内科胸腔镜在胸腔积液诊治中的应用
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摘要
胸腔积液是内科常见疾病,目前诊断常规采用的方法包括胸腔积液诊断性穿刺化验、脱落细胞学检查、细菌培养及胸腔积液标志物的辅助诊断等,但经过上述检查后仍有相当一部分患者无法明确病因。近年来出现的内科胸腔镜检查,对胸腔积液特别是不明原因的胸腔积液的诊断有较好的临床应用价值。本文对胸腔积液各种常规诊断方法优缺点的比较及内科胸腔镜在胸腔积液诊治中的应用进行综述。
引文
[1]俞森洋.胸膜和胸膜腔的解剖和生理功能的研究[J].中华结核和呼吸杂志,2001,24(1):13-15.
[2]Light RW.Clinical practice.Pleural effusion[J].N Engl J Med,2002,346(25):1971-1977.
[3]姜淑娟,牟晓燕,张嵩,等.内科胸腔镜术对不明原因胸腔积液的诊断价值[J].中华结核和呼吸杂志,2013,36(5):337-340.
[4]Wang XJ,Yang Y,Wang Z,et al.Efficacy and safety of diagnostic thoracoscopy in undiagnosed pleural effusions[J].Respiration,2015,90(3):251-255.
[5]Loddenkemper R.Thoracoscopy--state of the art[J].Eur Respir J,1998,11(1):213-221.
[6]Lin CM,Lin SM,Chung FT,et al.Amplified Mycobacterium tuberculosis direct test for diagnosing tuberculous pleurisy--a diagnostic accuracy study[J].PLoS One,2012,7(9):e44842.
[7]Zhai K,Lu Y,Shi HZ.Tuberculous pleural effusion[J].J Thorac Dis,2016,8(7):E486-E494.
[8]Jeon D.Tuberculous pleurisy:an update[J].Tuberc Respir Dis(Seoul),2014,76(4):153-159.
[9]Ruan S,Chuang Y,Wang J,et al.Revisiting tuberculous pleurisy:pleural fluid characteristics and diagnostic yield of mycobacterial culture in an endemic area[J].Thorax,2012,67(9):822-827.
[10]Scherpereel A,Astoul P,Baas P,et al.Guidelines of the European Respiratory Society and the European Society of Thoracic Surgeons for the management of malignant pleural mesothelioma[J].Eur Respir J,2010,35(3):479-495.
[11]Maturu VN,Dhooria S,Bal A,et al.Role of medical thoracoscopy and closed-blind pleural biopsy in undiagnosed exudative pleural effusions:a single-center experience of 348 patients[J].JBronchology Interv Pulmonol,2015,22(2):121-129.
[12]Agarwal R,Aggarwal AN,Gupta D.Diagnostic accuracy and safety of semirigid thoracoscopy in exudative pleural effusions:a meta-analysis[J].Chest,2013,144(6):1857-1867.
[13]Valdes L,Alvarez D,San JE,et al.Tuberculous pleurisy:a study of254 patients[J].Arch Intern Med,1998,158(18):2017-2021.
[14]Anie Y,Sumi S,Varghese P,et al.Diagnostic approaches in patients with tuberculous pleural effusion[J].Diagn Microbiol Infect Dis,2007,59(4):389-394.
[15]Nithya H,Suraj KP,Rajagopal TP,et al.Medical thoracoscopy vs closed pleural biopsy in pleural effusions:A randomized controlled study[J].J Clin Diagn Res,2014,8(5):C1-C4.
[16]Agarwal A,Prasad R,Garg R,et al.Medical thoracoscopy:a useful diagnostic tool for undiagnosed pleural effusion[J].Indian JChest Dis Allied Sci,2014,56(4):217-220.
[17]Galbis JM,Mata M,Guijarro R,et al.Clinical-therapeutic management of thoracoscopy in pleural effusion:a groundbreaking technique in the twenty-first century[J].Clin Transl Oncol,2011,13(1):57-60.
[18]Hsu C.Cytologic detection of malignancy in pleural effusion:a review of 5,255 samples from 3,811 patients[J].Diagn Cytopathol,1987,3(1):8-12.
[19]Boutin C,Rey F.Thoracoscopy in pleural malignant mesothelioma:a prospective study of 188 consecutive patients.Part 1:Diagnosis[J].Cancer,1993,72(2):389-393.
[20]Light RW.Update on tuberculous pleural effusion[J].Respirology,2010,15(3):451-458.
[21]Zumla A,Raviglione M,Hafner RA,et al.Tuberculosis[J].N Engl J Med,2013,368(8):745-755.
