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目的观察改良中心静脉导管辅助超声引导胸膜活检术在胸膜病变的阳性率和安全性。方法对我院自2006～2010年诊断为胸膜疾病并行针刺胸膜活检102例患者的临床资料进行回顾性分析。结果 102例胸膜活检中提示结核性胸膜炎34例(30.8%)、慢性炎症18例(20.8%)、腺癌21例(18.1%)、鳞癌9例(8.0%)、小细胞癌4例(3.4%)、不明部位的转移癌5例(4.4%)、间皮瘤5例(4.4%),骨骼肌组织和纤维脂肪组织11例(10.1%),胸膜活检恶性阳性率33.8%,胸水脱落细胞阳性率为29.4%,总病理确诊率为86.7%,术后并发症主要是气胸3例(4.4%),胸膜反应2例(2.9%),出血l例(1.4%)。结论在胸膜疾病中超声定位针刺胸膜活检是一种有效的诊断手段,阳性率高,致命并发症极少。
Objective To observe the positive rate and safety of modified central venous catheter-assisted ultrasound guided pleural biopsy in pleural disease. Methods The clinical data of 102 cases of pleural biopsy in our hospital from 2006 to 2010 were retrospectively analyzed. Results Pleural biopsy in 102 cases showed tuberculous pleurisy in 34 cases (30.8%), chronic inflammation in 18 cases (20.8%), adenocarcinoma in 21 cases (18.1%), squamous cell carcinoma in 9 cases (8.0%) and small cell carcinoma in 4 cases 3.4%), 5 cases (4.4%) of unknown metastases, 5 cases of mesothelioma (4.4%), 11 cases of skeletal muscle tissue and fibrous adipose tissue (10.1%), the positive rate of pleural biopsy was 33.8% The positive rate of cells was 29.4%, the total pathological diagnosis rate was 86.7%. The main complications were 3 cases of pneumothorax (4.4%), 2 cases of pleural reaction (2.9%) and 1 case of bleeding (1.4%). Conclusion Ultrasound-guided pleurodesis in pleural disease is an effective diagnostic method with high positive rate and rare fatal complications.