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目的：探讨经胸腔镜局部应用碘伏及硝酸银稀释液治疗顽固性结核性胸腔积液的方法及疗效。方法：常规抽胸水注气形成人工气胸后开放性胸腔镜检查，经胸腔镜抽净胸水，碘伏冲洗胸腔，硝酸银稀释液收敛炎性胸膜，放置闭式引流，并配合有效抗痨治疗。结果：镜下见脏壁层胸膜充血、糜烂，有粘连带形成，经１次胸腔镜治疗７ｄ后胸水消失，拔管后未再复发，随访半年，１４例患者均治愈，Ｘ线检查无明显胸膜肥厚。结论：经胸腔镜局部用药治疗顽固性结核性胸腔积液简便、安全，无后遗症。
Objective: To investigate the method and efficacy of thoracoscopic local application of iodophor and silver nitrate in the treatment of refractory tuberculous pleural effusion. Methods: Conventional pleural effusion was injected to form open thoracoscopy after artificial pneumothorax. Thoracoscopic pleural effusion, iodophor flushing thoracic cavity and silver nitrate dilution fluid were used to converge the inflammatory pleura. The closed pleural drainage was placed and combined with effective anti-thrombosis therapy. Results: Pleural effusion, erosions and adhesions were observed in the microscope. Pleural effusion disappeared after 7 days of thoracoscopy and did not recur after extubation. All the patients were followed up for 6 months, and 14 cases were cured without obvious X-ray examination Pleural thickening. Conclusion: Topical thoracoscopic treatment of intractable tuberculous pleural effusion is simple, safe and without sequelae.