| Objective: To explore the value of thoracoscopy in the differential diagnosis of pleural effusion with different causes.Retrospective analysis of the data of patients with pleural effusion with different causes in our hospital,to acquire whether there are differences in the performance characteristics of different diseases under thoracoscopy,analysis of the timing of thoracoscopy in patients with different diseases from the perspective of health economics,to acquire the diagnostic rate of thoracoscopy for different diseases,whether the prognosis of patients with tuberculous pleural effusion by thoracoscopy is better than that of patients without thoracoscopy,as well as the risks and complications of thoracoscopy,whether there is a correlation between the color of pleural effusion and the benign and malignant of the disease,and whether the color of pleural effusion can be a reference for clinicians to make a preliminary judgment of the disease.Methods: The clinical data of 279 patients with pleural effusion in the First Affiliated Hospital of Bengbu Medical College from January 2012 to March 2019 were analyzed retrospectively.The general data,manifestations under thoracoscopy and histological data were analyzed to evaluate the diagnosis rate and complications of thoracoscopy.Analyze acquired data by means of statistical software SPSS21.0.Results: Among 279 cases,150 cases were examined by thoracoscopy,127 cases were diagnosed definitely,the rate of diagnosis was 84%.The diagnosis rate of tuberculous pleural effusion was 81.5%(66/81),malignant pleural effusion was 90.3%(56/62)and inflammatory pleural effusion was 71.4%(5/7).Patients were divided into thoracoscopic group and non thoracoscopic group(control group)according to whether thoracoscopic examination was performed.The diagnosis rate of thoracoscopic group was significantly higher than that of the control group.In the follow-up of the two groups,the recovery of patients in the thoracoscopic group was better than that in the control group,and the proportion of patients with pleural thickening was significantly lower than that in the control group;There were 4 cases of operation failure,2 cases of arrhythmia(1 case of ventricular fibrillation,1 case of atrial fibrillation),1 case of pleura reaction,1 case of severe adhesion,the operation was stopped immediately,the patients with ventricular fibrillation returned to normal after cardioversion,and the patients with atrial fibrillation and pleura reaction recovered gradually after stopping the operation,no thromboembolism,respiratory failure and other serious adverse reactions were found during the operation.After operation,6 cases had chest pain and 2 cases had low fever.All of them were improved after symptomatic treatment.Patients in the thoracoscopic group were divided into ≤ 7 days group and > 7 days group according to the time(days)from admission to thoracoscopic examination,no matter tuberculosis or malignant pleural effusion,the hospital time and cost of patients in the group of ≤ 7 days were significantly less than those in the group of > 7 days.The color of pleural effusion is divided into sanguineous and non-sanguineous.the analysis shows that there is a statistical difference between the color and the benign and malignant of the disease,the color of pleural effusion can play a limited role in judging the benign and malignant of the disease.Conclusion: Medical thoracoscopy in patients with unexplained pleural effusion has a high diagnosis rate,simple and safe operation,less complications,and can significantly improve the prognosis of patients,which is a high cost-effective diagnosis and treatment method.Ongoing thoracoscopy at the right time can reduce hospital stay and costs.Clinicians can make a preliminary estimate of the disease according to the color of pleural effusion. |
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