钳式胸膜活检与胸水细胞病理学对渗出性胸腔积液诊断的比较研究  

A comparative study of trocar-style pleural biopsy and pleural effusion cytology in diagnosis of exudative pleural effusion

作　　者：马轶坡 黎明 李哲恒 王京坡[4] 范灵敏 MA Yipo;LI Ming;LI Zheheng(Department of Respiratory Medicine,People＇ s Hospital of Dingzhou City,Hebei,Dingzhou 073000,China)

机构地区：[1]河北省定州市人民医院呼吸内科,073000 [2]河北省定州市人民医院肾内科,073000 [3]河北省定州市人民医院普外科,073000 [4]河北省定州市人民医院心内科,073000

出　　处：《河北医药》2018年第18期2836-2838,共3页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题(编号:zd20140036)

摘　　要：目的研究钳式胸膜活检技术在胸腔积液诊断方面的安全性和准确性。方法选取尚无确诊的胸腔积液患者120例,随机分成胸膜活检组和胸水细胞学组,每组60例。胸膜活检组患者采用C型钳式胸膜活检套管针对壁层胸膜进行活检。胸水细胞学组患者行胸腔积液超声检查定位,行胸腔穿刺置管术,引流出胸腔积液,送检胸水脱落细胞学。对比2组患者诊断阳性率、不良反应发生率、病理分型率和并发症发生率。结果胸膜活检组在诊断阳性率和病例分型率上均显著高于胸水细胞学组,差异均有统计学意义(P<0.05)。2组患者在气胸发生率、胸痛发生率及胸膜反应发生率上差异均无统计学意义(P>0.05)。结论钳式胸膜活检套管针作为一种较为新的闭式胸膜活检器材,具有较高的安全性和有效性,操作简单,并发症发生率较为低,可在临床上推广应用。Objective To investigate the safety and accuracy of the trocar-style pleural biopsy technique in diagnosis of pleural effusion. Methods A total of 120 patients with suspected pleural effusion were randomly divided into pleural biopsy group and pleural fluid cytology group,with 60 cases in each group. The patients in pleural biopsy group underwent biopsy of the parietal pleura using a C-clamped pleural biopsy cannula. In pleural fluid cytology group,patients underwent ultrasound examination of pleural effusion,thoracic puncture catheterization,drainage of pleural effusion,and pleural fluid cytology. The positive rate,adverse reaction rate,pathological typing rate and complication rate of the two groups were compared. Results The positive rate of diagnosis and pathological typing rate in pleural biopsy group were significantly higher than those in pleural fluid cytology group（P〈0. 05）. There were no significant differences in the incidence of pneumothorax,chest pain,and pleural response between the two groups（P〈0. 05）. Conclusion As a novel type of closed pleural biopsy device,trocarstyle pleural biopsy has various advantages,including high safety and effectiveness,simple operation and low complication rate,which can be widely applied in clinical practice.

关 键 词：胸膜活检 胸水细胞学 胸腔积液 

分 类 号：R561.3[医药卫生—呼吸系统]