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医学胸腔镜检查在未确诊胸腔积液中的诊断率

Diagnostic Yield of Medical Thoracoscopy in Undiagnosed Pleural Effusion.

作者信息

Kiani Arda, Abedini Atefeh, Karimi Mahmoud, Samadi Katayoun, Sheikhy Kambiz, Farzanegan Behrooz, Pour Abdollah Mihan, Jamaati Hamidreza, Jabardarjani Hamid Reza, Masjedi Mohammad Reza

机构信息

Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Tanaffos. 2015;14(4):227-31.

Abstract

BACKGROUND

One of the most common indications for pleuroscopy is undiagnosed pleural effusion, which comprises about 25% of all cases of pleural effusions, which remain undiagnosed despite primary tests. Pleuroscopy was performed for the first time in Iran in Masih Daneshvari hospital located in Tehran. The aim of this study was to assess the diagnostic yield of pleuroscopy performed in this center in Iran.

MATERIALS AND METHODS

Three-hundred patients with undiagnosed pleural effusions were enrolled in this study. For all patients, primary tests including pleural effusion analysis, cytology and closed pleural biopsy (if needed) were conducted and all of them were inconclusive. The semirigid thoracoscopy (pleuroscopy) was performed for all patients for diagnostic purposes.

RESULTS

Eighty-seven percent of the peluroscopies were diagnostic and 67% of them were diagnosed as malignancy while the rest were diagnosed as tuberculosis. Only 11 patients developed minor complications.

CONCLUSION

In conclusion, pleuroscopy is a safe procedure when performed by a skilled and experienced practitioner; it has a high diagnostic yield and results in only minor complications.

摘要

背景

胸腔镜检查最常见的指征之一是不明原因的胸腔积液,其约占所有胸腔积液病例的25%,尽管进行了初步检查,但仍无法确诊。伊朗首次进行胸腔镜检查是在德黑兰的马西赫·丹什瓦里医院。本研究的目的是评估在伊朗该中心进行胸腔镜检查的诊断率。

材料与方法

本研究纳入了300例不明原因胸腔积液患者。对所有患者进行了包括胸腔积液分析、细胞学检查和闭式胸膜活检(如有需要)在内的初步检查,所有这些检查均无定论。为所有患者进行了半硬性胸腔镜检查(胸腔镜检查)以进行诊断。

结果

87%的胸腔镜检查具有诊断价值,其中67%被诊断为恶性肿瘤,其余被诊断为结核病。只有11例患者出现了轻微并发症。

结论

总之,由熟练且经验丰富的医生进行胸腔镜检查是一种安全的操作;它具有较高的诊断率,且仅导致轻微并发症。

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