Analysis on clinical features and manifestations under thoracoscopy in elderly patients with tubercular pleurisy

Objective To summarize the clinical features and manifestations under thoracoscopy of 41 elderly patients with tubercular pleurisy,and to discuss the importance of medical thoracoscopy for the diagnosis of tubercular pleurisy in the elderly. Methods The clinical features and manifestations under thoracoscopy of 41 patients with tubercular pleurisy in the elderly diagnosed by flexible electron-assisted thoracoscopy and biopsy were retrospectively analyzed. Results The clinical presentations of tubercular pleurisy were atypical in the elderly.Cough(75.6%) and chest tightness and dyspnea(87.8%) were the most common,and the coexistence proportion of both disease(85.4%) and misdiagnosis rate(68.3%) were high.Based on observation of thoracoscopy there were small punctual sarcoidosis(41.5%),one or more sarcoidosis(26.8%),pleural congestion and edema(19.5%) and pleural thickening and fibrinous adhesion(12.2%) in 41 elderly patients.Distribution of the focus lesion was as follows: 46.3% on parietal pleura with posterior,12.2% on anterior,7.3% on lateral,7.3% on diaphragmatic pleura,19.5% diffusively distributed and 7.3% on visceral pleura.There was no serious complication. Conclusions The clinical profiles of tubercular pleurisy are nonspecific in the elderly.To make a definite diagnosis,medical thoracoscopic surgery should be carried out as early as possible.