双孔下软质胸腔镜联合硬质活检钳的临床应用

Application of Double-holes Soft Thoracoscopy Combined with Rigid Biopsy Forceps

关键词:  双孔软质胸腔镜  硬质活检钳  胸膜疾病  弥漫性肺部疾病  诊断

Key words:  double-holes soft thoracoscopy  rigid biopsy forceps  pleural disease  diffuse pulmonary disease  diagnosis

摘要:

本研究探讨双孔下软质胸腔镜联合硬质活检钳用于诊断弥漫性肺部疾病和不明原因胸膜疾病的可能性。对63例弥漫性肺部疾病和不明原因胸积液患者随机采用软质胸腔镜、硬质胸腔镜和双孔下软质胸腔镜联合硬质活检钳3种不同方法进行脏层胸膜或壁层胸膜活检，测量活检标本大小，观察术后疼痛评分和术后并发症，比较3种活检方法的诊断效率。结果表明：双孔下软质胸腔镜联合硬质活检钳活检的诊断阳性率明显高于软质胸腔镜组和硬质胸腔镜组，标本大小也大于软质胸腔镜组，但疼痛评分、术后并发症与其他2组无显著差异。双孔下软质胸腔镜联合硬质活检钳诊断弥漫性肺部疾病和不明原因胸积液具有术野大且清晰、诊断阳性率高且无严重并发症、无需特殊培训、投入不大等特点。该术式是可行的，值得在以上疾病诊断时应用。

Abstract:

This study explored the possibility of double-holes soft thoracoscope combined with hard biopsy forceps for the diagnosis of diffuse pulmonary disease and unexplained pleural disease. 63 patients with diffuse pulmonary disease and unexplained pleural effusion were randomly selected for visceral pleura or parietal pleura biopsy using three different methods, namely, soft thoracoscope, hard thoracoscope and double-holes soft thoracoscope combined with hard biopsy forceps. The size of biopsy specimens was measured, and the postoperative pain score and postoperative complications were observed. The diagnostic efficiency of the three biopsy methods was compared. The results showed that the diagnostic positive rate of double-holes semi-rigid thoracoscopy combined with rigid biopsy forceps was significantly higher than that of soft thoracoscopy and rigid thoracoscopy, and the specimen size was also larger than that of soft thoracoscopy group, but there was no significant difference in pain score and postoperative complications among them. The application of double-holes soft thoracoscopy combined with rigid biopsy forceps to diagnose diffuse pulmonary diseases and unexplained pleural effusion had the characteristics of large and clear surgical field, high diagnostic positive rate and no serious complications, no special training and low investment. This kind of operation is feasible and worthy of application in the above disease diagnosis.