内科胸腔镜在老年人不明原因胸腔积液中的诊断价值及安全性

发布时间：2018-03-09 19:16

本文选题：内科胸腔镜　切入点：胸腔积液　出处：《中国老年学杂志》2014年21期 　论文类型：期刊论文

【摘要】：目的评价内科胸腔镜诊断老年人不明原因渗出性胸腔积液的诊断价值及安全性。方法选取2012年7月至2014年5月该院收治的66例胸腔积液患者,应用内科胸腔镜进行检查,术中对可疑病变部位进行直视下多点活检,明确胸腔积液的成因,比较镜下表现与病理结果的相关性,观察手术的安全性及术后并发症,进一步评价手术的安全性。结果经病理确诊61例,确诊率为92.42%,其中恶性肿瘤37例(56.06%),包括转移性腺癌27例(40.91%),鳞癌4例(6.06%),小细胞癌2例(3.03%),恶性胸膜间皮瘤4例(6.06%);结核性胸膜炎18例(27.27%),化脓性感染4例(6.06%),非特异性慢性炎症2例(3.03%);病因不明5例(7.58%)。术后并发症为发热2例(3.03%),急性肺水肿1例(1.51%),经治疗后均痊愈,其他病例均未发生严重并发症。结论内科胸腔镜检查对老年人不明原因渗出性胸腔积液诊断阳性率高、简单、安全、微创、有效、并发症发生率低,可作为临床常规诊断手段进行推广。
[Abstract]:Objective to evaluate the diagnostic value and safety of thoracoscopy in elderly patients with effusion of unknown origin. Methods 66 patients with pleural effusion from July 2012 to May 2014 were selected and examined by thoracoscopy. In order to determine the causes of pleural effusion, the safety and complications of operation were observed by comparing the pathological findings with the pathological findings. Results 61 cases were confirmed by pathology. The diagnosis rate was 92.42. 37 cases of malignant tumor were diagnosed as follows: 27 cases of metastatic adenocarcinoma, 4 cases of squamous cell carcinoma, 2 cases of small cell carcinoma, 3 cases of small cell carcinoma, 4 cases of malignant pleural mesothelioma, 27 cases of tuberculous pleurisy, 4 cases of suppurative infection, 6 cases of nonspecific chronic inflammation, and 6 cases of non specific chronic inflammation, including 27 cases of malignant tumor and 56.06% of malignant tumor, including 27 cases of metastatic adenocarcinoma, 4 cases of squamous cell carcinoma, 2 cases of small cell carcinoma, 2 cases of small cell carcinoma, 2 cases of small cell carcinoma and 4 cases of malignant pleural mesothelioma. The complications were fever in 2 cases, acute pulmonary edema in 1 case, and acute pulmonary edema in 1 case. Conclusion the positive rate of internal thoracoscopy in the diagnosis of exudative pleural effusion of unknown causes in the elderly is high, simple, safe, minimally invasive, effective, and the incidence of complications is low. It can be popularized as a routine diagnostic method in clinic.
【作者单位】：陕西省人民医院呼吸内一科;陕西省人民医院胸外科;
【基金】：陕西省自然科学基础研究计划项目(2012JM4009)
【分类号】：R561.3

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