由胸腔镜检查探讨经皮穿刺胸膜盲检对结核性胸膜炎及恶性胸腔积液确诊率差异的原因  

Analysis of different diagnostic value of percutaneous puncture biopsy to tuberculous pleuritis and malignant pleural effusion by thoracoscopy

作　　者：况里杉[1] 廖秀清[1] 

机构地区：[1]重庆市涪陵中心医院,重庆408000

出　　处：《临床肺科杂志》2015年第6期990-992,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的研究经皮穿刺胸膜盲检对结核性胸膜炎及恶性胸水确诊率差异的原因。方法回顾性分析结核性胸膜炎20例、恶性胸水12例胸腔镜检查结果,观察两组患者镜下形态学差异,分析胸膜结节或白斑样病变间黏膜组织的活检病理结果;结果肿瘤与结核均以弥漫性分布、结节状病变为主。在病变之间的胸膜组织也均呈现出充血、水肿、增厚、粗糙、纤维粘连等异常的形态特点。对病变间黏膜组织进行活检的结果提示:结核性胸膜炎组(95%)病理符合率显著高于恶性胸水组(16.7%)(P<0.01)。结论结核特征性病变分布更广泛,是导致经皮穿刺胸膜盲检对结核、恶性胸水确诊率差异的主要原因。Objective To analyze the cause of different diagnostic value to tuberculous pleuritis and malignant pleural effusion by percutaneous puncture biopsy. Methods The internal medicine thoracoscope results of 20 tuberculous pleuritis cases and 12 malignant pleural effusion cases were retrospectively analyzed. The difference of morphology manifestation was compared between the two groups. The pathological results of pleura biopsy between lesions were also analyzed. Results Both malignant and tuberculous groups showed nodular and diffused lesions. The mucosal tissue between nodular lesions mainly showed abnormal appearance, such as congestion, edema, thickening, rough, fibrous adhesions and so on. The characteristic pathology results could be find in 95% cases for tuberculous pleuritis, while 16. 7% in malignant pleural effusion group （P〈0. 05）. Conclusion Different diagnostic value of percutaneous puncture biopsy to tuberculous and malignant pleuritis could be explained by wider distribution of tuberculous characteristic lesion.

关 键 词：结核性胸膜炎 恶性胸水 内科胸腔镜 经皮穿刺胸膜盲检 确诊率 

分 类 号：R521.7[医药卫生—内科学]