可弯曲胸腔镜和硬质胸腔镜诊断不明原因胸腔积液的对比临床研究

发布时间：2018-12-10 19:54

【摘要】：目的对比可弯曲胸腔镜和硬质胸腔镜在不明原因胸腔积液诊断中的准确性和安全性。方法采用前瞻性随机对照研究,连续筛选四川大学华西医院2012年3月至2014年3月期间不明原因胸腔积液住院患者,患者年龄18~75岁。经知情同意后,患者随机进入可弯曲胸腔镜组或硬质胸腔镜组进行检查。结果可弯曲胸腔镜组入组49例患者,硬质胸腔镜组入组48例患者。两组共有44例患者通过胸腔镜检查确诊为恶性疾病,48例确诊为良性疾病。两组诊断不明原因胸腔积液总体准确性分别为93.9%和95.8%,可弯曲胸腔镜组诊断肿瘤的敏感性为96.0%,硬质胸腔镜组诊断肿瘤的敏感性为95.2%,两组诊断肿瘤的特异性均为100.0%,两组之间差异无统计学意义。两种胸腔镜技术并发症多数轻微,患者均耐受良好。结论对于不明原因胸腔积液,可弯曲胸腔镜诊断的准确性与硬质胸腔镜相当。尽管可弯曲胸腔镜取材组织小,但是通过多点多次取材,所获得的组织标本能满足病理科医生进行包括免疫组织化学检测在内的疾病诊断。
[Abstract]:Objective to compare the accuracy and safety of bendable thoracoscopy and rigid thoracoscopy in the diagnosis of unexplained pleural effusion. Methods prospective randomized controlled study was used to screen consecutive inpatients with unexplained pleural effusion aged 1875 years from March 2012 to March 2014 in Huaxi Hospital of Sichuan University. After informed consent, the patients were randomly assigned to the bendable or rigid thoracoscopic group. Results 49 patients in the flexible thoracoscopy group and 48 patients in the rigid thoracoscopy group. A total of 44 patients in both groups were diagnosed as malignant diseases and 48 benign diseases by thoracoscopy. The overall accuracy of the two groups in the diagnosis of pleural effusion of unknown cause was 93.9% and 95.8.The sensitivity of the flexible thoracoscopic group was 96.0 and that of the rigid thoracoscopic group was 95.2%. The specificity of diagnosis of tumor in the two groups was 100.0 and there was no significant difference between the two groups. Most of the complications of the two thoracoscopic techniques were mild and the patients were well tolerated. Conclusion for unexplained pleural effusion, the diagnostic accuracy of bendable thoracoscopy is equivalent to that of rigid thoracoscopy. Although the bendable thoracoscopic tissue is small, the tissue samples obtained by multiple points and multiple times can meet the needs of pathologists for the diagnosis of diseases, including immunohistochemical detection.
【作者单位】：四川大学华西医院呼吸与危重症医学科;
【基金】：四川省科技厅科技支撑计划项目(编号:2013SZ0001)
【分类号】：R561.3

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