结核性胸膜炎的内科胸腔镜表现及快速现场评价特点分析*

Performance and diagnostic value of medical thoracoscopy and rapid on-site evaluation for tuberculous pleurisy*

摘要:

摘要：目的??总结结核性胸膜炎在内科胸腔镜下的表现，并探讨快速现场评价技术对结核性胸膜炎的诊断价值。方法?回顾性分析2016年1月－2018年10月该科经内科胸腔镜诊断的56例结核性胸膜炎患者的临床资料，总结分析胸腔镜下表现及快速现场评价特点。结果?结核性胸膜炎的胸腔镜下主要表现包括：呈弥漫性分布的粟粒状结节、胸膜充血水肿、肥厚增生、胸膜粘连和大量纤维素性渗出等。结核性胸膜炎的快速现场评价特点表现主要包括：上皮样细胞及组织细胞混杂、可见多核巨细胞、大量淋巴细胞及纤维素渗出等。通过联合快速现场评价技术，胸腔镜下组织活检的平均次数为6次，平均操作时间为36.0 min。结论?在结核性胸膜炎的诊治中，内科胸腔镜联合快速现场评价技术可以明显缩短胸腔镜下胸膜活检次数，减少操作时间，具有较高的临床应用价值。

Abstract:

Abstract: Objective?To summarize the manifestations of medical thoracoscopy and rapid on-site evaluation in patients with tuberculous pleurisy.?Methods?56 patients with tuberculous pleurisy diagnosed by medical thoracoscopy from January 2016 to October 2018 were retrospectively analyzed. The characteristics of thoracoscopy and ROSE were summarized.?Results?The thoracoscopy manifestations of tuberculous pleurisy include diffuse miliary nodules, pleural congestion, edema, hypertrophy and hyperplasia, pleural adhesions, and fibrin deposition. ROSE microscopic findings of tuberculous pleurisy include mixed epithelioid and histiocyte, multinucleated giant cells, a large number of lymphocytes and fibrin exudation. With the application of ROSE technique, the median frequency of biopsy under thoracoscopy was 6 times, the median operation time was 36.0 minutes.?Conclusion?In the diagnosis of tuberculous pleurisy, medical thoracoscopy combined with rapid on-site evaluation technology can minimize the frequency of pleural biopsies and operation time.