可弯曲内科胸腔镜在恶性胸腔积液中的诊断价值 - tumor - 肿瘤.PDF

肿瘤2011年2月第31卷第2期 Tumor Vol. 31, February, 2011 145 DOI:10.3781/j .issn.1000-7431.2011.02 .011 Clinical Research ·临床研究 可弯 曲内科胸腔镜在恶性胸腔积液 中的诊断价值 顾建庆，韩宝惠 上海交通大学附属胸科医院呼吸内科，上海 200030 [摘要]  目的：评估可弯曲内科胸腔镜在恶性胸腔积液诊断中的应用价值。方法：对2007年10 月－20 10年6 月的 32例恶性胸腔积液患者行可弯曲内科胸腔镜检查的结果进行回顾性分析。所有患者在行内科胸腔镜检查前，其胸 腔积液常规、生化、微生物学及细胞学等实验室检查均未能明确病因。结果：32例恶性胸腔积液患者中肺癌2 8例 （腺癌22例、低分化癌6例），淋巴瘤2例，恶性胸膜间皮瘤2例。术后发热1例，未发生其他严重不良事件。 结 论：可弯曲内科胸腔镜是一种操作简便、安全而有效的诊断方法。对经其他常规检查无法明确诊断，且临床不能 排除恶性胸腔积液时，应及时行内科胸腔镜检查以明确诊断。 [关键词]  胸腔积液，恶性；胸腔镜检查；活组织检查；诊断 [中图分类号]  R730.49           [文献标志码]  A              [文章编号]  1000-743 1 （20 11）02-0 145-03 Application of flexirigid thoracoscopy in the diagnosis of malignant pleural effusion GU J ian-qing, HAN Bao-hui Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai J iaotong University , Shanghai 200030, China [A BSTRACT] Objective: To investigate the diagnostic value of flexirigid thoracoscopy in patients w ith malignant pleural effusion. Methods: From October 2007 to J une 20 10, 32 pat ients w it h malignant pleural effusion were retrospectively rev iewed. In these patients, the routine, biochemistry , microbiology and cytology laboratory tests all failed to make the diagnosis. T hen these patients received flexirigid thoracoscopy and the diagnosis of cause was identified. Results: In thirty-two patients w ith malignant pleural effusion, twenty-eight were diagnosed as hav ing lung cancer (twenty-two had adenocarcinoma and six had poorly differentiated carcinoma), two were diagnosed as hav ing ly mphoma, and two were diagnosed as hav ing malignant pleuralmesothelioma. No other serious adverse events occurred except for one case w ith postoperative fever. Conclusion: Flexirigid thoracoscopy is a simple, safe and effective clinical technique in the diagnosis of malignant pleural effusion. W hen the routine examinations