胸腔镜在渗出性胸腔积液中的临床研究  

Medical thoracoscope research in exudative pleural effusion

作　　者：杨燕[1] 徐大敏[1] 王浩凌[1] 

机构地区：[1]攀枝花市中心医院呼吸内科,四川攀枝花617000

出　　处：《临床肺科杂志》2016年第6期988-991,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的研究内科胸腔镜在渗出性胸腔积液检查中的高效性、安全性、并发症。方法 2013年12月至2015年8月128例渗出性胸腔积液患者,随机分为A组、B组,各组64例。A组胸腔积液行常规检查,B组行内科胸腔镜检查。结果 A组:36例为结核性,24例为恶性,3例为炎性或脓胸,1例患者病因不明确,5例患者需手术诊断。B组:40例为结核性,21例为恶性,3例炎性或脓胸,3例需手术诊断。恶性肿瘤患者45名(35.2%,P<0.01),结核性胸膜炎患者76人(59.4%),炎性或脓胸患者6人(4.7%),1人病因不明确(0.7%)。其中腺癌占28例,鳞癌5例,小细胞癌9例,恶性间皮瘤3例。内科胸腔镜并发症较少(7%,P<0.05)。结论内科胸腔积液诊断尤其针对反复或持续性胸腔积液患者,是一种高效、微创、安全的检查手段。Objective To study the efficiency, safety and complication of medical thoracoscope in effusion hydrothorax. Methods 128 patients with pleural effusion from December 2013 to August 2015 were randomly divid-ed into two groups. The group A was given routine examination, and the group B was performed by medical thoraco-scope. Results In the group A, there were 36 cases of tuberculous, 24 cases of malignant, 3 cases inflammatory or empyema, 1 case without clear etiology, and 5 cases needed to surgical diagnosis. In the group B, there were 40 ca-ses of tuberculosis, 21 cases were malignant, 3 cases of inflammatory or empyema, and 3 cases needed operation di-agnosis. There were 45 patients with malignant tumor （ 35. 2%, P〈0. 01 ） , 76 patients with tuberculous pleurisy （59. 4%）, 6 patients inflammatory or empyema （4. 7%）, and 1 case without clear causes （0. 7%）. Among them, there were 28 cases of adenocarcinoma, 5 cases of squamous cell carcinoma, 9 cases of small cell carcinoma, and 3 cases of malignant mesothelioma. The incidence of department of internal medicine complications was lower （7%, P〈0. 05）. Conclusion It is an effective, minimally invasive and safe method for the diagnosis of pleural effusion by medical thoracoscope, especially for patients with recurrent or persistent pleural effusion.

关 键 词：胸腔镜 胸腔积液 诊断 

分 类 号：R561.3[医药卫生—呼吸系统]