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題名 | Diagnostic Thoracoscopy for Undiagnosed Pleural Effusions=胸腔鏡對不明原因肋膜積液之診斷價值 |
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作者 | 郭許達; 彭明仁; 陳培然; 林芳杰; 李聰明; 林榮祿; Kuo, Hsu-tah; Peng, Ming-jen; Chen, Pei-zan; Lin, Fung-j; Lee, Chun-ming; Lin, Ron-luh; |
期刊 | 胸腔醫學 |
出版日期 | 19970300 |
卷期 | 12:1 1997.03[民86.03] |
頁次 | 頁4-9 |
分類號 | 415.43 |
語文 | eng |
關鍵詞 | 胸腔鏡; 肋膜積液; Thoracoscopy; Pleural effusion; Tuberculosis; Malignant pleural effusion; |
英文摘要 | Between January 1987 and October 1995, there were 43 patients with pleural effusions undiagnosed by conventional methods enrolled in our study. All underwent thoracoscopy under local anesthesia. There were 29 men and 14 women with mean age 54.8 years (range, 25 to 83 years.) Forty-three procedures were performed and 24 effusions were proved to be benign and 19 were malignant. There were 20 patients diagnosed to have pleural tuberculosis. There were 4 effusions with a benign etiology, including 1 extramedullary hematopoiesis, 1 Para pneumonic and 2 didpopathic effusions. There were 19 malignant effusions: 14-metastaitic carcinoma, 2 mesothelima, 1 lymphoma, 1 plasmacytoma and 1 false negative. In malignant cases, 18/19 (94.7%) was proved by thoracoscopy. The histological diagnosis of these met static arecinoma were adenocarcinoma in 9, suqamous cell caricnoma in 2, spindle cell carinoma in 1 and undifferentiated carcinoma in 2 cases. The origins of the malignancies were presumed to be from the lung in 11, from the colon in 2, from the ovary in 1 and from the liver in 1. The most common side effects were subcutaneous emphysema (10/43, 23%), chest pain (2/43, 4.7%), fever (1/43, 2.3%), and psychotic reaction (1/43, 2.3%). We conclude that thoracoscopy using a rigid telescope under local anesthesia has a high negative predictive value of 95.8%. The adverse effects are minimal. Therefore, it is a very effective and helpful in undiagnosed pleural effusions. |
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