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目的:探讨胸膜活检对胸腔积液病因诊断的价值。方法:对127例胸腔积液患者行首次胸膜活检术。结果:127例患者获取胸膜组织125例,穿刺成功率98.4%,经病理检查有41例为正常胸膜组织,特异性病理诊断84例,病理诊断阳性率(67.2%)。恶性胸腔积液胸膜活检阳性38例(45.2%),结核性胸腔积液胸膜活检阳性31例(36.9%),非特异性炎15例(17.9%)。38例恶性肿瘤经免疫组织化学和特殊染色分类,腺癌27例,小细胞肺癌2例,鳞癌2例,恶性间皮瘤2例,转移癌3例,淋巴瘤1例,未分化癌1例。发生并发症者4例(3.1%),全部为气胸,肺压缩均小于15%,未做特殊处理数日后自行吸收。结论:胸膜活检是一项安全、简单、有效的胸膜疾病的重要的内科确诊手段。
Objective: To investigate the value of pleural biopsy in the diagnosis of pleural effusion. Methods: The first pleural biopsy was performed in 127 patients with pleural effusion. Results: 127 cases of pleural tissue obtained in 125 cases, the puncture success rate was 98.4%. The pathological examination of 41 cases of normal pleural tissue, 84 cases of specific pathological diagnosis, the positive rate of pathological diagnosis (67.2%). Pleural effusion malignant pleural biopsy was positive in 38 cases (45.2%), tuberculous pleural effusion pleural biopsy positive in 31 cases (36.9%), non-specific inflammation in 15 cases (17.9%). 38 cases of malignant tumor by immunohistochemistry and special staining classification, adenocarcinoma in 27 cases, 2 cases of small cell lung cancer, squamous cell carcinoma in 2 cases, 2 cases of malignant mesothelioma, metastatic carcinoma in 3 cases, 1 case of lymphoma, undifferentiated carcinoma 1 example. Complications occurred in 4 cases (3.1%), all of the pneumothorax, pulmonary compression were less than 15%, without special treatment after several days of self-absorption. Conclusion: pleural biopsy is a safe, simple and effective pleural disease, an important medical diagnosis.