本文關鍵詞： 肺結核 結核性胸膜炎 內(nèi)科胸腔鏡 胸膜粘連　出處：《昆明醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：[目的]通過內(nèi)科胸腔鏡對結核性胸膜炎胸膜粘連嚴重程度進行分級,探討影響結核性胸膜炎胸膜粘連程度的相關因素。[方法]選取昆明醫(yī)科大學附屬第一醫(yī)院呼吸內(nèi)2科2015年1月至2017年1月行局麻下內(nèi)科胸腔鏡確診的結核性胸腔積液的70例病例資料,在內(nèi)科胸腔鏡檢查下將患者胸膜粘連嚴重程度劃分為6級。分析研究胸腔積液中PH值、腺苷脫氨酶、乳酸脫氫酶、總蛋白、紅細胞、白細胞、單核細胞百分比、葡萄糖、氯離子,外周血白細胞、C反應蛋白以及患者年齡、患病時間等因素與結核性胸膜炎胸膜粘連程度的相關性。上述所有數(shù)據(jù)均采用SPSS17.0軟件包進行統(tǒng)計學分析。計量資料若符合正態(tài)分布用均數(shù)±標準差(x±s)來表示,不符合正態(tài)分布用四分位數(shù)間距(P25、P50、P75)表示。計數(shù)資料以例數(shù)或率來表示。內(nèi)科胸腔鏡下結核性胸膜炎胸膜粘連程度的相關因素分析采用Kruskal-Wallis H檢驗、Spearman秩相關分析以及有序多分類Logistic回歸分析。用F的顯著性概率作為變量選入或剔除的標準,選入標準為≤0.05,剔除的標準為≥0.10,以P0.0,5為差異具有統(tǒng)計學意義。[結果]70例患者中胸膜粘連程度分級分別為0級11例(15.71%),1級 25 例(35.71%),2 級 16 例(22.86%),3 級 10 例(14.29%),4 級 8 例(11.43%),5級0例(0%)。胸腔積液PH的相關系數(shù)為-0.874,p值0.01,結果具有統(tǒng)計學差異。患者患病時間的相關系數(shù)為0.954,p值0.01,結果具有統(tǒng)計學差異。胸腔積液中腺苷脫氨酶、乳酸脫氫酶、總蛋白、紅細胞、白細胞、單核細胞百分比、葡萄糖、氯離子,外周血白細胞、C反應蛋白以及患者年齡等因素的p值均大于0.05,均無統(tǒng)計學意義。[結論]在內(nèi)科胸腔鏡直視下可以對結核性胸腔積液胸膜粘連程度進行分級判斷。在結核性胸膜炎中胸腔積液PH值接近正常對胸膜粘連程度是保護因素,而患者患病時間是胸膜粘連程度增加的危險因素,故胸腔積液pH值和患者患病時間有助于胸膜粘連程度的預測。而胸腔積液中的腺苷脫氨酶、乳酸脫氫酶、總蛋白、單核細胞百分比、葡萄糖,外周血白細胞、C反應蛋白及患者年齡等因素在預測胸膜粘連程度并沒有太多價值。
[Abstract]:[Objective] to study the related factors influencing the degree of pleural adhesion in tuberculous pleurisy. [Methods: 70 cases of tuberculous pleural effusion diagnosed by thoracoscopy under local anesthesia from January 2015 to January 2017 in 2 departments of the first affiliated Hospital of Kunming Medical University were selected. The degree of pleural adhesion was divided into 6 grades by thoracoscopic examination. The PH value, adenosine deaminase, lactate dehydrogenase, total protein, erythrocyte and white blood cell in pleural effusion were analyzed and studied. Percentage of monocytes, glucose, chloride, peripheral leukocyte C reactive protein, and age of patients. All the above data were statistically analyzed by SPSS17.0 software package. If the measured data were in accordance with the mean 鹵standard of normal distribution, the relationship between the time of the disease and the degree of pleural adhesion in tuberculous pleurisy was analyzed by SPSS17.0 software package. Difference (. X 鹵s). It does not fit the normal distribution with the quartile spacing of P25 and P50. Kruskal-Wallis H test was used to analyze the factors related to the degree of pleural adhesion of tuberculous pleurisy under internal thoracoscopic examination. Spearman rank correlation analysis and ordered multiple classification Logistic regression analysis. Using the significant probability of F as the criterion of variable selection or elimination, the selection standard is 鈮，

本文編號：1456505