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目的 探讨内科胸腔镜检查对疑难胸膜疾病的诊断检查和胸腔镜检操作关键。方法 回顾性分析 91例内科胸腔镜检查诊断胸膜疾病的病例资料 ,总结病因组成和并发症。结果 91例胸膜疾病患者 ,男性 73例 ,女性 18例 ,胸腔积液 71例 ,自发性气胸 2 0例。胸腔积液病因 :恶性肿瘤 39例 ,结核 15例 ,慢性炎症 14例 ;气胸病因 :肺大疱 6例 ;胸膜粘连 3例 ;肺破裂 1例 ;无原因者 8例。并发症以发热多见 ,无与胸腔镜检查相关的死亡。结论 该院胸腔镜诊断的胸腔积液以恶性肿瘤最常见 ,其次为结核。难治性气胸首要病因为肺大疱。对胸液分析、细胞学检查和闭式胸膜活检不能确诊的胸膜疾病有必要考虑内科胸腔镜检查
Objective To investigate the key points of medical thoracoscopy in the diagnosis and diagnosis of difficult pleural diseases. Methods A retrospective analysis of 91 cases of medical thoracoscopy diagnosis of pleural disease cases, summarize the causes and complications. Results 91 patients with pleural disease, 73 males, 18 females, 71 cases of pleural effusion, 20 cases of spontaneous pneumothorax. Pleural effusion causes: 39 cases of malignant tumors, 15 cases of tuberculosis, chronic inflammation in 14 cases; pneumothorax causes: bullae in 6 cases; pleural adhesions in 3 cases; lung rupture in 1 case; no reason in 8 cases. Complications to fever more common, no death associated with thoracoscopy. Conclusions The pleural effusion diagnosed by thoracoscope is the most common malignant tumor, followed by tuberculosis. The primary cause of refractory pneumothorax is bullae. Pleural fluid analysis, cytology and closed pleural biopsy can not be diagnosed with pleural disease is necessary to consider medical thoracoscopy