中文摘要：

目的分析不明原因胸腔积液在内科胸腔镜下表现及病理诊断。方法回顾性分析该院412例不明原因胸腔积液进行内科胸腔镜检查镜下表现与病理结果,评价手术安全性。结果确诊恶性肿瘤176例,恶性胸膜间皮瘤47例,结核性胸膜炎104例,慢性炎症39例,确诊率88.8%。恶性肿瘤主要表现为菜花样、葡萄串样结节或肿块。结核主要为胸膜弥漫性充血肿胀及粟粒样结节,亦可见干酪样坏死。1例发生胸膜反应,1例术中血压下降,经处理均恢复正常。结论肿瘤与结核胸膜病变在胸腔镜下表现有差异,不同病理类型肿瘤胸腔镜下表现无差异;内科胸腔镜检查在胸膜疾病诊断中具有确诊率高、安全及创伤小的优点。

英文摘要：

【Objective】To evaluate the clinical application of medical thoracoscopy for the diagnosis of unknown origin pleural effusion. 【Methods】A retrospective review of 412 patients undergoing a thoracoscopic operation was performed. 【Results】Through histopathological examination, 176 malignant tumor with pleural matastasis, 47 malignant mesothelioma, 104 tuberculous pleurisy, and 39 chronic inflammation were definitely diagnosed, the diagnostic rate of biopsy was 88.3%. Malignant tumor displayed nodules or masses with different size like cauliflower or grape bunch; while tuberculous pleurisy always appeared as diffused pleural congestion and edema, with wide distribution of small miliary nodules, caseous necrosis might be seen. One patient had pleural reaction during the process of injecting gas into thoracic space, 1 patient＇s blood pressure fell down because of pleural reaction. 【Conclusion】Medical thoracoscopy with pleural biopsy is a relatively safe method with high diagnostic rate for pleural effusion of unknown origin.