TP to receive thoracoscopic biopsy diagnosis in our department from Sep .2011 to Jan. 2014 were collected , and a retrospective analysis was made on the age , gender , and thoracoscopic lesion characteristics .Results The thoracoscopic results showed：there were diffused pleural congestive and edema in five cases , pleural miliary and white nodules in 14 cases, pleural cavity fibrosis deposition and adhesions in 12 cases, and multilocular pleural thickening in five cases .The incidence of TP within one month was prevalent in the 2nd and 3rd stage;the positive rate of pathological acid-fast staining was high;the prognosis after anti-tuberculosis treatment was good , and there were no obvious pleural thickening or adhesion .The incidence of TP after one month was prevalent in the 3rd and 4th stage;the pathological findings showed that granulomatous inflammation with caseous necrosis was prevalent , and pleural thickening occurred in some patients after anti-tuberculosis treatment .Conclusion Thoracoscopy is one of the effective methods for early diagnosis of TP .

关 键 词：结核 胸膜炎 胸腔镜 临床特点 

分 类 号：R521.7[医药卫生—内科学]