内科胸腔镜对老年胸腔积液患者的诊断价值

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1、内科胸腔镜对老年胸腔积液患者的诊断价值【摘要】0的探讨内科胸腔镜对老年胸腔积液患者的诊断价值和安全性。方法90例不明原因胸腔积液患者行内科胸腔镜检查，观察镜下病变形态和病理结果。结果90例患者中有80例确诊，诊断总阳性率为88.9%,46例恶性胸腔积液，确诊45例，确诊率为97.8%。37例结核性胸腔积液，确诊35例，确诊率为94.6%。肿瘤患者45例，结核患者35例，两组患者的平均年龄、病程及吸烟史差异无统计学意义（P〉0.05）,结核患者的腺苷脱氨酶（adenosinedeaminase,ADA）显著高于肿瘤患者（P〈0.001）;而肿瘤

2、患者血清及胸水癌胚抗原（carcinoembryonieantigen,CEA）显著高于结核患者（K0.001）。7例诊断为非特异性炎症改变。所冇患者均顺利完成胸腔镜检查，并发症少。结论内科胸腔镜对于老年胸腔积液诊断阳性率高，安全性好。【关键词】内科胸腔镜；胸腔积液；诊断中图分类号：R561文献标识码：ADOI:10.3969/j.issn.10031383.2017.01.015Valueofmedicalthoracoscopyindiagnosisofelderlypatientswithpleuraleffusion[HJ2][HJ]

3、QINShujuan,TANTaiying(DepartmentofRespiratoryDisease,TheEighthAffiliatedHospitalofGuangxiMedicalUniversity—GuigangPeople'sHospital,Guigang537100,China)[HJ2][HJ][Abstract]ObjcctivcToinvestigatediagnosticvalueandsafetyofmedicalthoracoscopyforelderlypatientswithpleuraleffusion

4、.Methods%elderlypatientswithpleuraleffusion,whosecauseswerestillunknown,wereselectedtobediagnosedbythemedicalthoracoscopy,andtheshapeoflesionsandpathologicalresultsunderscopewereobserved.ResultsOfthese90elderlypatients,80caseshaddefinitediagnosis(positiveratewas88.9%).Ofthe

5、se46caseswithmalignantpleuralfluid,45caseshaddefineddiagnosis(positiveratewas97.8%).Ofthese37tuberculosiscases,35caseshaddefineddiagnosis(positiveratewas94.6%).45patientswithtumorand35patientswithtuberculosiswereconfirmed，anddifferenceofmeanage,courseofdiseaseandsmokinghist

6、oryofthetwogroupswasnotstatisticallysignificant(P>0.05).Adenosinedeaminase(ADA)ofthetuberculosispatientswassignificantlyhigherthanthatofpatientswithcancer(P<0.001)，whilescrumandpleuralfluidcarcinoembryonieantigen(CEA)ofthepatientswithcancerweresignificantlyhigherthanthoseof

7、thetuberculosispatients（P〈0.001）.Inaddition，7caseswerediagnosedwithnonspecificinflammatorychanges.Allpatientssuccessfullyfinishedthoracoscopyandhadfewcomplications.ConelusionMedicalthoracoscopypossesseshighpositivediagnosticrateandsafetyforelderlypatientswithpleuraleffusion

8、.[Keywords]medicalthoracoscopy；pleuraleffusion；diagnosis?瓤菩厍痪凳墙?年来开展应用的一项微创检查yy法，其