结核性胸膜炎胸腔镜下形态学特征分析及其诊断价值  

作　　者：田江华[1] 涂军伟[1] 赵建平[1] 朱景倩[1] 盛琳[1] 陈慧君[1] 

机构地区：[1]浙江省金华市中心医院,321000

出　　处：《浙江临床医学》2016年第3期402-404,共3页Zhejiang Clinical Medical Journal

摘　　要：目的观察结核性胸膜炎胸腔镜下形态学特征，探讨胸腔镜对结核性胸膜炎的诊断价值。方法回顾性分析2013年6月至2015年6月经胸腔镜检查的66例结核性胸膜炎患者临床资料、胸腔镜下形态学特点及病理检查结果。结果66例结核性胸膜炎胸腔镜下主要分为五种类型：充血、水肿、胸膜增厚（4例）；弥漫性粟粒样结节（14例）；单发或多发胸膜结节（21例）；胸膜粘连或纤维间隔（20例），坏死（7例）。采用spearman相关分析病程与胸腔镜下形态学表现的相关性，提示结核性胸膜炎镜下形态表现与病程长短呈正相关（r=0．413，P〈O．05）。结论结核性胸膜炎患者内科胸腔镜下表现形态多样，内科胸腔镜诊断结核性胸膜炎准确、安全，具有较高的临床价值。Objective To explore the diagnostic value of medical thoracoscopy in the classification of tubereulous pleurisy. Methods Retrospective study were performed on the clinical date, the more hological features and pathological results of 66 patients who had been diagnosed with tuberculous pleurisy by thoracoscopy in our hospital from June 2013 to June 2015. Results 62 patients （ 93.9% ） were successfully diagnosed by thoracoscope, the other 4 patients were diagnosed with trials of anti-tuberculosis treatment.There are five types of the morphological features of tuberculous pleurisy under thoracoscope： Hyperemic, edematous and thickened pleura （ 4 patients, 6.1% ） ; Diffuse milliary nodules on the pleura （ 14 patients 21.21% ） ; Single or multiple pleural nodules on the pleura （ 21 patients 31.82% ） ; Pleural adhesions or fibrotic septa （ 20 patients 30.30% ） ; Necrosis scattered over the pleura （ 7 patients 10.61% ） . According to the duration of disease, 66 case of tuberculous pleurisy patients in this study divided into four groups based on the duration：groupA （ duration~〈 lweek ） , groupB （ lweek〈duration≤2weeks ） , groupC （ 2weeks〈duration≤4weeks ） , groupD （ duration〉4weeks ） .Using Spearman correlation analysis method to analyze the relationship were between the morphologic features and the duration of each group.The results showed Spearman correlation coefficient R=0.413, P=0.001〈0.05, suggesting that the relationship between thoracoscopic morphological features and the duration of tuberculous pleurisy was significant. Conclusion Forms of patients with tuberculous pleurisy under thoracoscopy are diverse, Medical thoracoscopy is the accurate and safe method for diagnosing TP.The medical thoracoscopy can help diagnose the type of tuberculous pleurisy, conduct the treatment and evaluate the prognosis, by observing the morphologoical features of tuberculous pleurisy and microscopy.

关 键 词：结核性胸膜炎 内科胸腔镜 病程 形态学特征 

分 类 号：R521.7[医药卫生—内科学]