浅析闭式胸膜活检在胸腔积液病因诊断中的应用
|
摘要
目的研究分析胸腔积液患者接受闭式胸膜活检对病因诊断的价值。方法 50例不明原因胸腔积液患者,均给予常规、生化、细胞学检查及闭式胸膜活检,并行病理检查。观察病理检查结果 ,比较常规、生化、细胞学检查结果及闭式胸膜活检结果 ,常规、生化、细胞学检查及闭式胸膜活检并发症发生情况。结果病理检查显示, 5例(10.0%)不能明确病因, 27例(54.0%)确诊为结核性胸腔积液,18例(36.0%)确诊为恶性胸腔积液。常规、生化、细胞学检查显示,均为渗出性胸腔积液, 27例(54.0%)不能明确病因, 13例(26.0%)确诊为结核性胸腔积液, 10例(20.0%)确诊为恶性胸腔积液,检出率为46.0%。闭式胸膜活检显示, 16例(32.0%)不能明确病因, 19例(38.0%)确诊为结核性胸腔积液, 15例(30.0%)确诊为恶性胸腔积液,检出率为68.0%。闭式胸膜活检检出率高于常规、生化、细胞学检查,差异具有统计学意义(χ2=4.937, P<0.05)。常规、生化、细胞学检查没有出现并发症,闭式胸膜活检发生1例胸膜反应,并发症发生率为2.0%,常规、生化、细胞学检查及闭式胸膜活检并发症发生率比较,差异无统计学意义(χ2=1.010, P>0.05)。结论胸腔积液患者接受闭式胸膜活检的诊断效果比较理想,临床操作简单,安全可靠,检出率较高,值得推广使用。
Objective To study and analyze the value of closed pleural biopsy in etiological diagnosis of pleural effusion. Methods A total of 50 patients with unexplained pleural effusion underwent routine, biochemical, cytological and closed pleural biopsy, and pathological examination. The results of pathological examination were observed, and results routine, biochemical, cytological examination and closed pleural biopsy, and occurrence of complications of routine, biochemical, cytological examination and closed pleural biopsy were compared. Results Pathological examination showed that 5 cases(10.0%) could not identify the cause, 27 cases(54.0%) were diagnosed as tuberculous pleural effusion, and 18 cases(36.0%) were diagnosed as malignant pleural effusion. Routine, biochemical and cytological examination showed that all cases were exudative pleural effusion. There were 27 cases(54.0%) could not identify the etiology, 13 cases(26.0%) were diagnosed as tuberculous pleural effusion and 10 cases(20.0%) were diagnosed as malignant pleural effusion, with detection rate as 46.0%. Closed pleural biopsy showed that 16 cases(32.0%) could not identify the cause, 19 cases(38.0%) were diagnosed as tuberculous pleural effusion, 15 cases(30.0%) were diagnosed as malignant pleural effusion, with detection rate as 68.0%. The detection rate of closed pleural biopsy was higher than that of routine, biochemical and cytological examinations, and the difference was statistically significant(χ2=4.937, P<0.05). There were no complications in routine, biochemical and cytological examinations. 1 case had pleural reaction in closed pleural biopsy, with incidence of complications as 2.0%. There was no significant difference in the incidence of complications between routine, biochemical, cytological examinations and closed pleural biopsy(χ2=1.010, P>0.05). Conclusion Closed pleural biopsy shows ideal diagnostic effect for patients with pleural effusion with simple clinical operation. It is safety and reliability with high detection rate. It is worth popularizing and using.
