Seto T, Semba H, Fukai Y, Seto M, Inayoshi A, Kurano R
Division of Respiratory Disease, Surgery, Kumamoto Regional Medical Care Center.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Sep;34(9):947-52.
When performing thoracoscopy in patients with pleural effusion of unknown origin, we used two bronchoscopes simultaneously, one for observation and one for biopsy. A total of 50 patients with pleural effusion of unknown origin were studied. In all of those studies, pleural effusion was exudative, lymphocyte-dominant, had a low level of adenosine deaminase, no malignant cells, and no tuberculosis or other bacteria in pleural effusion smears. Fourteen were out-patients. A catheter was inserted into the pleural space under local anesthesia, and 300 ml to 500 ml of pure oxygen was injected to create a pneumothorax. Two flexible fiberoptic bronchoscopes were used simultaneously, one for observation and one for biopsy. Approximately 1 hour after the examination, the out patients were able to return home. Lesions in the pleural cavity were found in 42 of these 50 patients, and histological diagnosis was possible in 46. This is a simple procedure with no major side effects. The equipment required is familiar to pulmonary physicians, and the diagnostic yield is high.
在对不明原因胸腔积液患者进行胸腔镜检查时，我们同时使用了两个支气管镜，一个用于观察，一个用于活检。共研究了50例不明原因胸腔积液患者。在所有这些研究中，胸腔积液为渗出液，以淋巴细胞为主，腺苷脱氨酶水平低，无恶性细胞，胸腔积液涂片无结核或其他细菌。14例为门诊患者。在局部麻醉下将导管插入胸腔，注入300毫升至500毫升纯氧以造成气胸。同时使用两个可弯曲纤维支气管镜，一个用于观察，一个用于活检。检查后约1小时，门诊患者即可回家。这50例患者中有42例发现胸腔内有病变，46例可进行组织学诊断。这是一个简单的操作，没有严重的副作用。所需设备为肺科医生所熟悉，诊断率高。
