胸腔镜下胸膜活检在良恶性胸腔积液诊断中的价值

摘要

Objective To evaluate the diagnosis value of thoracoscopic pleural biopsy for benign and malignant pleural effusion.Methods Sixty cases of benign and malignant pleural effusion diagnosed in Xi′an high tech hospital from July 2014 to Jan.2015 were analyzed retrospectively.Among them, 30 cases of pleural biopsy were observation group, and 30 cases of the control group were guided by color Doppler ultra-sound.Compare the drawn success rate, active organization size, pathologic positive rate and the occurrence of post-test of the two groups of patients and analyze its security complications .Results Drawn from the ob-servation group was significantly higher success rate [100.0% (30/30) vs 80.0% (24/30)], the differ-ence was statistically significant ( P<0.05 ); the diameter of the living tissue in the observation group was significantly lower than the control group [(3.16 ±0.16) mm vs (1.83 ±0.25) mm](P<0.05);the pos-itive rate of pathological observation group was significantly lower than control group [ 73.3% ( 22/30 ) vs 91.67% (22/24)], the difference was statistically significant (P<0.05).Two groups of patients the inci-dence of complications was no significant difference (P>0.05).Conclusion The sampling success rate of pleural biopsy was high and the adverse reaction rate is low and safe.It has good diagnostic value and worth popularizing and applying.%目的：探讨胸腔镜下胸膜活检在良恶性胸腔积液诊断中的应用价值。方法回顾性分析2014年1月至2015年7月西安高新医院接受诊断的良恶性胸腔积液患者60例，其中胸腔镜下胸膜活检患者30例为观察组，彩色多普勒超声引导下闭式胸膜活检为30例为对照组。统计两组患者的取材成功率，活性组织大小，病理阳性率，及检测后并发症的发生情况以及检测安全性。结果观察组取材成功率显著高于对照组[100.0％（30／30）比80.0％（24／30）]，差异有统计学意义（ P ＜0.05）；观察组患者活性组织直径显著大于对照组[（3．16±0．16） mm 比（1．83±0．25） mm]（P ＜0.05）；观察组患者病理阳性率显著低于对照组[73.3％（22／30）比91．7％（22／24）]，差异有统计学意义（P＜0.05）；两组患者并发症发生率比较差异无统计学意义（P＞0．05）。结论通过胸腔镜下胸膜活检取样成功率高，不良反应率低且安全性良好，具有良好的诊断价值，值得推广以及应用。