内科胸腔镜与闭式胸膜活检对胸腔积液的诊断价值比较  

Clinical Application of Thoracoscope and Closed Pleural Biopsy in the Diagnosis of Pleural Effusion

作　　者：游通 卢睿[2] 

机构地区：[1]宜宾市第三人民医院呼吸科 [2]宜宾市第一人民医院神经外一科,四川宜宾644000

出　　处：《医疗装备》2017年第16期22-23,共2页Medical Equipment

摘　　要：目的探究以闭式胸膜活检、内科胸腔镜检查对患者胸腔积液诊断的准确性。方法选择医院2015年7月至2016年8月门诊收治的172例不明原因的胸腔积液患者,按检查方式的不同分为胸镜组(以胸腔镜进行诊断)、活检组(采用闭式胸膜活检),每组86例,比较两种检查方式病理分类情况及疾病诊断阳性率情况,统计检查过程中不良反应情况。结果胸镜组与活检组在恶性肿瘤、慢性炎性反应、胸膜坏死组织检出方面,差异均有统计学意义(P<0.05);胸镜组不良反应发生率为9.3%,与活检组8.1%比较,差异无统计学意义(P>0.05);胸镜组病理确诊阳性率为87.2%,明显高于活检组61.6%(P<0.05)。结论临床对胸腔积液患者检查时,闭式胸膜活检、内科胸腔镜均有一定诊断价值,但后者在恶性肿瘤、慢性炎性反应等方面病理诊断阳性率要高。Objective To compare the clinical accuracy of closed pleural biopsy and thoracoscope in the diagnosis of pleural effusion. Methods 172 unexplained pleural effusion patients treated from July 2015 to August 2016 in our clinics were selected. The subjects were divided into thoracoscope group and biopsy group according to the different examination methods; two groups respectively adopted the thoracoscope and closed pleural biopsy. The pathological type,positive detection rate and adverse reaction rate was observed. Results The diagnosis accuracy of malignant tumor,chronic inflammation and necrotic tissue for thoracoscope group was higher than biopsy group（ P〈 0. 05）; the adverse event rate for thoracoscope group（9. 3%） and biopsy group（8. 1%） was not significantly different（ P 〉0. 05）; the positive detection rate for thoracoscope group（87. 2%） was significantly higher than biopsy group（61. 6%）（P〈 0. 05）. Conclusions The closed pleural biopsy and thoracoscope is of great importance in the diagnosis of pleural effusion. However,the positive detection rate of malignant tumor and chronic inflammation based on the thoracoscope is higher.

关 键 词：胸腔镜 诊断 胸腔积液 闭式胸膜活检 

分 类 号：R561[医药卫生—呼吸系统]