[22]Casal RF,Eapen GA,Morice RC,et al.Medical thoracoscopy[J].Curr Opin Pulm Med,2009,15(4):313-320.
[23]Wang Z,Xu LL,Wu YB,et al.Diagnostic value and safety of medical thoracoscopy in tuberculous pleural effusion[J].Respir Med,2015,109(9):1188-1192.
[24]Loddenkemper R,Grosser H,Mai J,et al.Diagnosis of tuberculous pleural effusion:prospective comparison of laboratory chemical,bacteriologic,cytologic and and histologic study results[J].Prax Klin Pneumol,1983,37(11):1153-1156.
[25]Wu YB,Xu LL,Wang XJ,et al.Diagnostic value of medical thoracoscopy in malignant pleural effusion[J].BMC Pulm Med,2017,17(1):109.
[26]Maturu VN,Dhooria S,Bal A,et al.Role of medical thoracoscopy and closed-blind pleural biopsy in undiagnosed exudative pleural effusions:a single-center experience of 348 patients[J].JBronchology Interv Pulmonol,2015,22(2):121-129.
[27]Starr RL,Sherman ME.The value of multiple preparations in the diagnosis of malignant pleural effusions.A cost-benefit analysis[J].Acta Cytol,1991,35(5):533-537.
[28]Pereyra MF,San-Jose E,Ferreiro L,et al.Role of blind closed pleural biopsy in the managment of pleural exudates[J].Can Respir J,2013,20(5):362-366.
[29]Boutin C,Astoul P.Diagnostic thoracoscopy[J].Clin Chest Med,1998,19(2):295-309.
[30]罗炳清,薛克营,吴雪梅,等.胸腔镜下胸膜固定术治疗恶性胸腔积液的疗效分析[J].临床肺科杂志,2013,18(4):690-692.
[31]Light RW.Parapneumonic effusions and empyema[J].Proc Am Thorac Soc,2006,3(1):75-80.
[32]Yang W,Zhang B,Zhang ZM.Infectious pleural effusion status and treatment progress[J].J Thorac Dis,2017,9(11):4690-4699.
[33]Koegelenberg CFN,Diaconi AH,Bolligeri CT.Parapneumonic pleural effusion and empyema[J].Respiration,2008,75(3):241-250.
[34]Tassi GF,Davies RJO,Noppen M.Advanced techniques in medical thoracoscopy[J].Eur Respir J,2006,28(5):1051-1059.
[35]Brutsche MH,Tassi GF,Gyorik S,et al.Treatment of sonographically stratified multiloculated thoracic empyema by medical thoracoscopy[J].Chest,2005,128(5):3303-3309.
[36]刘昌起.胸膜疾病的病因和发病机制[J].中华结核和呼吸杂志,2001,24(1):16-17.
[2]Light RW.Clinical practice.Pleural effusion[J].N Engl J Med,2002,346(25):1971-1977.
[3]姜淑娟,牟晓燕,张嵩,等.内科胸腔镜术对不明原因胸腔积液的诊断价值[J].中华结核和呼吸杂志,2013,36(5):337-340.
[4]Wang XJ,Yang Y,Wang Z,et al.Efficacy and safety of diagnostic thoracoscopy in undiagnosed pleural effusions[J].Respiration,2015,90(3):251-255.
[5]Loddenkemper R.Thoracoscopy--state of the art[J].Eur Respir J,1998,11(1):213-221.
[6]Lin CM,Lin SM,Chung FT,et al.Amplified Mycobacterium tuberculosis direct test for diagnosing tuberculous pleurisy--a diagnostic accuracy study[J].PLoS One,2012,7(9):e44842.
[7]Zhai K,Lu Y,Shi HZ.Tuberculous pleural effusion[J].J Thorac Dis,2016,8(7):E486-E494.
[8]Jeon D.Tuberculous pleurisy:an update[J].Tuberc Respir Dis(Seoul),2014,76(4):153-159.
[9]Ruan S,Chuang Y,Wang J,et al.Revisiting tuberculous pleurisy:pleural fluid characteristics and diagnostic yield of mycobacterial culture in an endemic area[J].Thorax,2012,67(9):822-827.
[10]Scherpereel A,Astoul P,Baas P,et al.Guidelines of the European Respiratory Society and the European Society of Thoracic Surgeons for the management of malignant pleural mesothelioma[J].Eur Respir J,2010,35(3):479-495.
[11]Maturu VN,Dhooria S,Bal A,et al.Role of medical thoracoscopy and closed-blind pleural biopsy in undiagnosed exudative pleural effusions:a single-center experience of 348 patients[J].JBronchology Interv Pulmonol,2015,22(2):121-129.
