Objective To discuss the efficacy of fiberoptic bronchoscopy, instead of thoracoscopy, for the diagnosis and management of malignant pleural effusion. Methods During 2002 to 2010, under ECG and blood oxygen monitoring, and local anesthesia, we explored the pleural cavity in 26 patients with malignant pleural effusion by fiberoptic bronchoscopy. Biopsy of the lesions, tumor debulking, as well as talc pleurodesis were carried out in the patients. Results The diagnosis rate was 84. 6% (22/26) , 22 of the patients were diagnosed with malignancy. Biopsy was failed in one patient because the pleural was too tense. In three patients, pleural biopsy found no tumor cells. CR was achieved in 16 cases, while PR in 9 (the lung could be completely re-expanded) , and PD in the other one (lung re-expansion failed). The effective rate ( CR + PR) was 96. 2% (25/26). Conclusions Fiberoptic bronchoscopy can be used to replace thoracoscopy for pleural biopsy and talc pleurodesis. It is effective in diagnosing and managing malignant pleural effusion with a low risk and high diagnosis rate.%目的 探讨纤维支气管镜代胸腔镜在恶性胸腔积液的诊断和治疗中的作用. 方法 2002 ～2010年,对26例恶性胸腔积液在血氧监护、局部麻醉下置入纤维支气管镜探查胸膜腔,并以活检钳行病变活检,肿瘤减灭,滑石粉胸膜固定.结果 病理确诊率84.6％ (22/26),诊断恶性22例,1例因胸膜坚韧无法活检,3例胸膜活检未见肿瘤细胞.胸水控制完全缓解(CR) 16例,部分缓解(PR)9例(肺不能完全复张),疾病进展(PD)1例(肺不能复张).CR +PR共25例,有效率96.2％.结论 纤维支气管镜代胸腔镜行胸膜活检及胸膜腔滑石粉固定,手术风险小,诊断率及治疗有效率高,在恶性胸腔积液的诊断和治疗中具有很高的临床价值.
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