内科胸腔镜治疗结核性胸膜炎的意义*

Clinical significance of thoracoscopy in treatment of tuberculous pleurisy*

摘要:

分析内科胸腔镜治疗结核性胸膜炎的临床意义。方法?收集该院40例诊断为结核性胸膜炎的患者，其中由内科胸腔镜下确诊结核性胸膜炎患者为20例，纳为治疗组；由常规胸腔穿刺后通过胸水化验、结核菌素试验而临床诊断为结核性胸膜炎患者20例，纳为对照组；两组诊断后均给予了相同抗结核方案治疗。计算两组患者住院天数，统计治疗组、对照组住院期间共行的胸腔穿刺数；测量两组患者治疗12个月后的胸部CT上胸膜肥厚度。结果?治疗组和对照组的平均住院天数分别为（9.55±1.63）和（13.60±3.59）d， 治疗组明显短于对照组，两组比较差异有统计学意义（P?<0.05）；治疗组与对照组平均行胸腔穿刺术次数为（1.50±0.76）和（2.80±0.99）次，治疗组明显少于对照组，两组比较差异有统计学意义（P?<0.05）。治疗组与对照组治疗12个月后的胸膜CT上平均胸膜肥厚度分别为（0.15±0.09）和（2.30±0.13）mm，治疗组明显薄于对照组，两组比较差异有统计学意义（P?<0.05）。结论?使用内科胸腔镜下确诊结核性胸膜炎的患者，可减少住院日，减少胸腔穿刺频次，减少胸膜肥厚度。临床上若疑诊结核性胸膜炎者，建议优先考虑行内科胸腔镜诊治。

Abstract:

To analyze the clinical significance of thoracoscopy in treatment of tuberculous pleurisy. ?Methods?We collected 40 cases of tuberculous pleurisy as research objects, 20 patients as treatment groups were diagnosed with tuberculous pleurisy by medical thoracoscopy, while the other 20 patients as control groups, diagnosed by hydrothorax test and tuberculin test by conventional thoracic puncture. Patients in both groups were treated with the same antituberculosis treatment. The hospitalization days and the thoracic puncture times of the two groups was calculated. Then measure the thickness of the pleural fertilizer by chest CT after 12 months of treatment.?Results?There was a statistical difference of the average hospitalization days between the treatment group (9.55?±?1.63)?d and the control group (13.60?±?3.59)?d, P?