Objective To study and analyze the value of closed pleural biopsy in etiological diagnosis of pleural effusion. Methods A total of 50 patients with unexplained pleural effusion underwent routine, biochemical, cytological and closed pleural biopsy, and pathological examination. The results of pathological examination were observed, and results routine, biochemical, cytological examination and closed pleural biopsy, and occurrence of complications of routine, biochemical, cytological examination and closed pleural biopsy were compared. Results Pathological examination showed that 5 cases(10.0%) could not identify the cause, 27 cases(54.0%) were diagnosed as tuberculous pleural effusion, and 18 cases(36.0%) were diagnosed as malignant pleural effusion. Routine, biochemical and cytological examination showed that all cases were exudative pleural effusion. There were 27 cases(54.0%) could not identify the etiology, 13 cases(26.0%) were diagnosed as tuberculous pleural effusion and 10 cases(20.0%) were diagnosed as malignant pleural effusion, with detection rate as 46.0%. Closed pleural biopsy showed that 16 cases(32.0%) could not identify the cause, 19 cases(38.0%) were diagnosed as tuberculous pleural effusion, 15 cases(30.0%) were diagnosed as malignant pleural effusion, with detection rate as 68.0%. The detection rate of closed pleural biopsy was higher than that of routine, biochemical and cytological examinations, and the difference was statistically significant(χ2=4.937, P<0.05). There were no complications in routine, biochemical and cytological examinations. 1 case had pleural reaction in closed pleural biopsy, with incidence of complications as 2.0%. There was no significant difference in the incidence of complications between routine, biochemical, cytological examinations and closed pleural biopsy(χ2=1.010, P>0.05). Conclusion Closed pleural biopsy shows ideal diagnostic effect for patients with pleural effusion with simple clinical operation. It is safety and reliability with high detection rate. It is worth popularizing and using.
引文
[1]谢强,陈群,钟爱虹,等.可弯曲电子内科胸腔镜在老年恶性胸腔积液诊断中的应用.实用老年医学, 2014, 28(2):168-170.
[2]劳程强,吴和波,张静珊,等. B超引导经皮胸膜穿刺活检对老年胸腔积液的诊断价值.深圳中西医结合杂志, 2014, 24(1):108-109.
[3]黄文侨,陈旭君,舒逸,等. CT介导经皮闭式Cope针刺胸膜活检对渗出性胸腔积液诊断价值的分析.内科理论与实践, 2014,9(4):280-281.
[4]徐智,林科雄,姚伟,等.内科胸腔镜对548例不明病因胸腔积液的诊断价值.第三军医大学学报, 2014, 36(21):2211-2215.
[5]林诗杰.胸腔积液行闭式胸膜活检32例临床分析.中国医学工程, 2013, 21(7):87.
[6]邓治平,杨莹,吴小玲,等.电子支气管镜胸膜活检联合壁层胸膜冷冻活检对渗出性胸腔积液的诊断价值.中国呼吸与危重监护杂志, 2013, 12(4):390-393.
[7]王作飞,王传兵,石银龙,等.可曲式内科胸腔镜在不明原因胸腔积液诊断中的应用价值.江苏医药, 2015, 41(2):228-229.
[8]况里杉,张孝彬,廖秀清.内科胸腔镜与经皮穿刺胸膜盲检对渗出性胸腔积液诊断价值的对比研究.海南医学, 2014, 25(1):21-23.
[9]党焱,朱波,李敏,等.内科胸腔镜诊断胸腔积液160例临床分析.临床肺科杂志, 2015, 20(10):1794-1797.
[2]劳程强,吴和波,张静珊,等. B超引导经皮胸膜穿刺活检对老年胸腔积液的诊断价值.深圳中西医结合杂志, 2014, 24(1):108-109.
[3]黄文侨,陈旭君,舒逸,等. CT介导经皮闭式Cope针刺胸膜活检对渗出性胸腔积液诊断价值的分析.内科理论与实践, 2014,9(4):280-281.
[4]徐智,林科雄,姚伟,等.内科胸腔镜对548例不明病因胸腔积液的诊断价值.第三军医大学学报, 2014, 36(21):2211-2215.
[5]林诗杰.胸腔积液行闭式胸膜活检32例临床分析.中国医学工程, 2013, 21(7):87.
[6]邓治平,杨莹,吴小玲,等.电子支气管镜胸膜活检联合壁层胸膜冷冻活检对渗出性胸腔积液的诊断价值.中国呼吸与危重监护杂志, 2013, 12(4):390-393.
[7]王作飞,王传兵,石银龙,等.可曲式内科胸腔镜在不明原因胸腔积液诊断中的应用价值.江苏医药, 2015, 41(2):228-229.
[8]况里杉,张孝彬,廖秀清.内科胸腔镜与经皮穿刺胸膜盲检对渗出性胸腔积液诊断价值的对比研究.海南医学, 2014, 25(1):21-23.
[9]党焱,朱波,李敏,等.内科胸腔镜诊断胸腔积液160例临床分析.临床肺科杂志, 2015, 20(10):1794-1797.