摘要
目的了解内科胸腔镜在胸膜间皮瘤诊断和治疗中的价值。方法21例胸膜间皮瘤患者,男17例,女4例,平均(62±12)岁。所有患者连续3次行胸水细胞学及经皮胸膜活检后实施内科胸腔镜。弥漫性胸膜间皮瘤患者胸腔镜术后行胸膜粘连术。观察对比3种方法的病理诊断阳性率、并发症及利用胸腔镜行胸膜粘连术的疗效。结果胸水细胞学、胸膜活检及胸腔镜3种检查方法在胸膜间皮瘤中的诊断阳性率分别为14.3%(3/21)、57.4%(12/21)和100.0%(21/21),两两对比均P<0.05,差异有显著性。胸膜活检和胸腔镜检查的并发症的发生率分别为19.0%(4/21)和28.6%(6/21),胸腔镜检查并发症的发生率稍高,P>0.05,差异无显著性。19例患者行胸膜粘连术,12例注入顺铂,7例使用博莱霉素,总有效率达84.2%(16/19);半年的复发率为31.3%。结论内科胸腔镜操作简单安全,在胸膜间皮瘤的诊断中阳性率高,具有诊断治疗一次进行的优点,是胸膜间皮瘤诊治的首选方法。
To evaluate medical thoracoscopy in the diagnosis and treatment of pleural mesothelioma. Twenty-one patients with pleural mesothelioma were studied, 17 male and 4 female, with a mean age of (62±12) years. All were brought into medical thoracoscopy after three consecutive pleurorrhea cytology and percutaneous pleural biopsy. The patients with diffuse pleural mesotheloima underwent pleurodesis after thoracoscopy. The diagnostic yield of all three techniques compared, complications and the effect of pleurodesis were compared. The diagnostic yield of pleurorrhea cytology, percutaneous pleural biopsy and thoracoscopy were 14.3%(3/12), 57.4%(12/21) and 100.0% (21/21) respectively. A statistical significance was found when any two were compared (P <0.05). There was no significant difference between the complication rates of pleural biopsy and thoracoscopy. Nineteen patients were treated by pleurodesis, twelve cases were injected with cisplatin, and seven cases were given bleomycin. The total effective rate was 84.2% (16/19) and the recurrence rate in six months was 31.3%. [Conclusion] Medical thoracoscopy is a simple and safe technique with a high positive rate in the diagnosis of pleural mesothlioma. In addition, it can used to diagnose and treat pleural mesothelioma at the same time. It is the primary remedy for this disease.
出处
《中国内镜杂志》
CSCD
北大核心
2005年第1期30-32,共3页
China Journal of Endoscopy
关键词
胸腔镜术
间皮瘤
胸膜
thoracoscopy
mesothelioma
pleural
