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目的 探讨针刺胸膜活检在胸膜疾病诊断中的价值和安全性。方法对1989年6月～2002年9月间诊断明确且做过1次以上胸膜活检的594例胸腔积液患者的临床资料进行回顾分析。结果 594例中结核性胸膜炎408例,恶性胸膜炎161例,两者胸膜活检的阳性率分别为74.0％(302/408)和70.2％(113/161)。在其他病因所致的25例胸腔积液的诊断中,胸膜活检未提示特征性病理改变。术后并发症主要为:气胸(69.0％)、出血(31.0％)、发热(19.0％)和肿瘤细胞种植(5.0％)。结论 在结核性及恶性胸腔积液的诊断中,针刺胸膜活检是一种有效的手段,多次活检可提高恶性胸膜炎的确诊率,致命并发症极少。
Objective To investigate the value and safety of acupuncture pleural biopsy in the diagnosis of pleural disease. Methods The clinical data of 594 patients with pleural effusion diagnosed and pleural biopsy performed more than once from June 1989 to September 2002 were retrospectively analyzed. Results Among 594 cases, 408 were tuberculous pleurisy and 161 were malignant pleurisy. The positive rates of pleural biopsy were 74.0% (302/408) and 70.2% (113/161) respectively. Pleural biopsy did not suggest a characteristic pathologic change in the diagnosis of 25 other pleural effusions due to other causes. Postoperative complications were mainly pneumothorax (69.0%), hemorrhage (31.0%), fever (19.0%) and tumor cell implantation (5.0%). Conclusion In the diagnosis of tuberculous and malignant pleural effusion, acupuncture pleural biopsy is an effective method. Multiple biopsy can improve the diagnosis rate of malignant pleurisy with very few fatal complications.