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1、內(nèi)科胸腔鏡對老年胸腔積液患者的診斷價值【摘要】0的探討內(nèi)科胸腔鏡對老年胸腔積液患者的診斷價值和安全性。方法90例不明原因胸腔積液患者行內(nèi)科胸腔鏡檢查，觀察鏡下病變形態(tài)和病理結(jié)果。結(jié)果90例患者中有80例確診，診斷總陽性率為88.9%,46例惡性胸腔積液，確診45例，確診率為97.8%。37例結(jié)核性胸腔積液，確診35例，確診率為94.6%。腫瘤患者45例，結(jié)核患者35例，兩組患者的平均年齡、病程及吸煙史差異無統(tǒng)計(jì)學(xué)意義（P〉0.05）,結(jié)核患者的腺苷脫氨酶（adenosinedeaminase,ADA）顯著高于腫瘤患者（P〈0.001）;而腫瘤
2、患者血清及胸水癌胚抗原（carcinoembryonieantigen,CEA）顯著高于結(jié)核患者（K0.001）。7例診斷為非特異性炎癥改變。所冇患者均順利完成胸腔鏡檢查，并發(fā)癥少。結(jié)論內(nèi)科胸腔鏡對于老年胸腔積液診斷陽性率高，安全性好?！娟P(guān)鍵詞】內(nèi)科胸腔鏡；胸腔積液；診斷中圖分類號：R561文獻(xiàn)標(biāo)識碼：ADOI:10.3969/j.issn.10031383.2017.01.015Valueofmedicalthoracoscopyindiagnosisofelderlypatientswithpleuraleffusion[HJ2][HJ]
3、QINShujuan,TANTaiying(DepartmentofRespiratoryDisease,TheEighthAffiliatedHospitalofGuangxiMedicalUniversity—GuigangPeople'sHospital,Guigang537100,China)[HJ2][HJ][Abstract]ObjcctivcToinvestigatediagnosticvalueandsafetyofmedicalthoracoscopyforelderlypatientswithpleuraleffusion
4、.Methods%elderlypatientswithpleuraleffusion,whosecauseswerestillunknown,wereselectedtobediagnosedbythemedicalthoracoscopy,andtheshapeoflesionsandpathologicalresultsunderscopewereobserved.ResultsOfthese90elderlypatients,80caseshaddefinitediagnosis(positiveratewas88.9%).Ofthe
5、se46caseswithmalignantpleuralfluid,45caseshaddefineddiagnosis(positiveratewas97.8%).Ofthese37tuberculosiscases,35caseshaddefineddiagnosis(positiveratewas94.6%).45patientswithtumorand35patientswithtuberculosiswereconfirmed，anddifferenceofmeanage,courseofdiseaseandsmokinghist
6、oryofthetwogroupswasnotstatisticallysignificant(P>0.05).Adenosinedeaminase(ADA)ofthetuberculosispatientswassignificantlyhigherthanthatofpatientswithcancer(P<0.001)，whilescrumandpleuralfluidcarcinoembryonieantigen(CEA)ofthepatientswithcancerweresignificantlyhigherthanthoseof
7、thetuberculosispatients（P〈0.001）.Inaddition，7caseswerediagnosedwithnonspecificinflammatorychanges.Allpatientssuccessfullyfinishedthoracoscopyandhadfewcomplications.ConelusionMedicalthoracoscopypossesseshighpositivediagnosticrateandsafetyforelderlypatientswithpleuraleffusion
8、.[Keywords]medicalthoracoscopy；pleuraleffusion；diagnosis?瓤菩厙瘓凳墻?年來開展應(yīng)用的一項(xiàng)微創(chuàng)檢查yy法，其