[12]Agarwal R,Aggarwal AN,Gupta D.Diagnostic accuracy and safety of semirigid thoracoscopy in exudative pleural effusions:a meta-analysis[J].Chest,2013,144(6):1857-1867.
[13]Valdes L,Alvarez D,San JE,et al.Tuberculous pleurisy:a study of254 patients[J].Arch Intern Med,1998,158(18):2017-2021.
[14]Anie Y,Sumi S,Varghese P,et al.Diagnostic approaches in patients with tuberculous pleural effusion[J].Diagn Microbiol Infect Dis,2007,59(4):389-394.
[15]Nithya H,Suraj KP,Rajagopal TP,et al.Medical thoracoscopy vs closed pleural biopsy in pleural effusions:A randomized controlled study[J].J Clin Diagn Res,2014,8(5):C1-C4.
[16]Agarwal A,Prasad R,Garg R,et al.Medical thoracoscopy:a useful diagnostic tool for undiagnosed pleural effusion[J].Indian JChest Dis Allied Sci,2014,56(4):217-220.
[17]Galbis JM,Mata M,Guijarro R,et al.Clinical-therapeutic management of thoracoscopy in pleural effusion:a groundbreaking technique in the twenty-first century[J].Clin Transl Oncol,2011,13(1):57-60.
[18]Hsu C.Cytologic detection of malignancy in pleural effusion:a review of 5,255 samples from 3,811 patients[J].Diagn Cytopathol,1987,3(1):8-12.
[19]Boutin C,Rey F.Thoracoscopy in pleural malignant mesothelioma:a prospective study of 188 consecutive patients.Part 1:Diagnosis[J].Cancer,1993,72(2):389-393.
[20]Light RW.Update on tuberculous pleural effusion[J].Respirology,2010,15(3):451-458.
[21]Zumla A,Raviglione M,Hafner RA,et al.Tuberculosis[J].N Engl J Med,2013,368(8):745-755.
[22]Casal RF,Eapen GA,Morice RC,et al.Medical thoracoscopy[J].Curr Opin Pulm Med,2009,15(4):313-320.
[23]Wang Z,Xu LL,Wu YB,et al.Diagnostic value and safety of medical thoracoscopy in tuberculous pleural effusion[J].Respir Med,2015,109(9):1188-1192.
[24]Loddenkemper R,Grosser H,Mai J,et al.Diagnosis of tuberculous pleural effusion:prospective comparison of laboratory chemical,bacteriologic,cytologic and and histologic study results[J].Prax Klin Pneumol,1983,37(11):1153-1156.
[25]Wu YB,Xu LL,Wang XJ,et al.Diagnostic value of medical thoracoscopy in malignant pleural effusion[J].BMC Pulm Med,2017,17(1):109.
[26]Maturu VN,Dhooria S,Bal A,et al.Role of medical thoracoscopy and closed-blind pleural biopsy in undiagnosed exudative pleural effusions:a single-center experience of 348 patients[J].JBronchology Interv Pulmonol,2015,22(2):121-129.
[27]Starr RL,Sherman ME.The value of multiple preparations in the diagnosis of malignant pleural effusions.A cost-benefit analysis[J].Acta Cytol,1991,35(5):533-537.
[28]Pereyra MF,San-Jose E,Ferreiro L,et al.Role of blind closed pleural biopsy in the managment of pleural exudates[J].Can Respir J,2013,20(5):362-366.
[29]Boutin C,Astoul P.Diagnostic thoracoscopy[J].Clin Chest Med,1998,19(2):295-309.
[30]罗炳清,薛克营,吴雪梅,等.胸腔镜下胸膜固定术治疗恶性胸腔积液的疗效分析[J].临床肺科杂志,2013,18(4):690-692.
[31]Light RW.Parapneumonic effusions and empyema[J].Proc Am Thorac Soc,2006,3(1):75-80.
[32]Yang W,Zhang B,Zhang ZM.Infectious pleural effusion status and treatment progress[J].J Thorac Dis,2017,9(11):4690-4699.
[33]Koegelenberg CFN,Diaconi AH,Bolligeri CT.Parapneumonic pleural effusion and empyema[J].Respiration,2008,75(3):241-250.
[34]Tassi GF,Davies RJO,Noppen M.Advanced techniques in medical thoracoscopy[J].Eur Respir J,2006,28(5):1051-1059.
[35]Brutsche MH,Tassi GF,Gyorik S,et al.Treatment of sonographically stratified multiloculated thoracic empyema by medical thoracoscopy[J].Chest,2005,128(5):3303-3309.
[36]刘昌起.胸膜疾病的病因和发病机制[J].中华结核和呼吸杂志,2001,24(1):16-17.