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Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
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这位患者是否患有排泄性肺溢液? 理性的临床检查系统审查
M Elizabeth Wilcox1, Christopher A K Y Chong2, Matthew B Stanbrook3
1Department of Medicine, University of Toronto, University Health Network, Toronto, Ontario, Canada.
JAMA
|June 19, 2014
概括
胸腔溢液的准确诊断依赖于莱特的标准,胆固醇和乳酸脱酶 (LDH) 水平. 胸腔切开通常是安全的,但超声波指导并不能降低肺胸风险.
科学领域:
- 肺部病理学 肺部病理学
- 内部医学 内部医学
- 诊断程序 诊断程序 诊断程序
背景情况:
- 胸腔结合对于诊断多流的原因至关重要.
- 虽然通常是安全的,但潜在的并发症包括低氧化,出血和肺胸.
研究的目的:
- 系统地审查证据,以区分透汗和排汗的排泄.
- 识别胸腔切开技术,以尽量减少并发症风险.
主要方法:
- 随机和观察性研究的系统审查.
- 在2014年2月之前搜索过Cochrane图书馆,MEDLINE和Embase.
- 分析了诊断准确度 (概率比率) 和不良事件发生率.
主要成果:
- 液的诊断是准确的,在液胆固醇>55 mg/dL,LDH>200 U/L,或胆固醇/血清胆固醇比>0.3.3.
- 所有莱特标准的缺失使得排泄物诊断不太可能 (LR,0.04).
- 肺胸发生在6.0%的病例中;超声指导没有降低这种风险.
结论:
- 光的标准,胆固醇和LDH水平是诊断肺部排泄物的关键.
- 胸腔切开的超声指导并没有降低肺胸病发病率.
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