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小型胸腔镜与传统医用胸腔镜在渗出性胸腔积液患者中的应用比较

Minithoracoscope versus Conventional Medical Thoracoscope in Patients with Exudative Pleural Effusion.

作者信息

Okasha Hamoda Hamed, Abdel Hafez Sayed Ahmed Mohamed, Abouelkhier Abdalla Dina, Shebl Abd Alhady Mohamed, Elnahas Mohamed, Rezk Nasef Abd-Elsalam

机构信息

Chest Medicine Department, Mansoura University, Mansoura, Egypt.

Pathology Department, Mansoura University, Mansoura, Egypt.

出版信息

Clin Med Insights Circ Respir Pulm Med. 2020 Oct 26;14:1179548420966243. doi: 10.1177/1179548420966243. eCollection 2020.

Abstract

BACKGROUND

Thoracoscopy allows visualization of the pleural cavity including diaphragm, visceral pleura, and lungs. It provides the physician with information about the disease extent and it has the ability to get a biopsy from these lesions to differentiate between tumors and fibrotic reactions. This study aims to compare minithoracoscopy and medical thoracoscope in patients with exudative pleural effusion as regards the diagnostic yield, safety, complications, and duration of hospital stay.

PATIENTS AND METHODS

Sixty patients were diagnosed with exudative pleural effusion and were randomly divided into 2 equal groups: Group (1): included 30 patients who underwent minithoracoscopy and Group (2): included the remaining 30 cases who underwent the standard thoracoscope.

RESULTS

Pathological examination of the sample revealed that biopsy size was 2.02 and 1.25 in group 1 and group 2 was respectively with highly statistically significant between both groups ( < .001). Group 1 revealed TB, malignant, chronic nonspecific pleurisy, Staph aureus, Klebsiella, and Pseudomonas in 30% (9), 30% (9), 33.3% (10), 69% (9), 15% (2), and 15% (2) of cases respectively. While group 2 reveled TB, malignancy, chronic nonspecific pleurisy, Staph aureus, Klebsiella, Pseudomonas, and other causes in 40% (12), 23.3% (7), 23.3% (7), 67% (8), 8% (1), 8% (1), and 16% (2) respectively with no statistically significant differences between both groups ( > .05).

CONCLUSION

Minithoracoscopy is well tolerated by patients as minimal pain and early hospital discharge could be achieved by that approach.

摘要

背景

胸腔镜检查可观察胸膜腔,包括膈肌、脏层胸膜和肺。它为医生提供有关疾病范围的信息,并且能够从这些病变处获取活检组织,以区分肿瘤和纤维化反应。本研究旨在比较微型胸腔镜和医用胸腔镜在渗出性胸腔积液患者中的诊断率、安全性、并发症及住院时间。

患者与方法

60例被诊断为渗出性胸腔积液的患者被随机分为两组,每组30例:第1组:30例接受微型胸腔镜检查;第2组:其余30例接受标准胸腔镜检查。

结果

样本的病理检查显示,第1组和第2组的活检组织大小分别为2.02和1.25,两组间差异具有高度统计学意义(<0.001)。第1组分别有30%(9例)、30%(9例)、33.3%(10例)、69%(9例)、15%(2例)和15%(2例)的病例被诊断为结核病、恶性肿瘤、慢性非特异性胸膜炎、金黄色葡萄球菌、克雷伯菌和铜绿假单胞菌。而第2组分别有40%(12例)、23.3%(7例)、23.3%(7例)、67%(8例)、8%(1例)、8%(1例)和16%(2例)被诊断为结核病、恶性肿瘤、慢性非特异性胸膜炎、金黄色葡萄球菌感染、克雷伯菌感染、铜绿假单胞菌感染及其他病因,两组间差异无统计学意义(>0.05)。

结论

微型胸腔镜检查患者耐受性良好,该方法可使患者疼痛轻微并早日出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89a4/7597566/0440ba312731/10.1177_1179548420966243-fig1.jpg

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