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目的探讨内科胸腔镜对儿童结核性胸膜炎的诊断与治疗。方法 2009年11月至2011年11月在贵阳市肺科医院住院治疗的26例胸腔积液患儿,均为诊断不明、穿刺抽液治疗效果不佳及胸腔内有包裹及纤维分隔者,对其进行内科胸腔镜检查,同时在胸腔镜直视下对21例明显黏连包裹病变及干酪坏死物进行清除治疗。结果 26例患儿胸腔镜清除物中结核菌培养阳性13例,病理证实结核20例,检查治疗中未见明显不良反应,总有效率为100%。结论内科胸腔镜检查可提高儿童结核性胸膜炎的确诊率,对胸腔内黏连病变可通过胸腔镜作清除黏连包裹及药物灌洗等微创治疗,可提高包裹性胸膜炎治愈率;内科胸腔镜检查患儿耐受性好,并发症少,是一种有较高诊断治疗价值的方法。
Objective To investigate the diagnosis and treatment of tuberculosis pleurisy in children by medical thoracoscopy. Methods From November 2009 to November 2011, 26 children with hydrothorax were hospitalized in Guiyang Pulmonary Hospital. All of them were diagnosed as unknown, the results of puncture and drainage were poor and there were parcels and fibrous septa in the chest cavity. The medical thoracoscopy, at the same time in the thoracoscopic visualization of 21 cases of viscous adhesions lesions and cheese necrosis were removed. Results Twenty-six cases of thoracoscope removal were positive for TB culture in 13 cases, and 20 cases were confirmed by pathology. There were no obvious adverse reactions in the examination and treatment, and the total effective rate was 100%. Conclusion The medical thoracoscopy can improve the diagnosis rate of tuberculous pleurisy in children. The intra-thoracic adhesions lesion can be treated by thoracoscope to remove the adhesions and drug lavage, which can improve the cure rate of encapsulated pleurisy. The medical thoracoscopy Check the children with good tolerance, fewer complications, is a higher diagnostic value of the method.