【摘要】 目的探讨结核性胸膜炎患者胸膜病变在胸腔镜下表现及与临床之间关系。方法对我院临床诊断结核性胸膜炎的447例患者作内科电子胸腔镜检查,将胸腔镜下表现与病程、病理及临床特点作回顾性分析。结果 447例结核性胸膜炎患者在胸膜腔内均发现明显病灶,早期表现为充血水肿、肉芽结节;晚期主要表现为纤维粘连包裹、胸膜肥厚等。各期不同形态的病变可单独或同时存在。病理确诊率70.2%。胸水及胸腔清除物结核菌培养阳性率46.3%。结论结核性胸膜炎在胸腔镜下可表现为多种形态,胸膜病变表现与病程关系密切,胸腔内纤维包裹形成是导致胸水吸收排出困难的主要原因,内科胸腔镜对诊断治疗结核性胸膜炎及判断预后有较高价值。更多还原

【Abstract】 Objective To explore the manifestations and clinical characteristics of pleural lesions of patients with tuberculous pleurisy via thoracoscopy. Methods 447 patients with tuberculous pleurisy were given medical electronic thoracoscopy. Their manifestations,pathology,and clinical characteristics were retrospectively analyzed.Results Significant lesions were found in all patients. Congestion,edema,and granulation nodules occurred in early stages,and intrathoracic fibronectin encapsulated,pleural thickening,etc resulted in later stage. Different forms of lesions in different stages could exist alone or in combination. The correct diagnosis rate was 70. 2%. Pleural effusion and pleural clearance’s mycobacterium tuberculosis cultivation positive rate was 46. 3%. Conclusion Tuberculous pleurisy could be manifested in many forms via thoracoscopy. These manifestations are closely related to the severity of the inflammation. The formation of encapsulated intrathoracic fiber is the major cause of the difficulty in absorption and excretion of pleural effusion. Medical thoracoscopy is valuable in diagnosis,treatment,and estimate prognosis for tuberculosis pleurisy.更多还原