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Chest：半硬质胸腔镜检查是一种安全有效的EPE诊断方法

2013-09-06 sd3212 DXY

半硬质胸腔EPE诊断方法
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对于半硬质胸腔镜在未确诊的渗出性胸腔积液（EPE）诊断过程中的作用，已发表的研究结果差异很大。为了评估上述检查的安全性，及其对EPE的总体诊断价值，来自印度昌迪加尔医学教育和研究研究生院肺内科的Ritesh Agarwal及其同事进行了一项研究，研究结果在线发表于2013年8月8日的（CHEST）杂志上。研究显示：半硬质胸腔镜检查是一种安全有效的EPE诊断方法。但研究者认为：这一研究结果还需要有精

对于半硬质胸腔镜在未确诊的渗出性胸腔积液（EPE）诊断过程中的作用，已发表的研究结果差异很大。为了评估上述检查的安全性，及其对EPE的总体诊断价值，来自印度昌迪加尔医学教育和研究研究生院肺内科的Ritesh Agarwal及其同事进行了一项研究，研究结果在线发表于2013年8月8日的（CHEST）杂志上。研究显示：半硬质胸腔镜检查是一种安全有效的EPE诊断方法。但研究者认为：这一研究结果还需要有精心设计的更大试验，对其进行验证。【原文下载】

该研究是针对半硬质胸腔镜检查文献的一项系统回顾和荟萃分析。研究者通过PubMed和EMBASE数据库，搜索了半硬质胸腔镜检查在EPE患者中应用的相关研究；并使用QUADAS-2工具对这些研究的质量进行了评估。随后，研究者分别计算了在纳入分析的每篇文献中，其半硬质胸腔镜检查的灵敏度、特异性、阳性似然比（PLR）、阴性似然比（NLR）、及诊断比值比（DOR）等指标；并应用随机效应模型对所有研究结果进行了汇总分析。此外，研究者还对个别研究结果进行了异质性和发表偏倚评估；并使用敏感性分析探讨了造成其异质性的潜在原因。
该研究的主要结果为：研究者将搜索到的17篇文献纳入了分析，共涉及未确诊的EPE患者755例。半硬质胸腔镜检查在这些患者中的总体敏感性、特异性、PLR、NLR、及DOR值，分别为91%、100%、4.92、0.08、和102.28。其总体的受试者工作特征曲线之曲线下面积为0.93。半硬质胸腔镜检查的并发症微不足道，也没有造成受检者死亡。有证据显示，相关文献报告的研究结果存在一定的异质性；但敏感性分析表明，在排除了受试者＜25例的较小研究后，这种异质性会显著降低。此外，研究没有发现发表偏倚的证据。

该研究结果显示：半硬质胸腔镜检查是一种安全、有效的EPE诊断方法。但研究者认为：由于相关研究的样本较小，所以，有必要进行精心设计的更大试验，以便对上述研究结果进行验证。此外，也需要有半硬质、和硬质胸腔镜检查头对头的试验比较。

原文下载

Agarwal R, Aggarwal AN, Gupta D.Diagnostic accuracy and safety of semirigid thoracoscopy in exudative pleural effusions: a meta-analysis.Chest. 2013 Aug 8. doi: 10.1378/chest.13-1187.

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    2014-08-18 Smile2680

    #Chest#

    0

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    2014-03-09 xiangyuzhou971

    #EST#

    0

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    2014-02-16 haouestc

    #诊断方法#

    0

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    2013-10-17 feather89

    #PE#

    0

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    2013-09-08 yinxm8304

    #胸腔镜#

    0