电子气管镜代替胸腔镜诊断不明原因胸腔积液的价值

目的:探讨电子支气管镜代替胸腔镜检查对不明原因胸腔积液的诊断价值。方法:选择44例不明原因胸腔积液的患者采用电子支气管镜代替胸腔镜检查,观察镜下病变形态和病理结果。结果:44例患者中,恶性病变33例,其中腺癌20例,鳞癌4例,小细胞癌3例,鳞腺癌1例,胸膜间皮瘤4例,淋巴瘤1例;10例良性病变中,结核8例,化脓性炎症2例;1例未能确诊。44例患者中43例明确诊断,诊断总阳性率为97.7%;所有病例中,明确诊断恶性病变占75.0%,结核占18.2%。并发症少,出血、疼痛、发热、胸腔内气体残留均极轻微且很快消失。结论:电子支气管镜代替胸腔镜检查具有诊断阳性率高、损伤小、操作简单安全等优点,对不明原因胸腔积液有较高的临床应用价值,值得及进一步研究。

Role of electronic bronchoscope replacing thoracoscope to detect unclear causes of pleural effusion

Objective:To investigate the role of electronic bronchoscope replacing to detect unclear causes of pleural effusion.Methods:44 cases of patients with pleural effusion ,whose causes were still unknown ,were selected to be detected by the electronic bronchoscope replacing thoracoscope ,and the ap-pearances of pathological changes under scope were described and the pathological results were defined.Results:33 of these 44 patients were diagnosed to have malignant disease ,which include 20 adenocarcinoma cases,4 squamous carcinoma cases,3 small cell lung carcinoma cases,1 adenosquamous carcinoma case, 4 pleural endotheliomas cases,1 malignant lymphoma case .The other 10 benign lesion cases include 2 tuberculosis cases, 2 chronic suppurative pleuritis cases, 1 failed diagnosis case. Of these 44 patients, 43 cases had definite diagnosis (the positive rate was 97.7%). Of all the patients, 75.0% cases were malignant disease, 18.2% cases were tuberculosis. There were few complications and no patients failed to finish this examine. Conclusions:The electronic bronchoscope replacing the thoracoscope possesses higher positive diagnostic rate and safety. And it has preferable value in clinical application for those unclear causes of pleural effusion.