作 者：
胡伟华;王磊;肖卫;陈振平;许菊秀;马家兰
摘 要：
目的:探讨内科胸腔镜在胸腔积液诊断中的价值。方法:选取医院收治的胸腔积液患者40例,使用内科胸腔镜进行检查并取得胸膜标本进行病理学检验。结果:40例患者经内科胸腔镜检查及胸膜活检病理学检查后,确诊为结核性胸膜炎20例(50.0%),胸膜转移癌14例(35.0%),细菌性脓胸1例(2.5.0%),风湿性胸膜炎1例(2.5%),乳糜性胸腔积液1例(2.5%),胸膜恶性间皮瘤1例(2.5%),未能确诊者2例(5.0%),确诊率为95.0%。术中及术后并发症少,以局部疼痛为主,症状轻微。结论:内科胸腔镜是一种安全、有效、微创的临床诊断方法,能明显提高胸腔积液病因的诊断率。
译 名：
Medical Thoracoscopy in the Diagnosis of Unexplained Pleural Effusion
作 者：
Hu Weihua;Wang Lei;Xiao Wei;Chen Zhenping;Xu Juxiu;Ma Jialan;Department of Respiration,the First Hospital of Yangtze University;
关键词：
medical thoracoscopy;;pleural effusion;;etiological diagnosis
摘 要：
Objective:An undiagnosed exudative pleural effusion is often a difficult diagnostic dilemma that needs further histological study for a definitive etiological diagnosis.Medical thoracoscopy is a minimally invasive procedure could resolve this problem.Methods:Between January 2012 and Augest 2013,we performed thoracoscopy in 40 patients for diagnosis of undiagnosed exudative pleural effusion.Clinical and paraclinical data of patients were collected prospectively and analyzed.Results:Thoracoscopy was diagnostic in 38patients(95.0%).The pathologic findings were tuberculosis(50.0%),carcinoma(35.0%),empyema thoracis(2.5%),rheumatic(2.5%),chylothorace(2.5%)and malignant mesothelioma(2.5%).Two cases remain undiagnosised(5.0%).No mortality or complication related to our operation was observed.Conclusion:Medical thoracoscopy is a minimally invasive procedure with a high definitive diagnostic accuracy in the evaluation of tuberculosis and malignant pleural effusions.Pulmonologist should refer these patients sooner to decrease the waiting period of diagnosis and treatment of such conditions.
