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目的探讨纤维支气管镜代替内科胸腔镜检查对胸膜疾病的临床应用。方法选择8例胸腔积液和1例气胸的患者采用纤维支气管镜代替内科胸腔镜检查,观察镜下病变形态并取活组织进行病理检查,帮助临床进一步明确诊断并内镜直视下介入治疗。结果经胸膜检查确诊结核性胸膜炎4例,结核性脓胸1例;心源性胸腔积液2例;恶性胸腔积液1例;气胸胸膜内固定术1例;同时加快引流,减少胸膜粘连,缩短病程等措施;其中5例检查后确诊。结论纤维支气管镜代替胸腔镜检查具有诊断阳性率高、损伤小、安全、手术费用少,设备价廉,具有实用性,同时内镜直视下引流胸腔积液快捷、高效、大大缩短病程。
Objective To investigate the clinical application of fibrobronchoscopy instead of medical thoracoscopy for pleural disease. Methods Eight cases of pleural effusion and one pneumothorax were selected to replace the medical thoracoscopy by fiberoptic bronchoscopy. The pathological changes of the lesions were observed and the biopsy tissues were taken for pathological examination to help further confirm the clinical diagnosis and endoscopic interventional treatment. Results 4 cases of tuberculous pleurisy, 1 case of tuberculous empyema, 2 cases of cardiogenic pleural effusion, 1 case of malignant pleural effusion and 1 case of pneumothorax and pleurodesis were confirmed by pleural examination. At the same time, drainage and pleural adhesions were reduced, Shorten the course of disease and other measures; of which 5 cases confirmed after examination. Conclusions Fiberoptic bronchoscopy instead of thoracoscopy has the advantages of high positive rate of diagnosis, small injury, safety, less operation cost, low cost and practicability. Meanwhile, drainage of pleural effusion under endoscopy is fast and efficient, which greatly shortens the course of disease.