不明原因的胸腔积液患者采用纤维支气管镜代胸腔镜检查对于指导临床确诊及预后的价值  

Value of Fiberoptic Bronchoscopy Instead of Thoracoscopy in Guiding Clinical Diagnosis and Prognosis of Patients With Unexplained Pleural Effusion

作　　者：梁辉 LIANG Hui(Department of Respiratory Medicine,Xinyi City People's Hospital,Xinyi Guangdong,525300)

机构地区：[1]广东省信宜市人民医院呼吸内科,广东信宜525300

出　　处：《智慧健康》2021年第15期34-36,159,共4页Smart Healthcare

摘　　要：目的 研究在检查诊断不明原因胸腔积液患者时,利用纤维支气管镜代替胸腔镜进行检查能够起到的临床确诊指导效果以及对检查预后的价值。方法 在2018年12月至2019年12月内选择出50例于广东省信宜市人民医院进行检查的不明原因胸腔积液患者,在获取患者同意后利用纤维支气管镜代替胸腔镜对患者进行检查,并取胸膜活检,将镜下诊断与病理结果进行比较,判断其差异,并观察检查后患者发生并发症的情况。结果 根据病理诊断显示,50例患者中结核性胸膜炎为24例,胸膜转移癌为12例,非特异性慢性炎症7例,胸膜间皮瘤4例,脓胸2例,无异常1例。对比镜下诊断与病理结果,有3例患者被误诊为慢性炎症,4例患者被误诊为结核性胸膜炎,其他患者的病理诊断与镜下诊断一致。同时,患者对检查耐受度良好,不良反应发生概率较低,且皆可通过针对性治疗及护理得到治愈或缓解。结论 对于不明原因胸腔积液患者,医院可利用纤维支气管镜代替胸腔镜进行检查诊断,这种检查方法不仅具有诊断阳性率高、操作简单的优点,能够对不明原因胸腔积液患者的诊断具有指导意义,而且创口小、安全性高且相对来说费用较低,对于患者的预后具有极高的应用价值。Objective To study guiding effect of fiberoptic bronchoscopy instead of thoracoscopy in diagnosis of patients with unexplained pleural effusion and its prognostic value.Methods The paper chose 50 patients with unexplained pleural effusion in our hospital from December 2018 to December 2019.After obtaining consent of patients,fiberoptic bronchoscopy was used instead of thoracoscopy to examine patients,taking pleural biopsy,microscopic diagnosis and pathological results were compared,difference and complications of patients after examination were observed.Results According to pathological diagnosis of 50 cases,there were 24 cases of tuberculous pleurisy,12 cases of pleural metastasis,7 cases of non-specific chronic inflammation,4 cases of pleural mesothelioma,2 cases of empyema and 1 case of no abnormality.Based on microscopic diagnosis and pathological results,3 cases were misdiagnosed as chronic inflammation,4 cases misdiagnosed as tuberculous pleurisy,and pathological diagnosis of other patients was consistent with microscopic diagnosis.At the same time,patients had good tolerance to examination with low adverse reactions rate,and can be cured or alleviated through targeted treatment and nursing.Conclusion Fiberoptic bronchoscopy instead of thoracoscopy has advantages of high positive rate and simple operation for unexplained pleural effusion patients,with guiding significance,small wound,high safety and relatively low cost for diagnosis of patients,which has high application value for prognosis of patients,and should be promoted in clinical practice widely.

关 键 词：纤维支气管镜 胸腔镜 不明原因胸腔积液 诊断 预后 

分 类 号：R561.3[医药卫生—呼吸系统]