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目的探讨纤维支气管镜代胸腔镜检查术对胸腔积液病因诊断的应用价值。方法回顾性总结187例经常规检查未明确病因的胸腔积液患者接受经纤维支气管镜代胸腔镜检查术资料。结果 187例胸腔积液患者中,171例明确病因,确诊率91.4%。其中,胸膜转移性腺癌61例(32.6%),转移性鳞癌4例(2.1%),恶性肿瘤未分型14例(7.5%),胸膜间皮瘤20例(10.7%),结核性胸膜炎53例(28.3%),非特异性胸膜炎15例(8.0%),化脓性胸膜炎2例(1.1%),尿毒症性胸水2例(1.1%),原因未明16例(8.6%)。无一例出现严重并发症。结论纤维支气管镜代胸腔镜用于胸腔积液的病因诊断为一种安全、有效、诊断率高的检查方法。
Objective To investigate the value of thoracoscope assisted by fibrobronchoscopy in the diagnosis of pleural effusion. Methods A retrospective review of 187 patients with pleural effusion underwent routine bronchoscopy without pleiotropic etiology received thoracoscopy. Results Of the 187 cases of pleural effusion, 171 cases had a definite etiology and the diagnosis rate was 91.4%. Among them, pleural metastatic adenocarcinoma in 61 cases (32.6%), metastatic squamous cell carcinoma in 4 cases (2.1%), malignant tumor in 14 cases (7.5%), pleural mesothelioma in 20 cases (10.7%), tuberculous pleurisy 53 cases (28.3%), 15 cases of non-specific pleurisy (8.0%), 2 cases of suppurative pleurisy (1.1%) and 2 cases of uremic pleural effusion (1.1%). No case of serious complications. Conclusion The diagnosis of pleural effusion by thoracoscope with fiberoptic bronchoscopy is a safe, effective and diagnostic method.