Diagnosis Significance Of Medical Thoracoscopy In Tuberculous Pleural Effusion

Objective To assess the diagnostic sensitivity and thesafety of medical thoracoscopy(MT) in the diagnosis of tuberculous pleural effusion.Methods We evaluated 52 patients who were suspected tuberculous pleural effusion with MT for exudative pleural effusion from june 1,2012 to july 1,2014, assessed the diagnosis rate and complications of medical thoracoscopy. Inclusion criteria:based on light standards, pleural effusion was exudative, and mainly lymphocytes. Standard for histopathologic diagnosis is tuberculous granuloma (with or without caseous necrosis), and effective anti-tuberculosis treatment hitches in six months follow-up, and rule out other granulomatous diseases. All patients were followed up for six months.Results 33 of 52 patients were tuberculous pleural effusion,29 cases diagnosed by medical thoracoscopy, the diagnostic sensitivity was 88%.Under the thoracoscope, clinical manifestations of these patients with tuberculous pleuritic were miliary nodules in 23 cases (70%), fiber cord-like adhesions in 12 cases (36%), extensive wrapped with fiber deposition in seven cases (21%), white scar in 5 cases (15%) Complications:Subcutaneous emphysema were 10 cases,4 cases of chest pain.3 cases of fever,2 cases of pneumothorax, two cases of hemoptysis, one case of wound infection, one case of gas embolism. The value of ADA in the diagnosis of tuberculous pleural effusion, the sensitivity was 94%, specificity was 79%, accuracy was 88%, positive predictive value was 88.6%, and negative predictive value was 88.2%, respectively.Conclusion Medical thoracoscopy was a method with high diagnostic value and safety in the diagnosis of tuberculous pleural effusion.