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目的 :探讨经皮胸膜活检对难治性胸腔积液的诊断价值。方法 :对常规检查未能确诊 ,经抗感染或抗结核治疗 2周超声检查胸腔积液厚度≥ 4cm ,且病因不明的 74例难治性胸腔积液经皮胸膜活检。结果 :4 0岁以上组 4 4例中恶性肿瘤 32例占 72 73% ,4 0岁以下组 30例中结核性胸腔积液 18例占 6 0 % ;草黄色胸水 34例中恶性肿瘤 9例占 2 6 4 7% ,血性胸水 32例中恶性肿瘤 2 6例占81 2 5 %。结论 :采用Cope胸膜活检针一次以 4个方位分别切取组织同时送检 ,防止钳夹标本 ,明显提高活检阳性率。与胸腔镜和开胸活检相比 ,经皮胸膜活检具有操作简便、安全和创伤小等优点 ,值得临床推广。
Objective: To investigate the diagnostic value of percutaneous pleural biopsy for refractory pleural effusion. Methods: The conventional examination failed to diagnose, anti-infective or anti-TB treatment of 2 weeks ultrasound examination of pleural effusion thickness ≥ 4cm, and the etiology of 74 cases of refractory pleural effusion percutaneous pleural biopsy. Results: Forty-four (44%) cases of malignant tumors accounted for 72.73% of the cases in the group of 40 years old, 18 cases of tuberculous pleural effusion (30%) in the group of 40 years old and 60 cases of grass yellow pleural effusion Accounting for 2647%, 32 cases of malignant tumors in 32 cases of bloody pleural effusion, 26 cases accounted for 81 2 5%. Conclusion: The Cope pleural biopsy needle was used to cut the tissue in 4 directions at the same time to prevent the clamp specimen from being marked, which obviously improved the positive rate of biopsy. Compared with thoracoscopy and thoracotomy biopsy, percutaneous pleural biopsy with the advantages of simple, safe and less invasive, worthy of clinical promotion.