40例渗出性胸液的临床分析  

A clinical analysis of 40 cases of extravasated pleural effusion

作　　者：杨松[1] 张耀亭[1] 殷建团[1] 

机构地区：[1]福建省漳州市解放军第175医院肺科,363000

出　　处：《临床肺科杂志》2005年第5期607-608,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨渗出性胸液的临床及鉴别要点。方法收集2003年1月至2004年12月于我科住院患者的临床资料,分别对渗出性胸液的临床表现、鉴别诊断和治疗进行分析。结果渗出性胸液最常见原因为结核性,其次为恶性肿瘤,少见者为肺吸虫病。结核性胸液多表现为单侧性,左、右侧胸液无显著性差异,胸液涂片结核杆菌阳性率很低,而恶性胸液大多表现双侧积液。为血性胸水,可找到癌细胞。结核性胸液对抗痨治疗有效。恶性胸液常有原发肺部或颈淋巴结等转移病灶。肺吸虫病性胸液可呈现微粘性咖啡色,胸液较难发现寄生虫,而血清抗体常阳性。结论渗出性胸液最常见原因是结核性,对抗痨无效的胸液要高度怀疑恶性胸液或寄生虫病,胸部X线、CT或颈部淋巴结活检有助于恶性胸液诊断,有效的化疗方案可控制恶性积液的快速产生和降低对机体的影响,血清免疫学检测血清抗体有助于寄生虫病合并胸液的确诊。Objective To analyze the clinical characteristics or differential diagnosis of extravasated pleural effusion.Methods Clinical data of inpatients suffered from extravasated pleural effusion (EBE) from March 2003 to December 2004 were collected. Respective analysis was carried out on the clinical manifestations, differential diagnosis, or treatment of PE.Results EPE was mainly resulted from tuberculosis. The rate of malignant pleural effusion (MPE) was second to the tuberculous pleural effusion (TPE). The least occurrence to PE was suffered from paragonimiasis. TPE mostly occurred at either pleural cavity. No significant difference between right and left was found. But PE was frequent at both the two pleural cavities. The TPE or MPE was characteristic of extravasate. The smear positive rate of tuberculous bacterium from the PE was not high. Bloody effusion was often found from MPE and malignant cell was easily found from the samples. It was effective by anti-tuberculous treatment on TPE. The primary or matastatic foci were often found in the lung or jugular lymph node. PE suffered from paragonimiasis may be little sticky and the colour of coffee. It was hard to detect the parasites, but easy to assay positive seral antibody. Conclusion The most pathogens resulted in PE is tuberculous bacteria. PE suffered from either malignant tumor or parasitosis should be considerably suspected when anti-tuberculous treatment brings no effect. It is necessary to diagnose the MPE by X-ray test, computerized tomography, or biopsy of jugular lymph nodes. Efficient chemotherapeutic program should be adopted so as to lessen the MPE and reduce the bad affect on the body. PE accompanied by parasitosis could be diagnosed with seroimmunological assay for the seral antibody.

关 键 词：渗出性 临床分析 2003年1月 血清免疫学检测 结核性胸液 恶性胸液 常见原因 血清抗体 寄生虫病 2004年 诊断和治疗 显著性差异 淋巴结活检 鉴别要点 临床表现 临床资料 住院患者 恶性肿瘤 肺吸虫病 结核杆菌 血性胸水 抗痨治疗 

分 类 号：R561[医药卫生—呼吸系统]