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中国癌症防治杂志

中国癌症防治杂志

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经内科胸腔镜多部位胸膜钳夹对恶性胸腔积液的诊治价值

达春和;边雨田;冯双成;刘丽君;李磊;张衡中;   

  1. 甘肃省兰州大学附属白银医院;
  • 收稿日期:2009-09-25 修回日期:2009-09-25 出版日期:2009-09-25 发布日期:2009-09-25

Diagnostic and therapeutical value of using multi-situs forceps cliping thoracoscopy for malignant pleural effusion

DA Chun-he,BIAN Yu-tian,FENG Shuang-cheng,et al.   

  1. (Department of Respiratory Diseases,Affiliated Hospital of Lanzhou University,Baiyin Gansu 730900,China
  • Received:2009-09-25 Revised:2009-09-25 Online:2009-09-25 Published:2009-09-25

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被引次数

1

摘要： 目的探讨经内科胸腔镜多部位胸膜钳夹对恶性胸腔积液的诊治价值。方法对31例恶性胸腔积液患者实施胸腔镜检查,并经内科胸腔镜多部位胸膜钳夹,术后置胸腔闭式引流管,接闭式引流瓶,引流3d拔管,与常规抽胸水检查方法比较阳性率、诊断率,观察胸膜固定疗效及不良反应。结果①常规方法阳性率71.0%,诊断率35.5%,确诊率19.4%,而胸腔镜阳性率、诊断率、确诊率均为100%,两种方法比较差异有统计学意义(P<0.01)。②31例恶性胸腔积液患者经治疗后完全缓解(CR)21例,部分缓解(PR)5例,稳定(SD)2例,无效(PD)4例,完全缓解率67.7%,总有效率83.9%,4例出现胸水复发,复发率19.0%,无持久性疼痛、大出血、心律失常和气胸等并发症发生。结论经内科胸腔镜多部位胸膜钳夹不仅能准确诊断恶性胸膜疾病,还能有效治疗恶性胸腔积液,具有操作简单、安全性高、病人易接受、检查与治疗一次完成的优势,可作为恶性胸腔积液的初始治疗方法。

关键词: 内科胸腔镜, 恶性胸腔积液, 多部位胸膜钳夹

Abstract: Objective To explore the therapeutical effect of medical thoracoscope in diagnosing and treating malignant pleural effusion by using forceps cliping on multi-situs pleura.Methods Multi-situs forceps cliping were performed in 31 patients with malignant pleural effusion.After examination,closed drainage remaining for 3 days and were extubated at the fourth day.The diagnostic rate,curative effect and adverse reaction were compared to the group treated with routine methods.Results In routine methods group,the positive rate,diagnostic rate and final diagnosis rate were 71.0%,35.5% and 19.4% respectively,while all of these three rates were 100% in thoracoscopy group,and the differences between the two groups were significant(P<0.01).Among the 31 patients,21 were complete remission,5 were partial remission,2 were stable and 4 were ineffective.Complete remission rate was 67.7%,and total effective rate was 83.9%.4 cases with pleural effusion recurrence,and the recurrence rate was 19.0%.Complications such as permanence pain,hemorrhage,arrhythmia and pneumothorax did not occur.Conclusions Medical thoracoscope not only has accurate diagnostic value but also has effective treatment effect for malignant pleural effusion.It has superiorities as simple operation,high safety,acceptance by patients,and the examination and therapy are performed simultaneously.Therefore the medical thoracoscopy can be widely applied as a primary treatment for malignant pleural effusion.

Key words: Medical thoracoscope, Malignant pleural effusion, Multi-situs pleura forceps cliping