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- Comparison of the Clinical Diagnostic Value between Pleural Needle Biopsy and Analysis of Pleural Effusion
- Adenosine Deaminase 之測定應用於診斷結核性肋膜積液
- 惡性肋膜積液的診斷
- Increased Soluble Fas Ligand Concentration in Tuberculous Pleural Effusion
- IgG4-Related Disease with Pleural Involvement Presenting as Progressive Dyspnea
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題名 | Comparison of the Clinical Diagnostic Value between Pleural Needle Biopsy and Analysis of Pleural Effusion=肋膜切片及肋膜積液抽取術診斷價值之比較 |
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作者 | 陳濘宏; 謝宜璋; 曹昌堯; | 書刊名 | 長庚醫學 |
卷期 | 20:1 1997.03[民86.03] |
頁次 | 頁11-16 |
分類號 | 415.43 |
關鍵詞 | 肋膜切片; 肋膜積液抽取術; 惡性腫瘤併肋膜積液; 結核性肋膜積液; Pleural biopsy; Thoracentesis; Malignant; Pleural effusion; Tuberculous pleural effusion; |
語文 | 英文(English) |
中文摘要 | 背景:許多肺部疾病都以肋膜積液表現,這些疾病的診斷常常須要進行胸腔超音波導引之肋膜切片及肋膜積液抽取術。為了比較在胸腔超音波導引下,肋膜切片及肋膜積液抽取術在臨床上之診斷價值,所以我們設計此一研究。 方法:我們分析從1989年到1990年,在長庚醫院進行超音波導引之肋膜切片及肋膜積液抽取術之病人,共176位。 結果:有66位經診斷為惡性腫瘤併肋膜積液,這其中有55%由肋膜切片之病理檢驗確立診斷,64%由肋膜積液抽取術之細胞學檢驗確立診斷,若二種方法合併可使診斷率提高到88%。在76位經診斷為結核性肋膜積液的病人中,只有19%是經由肋膜切片確立診斷,20%則是由肋膜積液之結核菌培養而診斷。其餘之結核性肋膜積液則由痰液培養(34%)或臨床上以抗結核菌藥物治療成功(41%)來間接証實。最後,仍有19位(11%)病人診斷為不明原因之肋膜積液。 結論:雖然肋膜積液抽取術較為簡單及安全,但合併肋膜切片及肋膜積液抽取術在臨床上可明顯提高惡性腫瘤併肋膜積液之診斷率;但是對其他良性肋膜積液,包括結核性肋膜積液,在診斷價值上,仍有待進一步研究及改進。 |
英文摘要 | BACKGROUND: Many disease are manifested by pleural effusion. Chest echo-guided thoracentesis and pleural biopsy are the two major procedures in diagnos ing pleural effusion, but the validity is still under debate. To compare the diagnostic value of echoguided pleural biopsy with pleural effusion analysis, we designed this retrospective study. METHODS: We reviewed 176 patients who underwent both procedures at Chang Gung Memorial Hospital from 1989 to 1990. RESULTS: Sixty-six patients (38%)were diagnosed with malignant pleural effusion which was proven by needle biopsy (55%) or effusion cytologic analysis (64%). Combining both methods increased the diagnostic rate to 88%. Among the 76 patients who were diagnosed with tuberculous pleural effusion, only 18% were proven by pleural biospy and 20% by pleural effusion culture. The other cases were confirmed by sputum exam (34%)or successful therapeutic trial (41%). The remaining 19 patients (11%) were diagnosed as undeterminate etiology. CONCLUSIONS: Combined pleural biospsy with cytologic analysis of the pleural effusion was more beneficial than any single method in identifying malignant pleural effusions, and repeated pleural biopsy increased the positive rate from 49% to 55% in our study. |
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