恶性胸腔积液352例临床分析  

Malignant Pleural Effusion:A clinical study of 352 cases

作　　者：黄斌[1] 卢东生[1] 陈侯腾[1] 廖槐[2] 谢灿茂[2] 

机构地区：[1]中山大学附属汕头医院,广东汕头515031 [2]中山大学附属第一医院,广东广州510089

出　　处：《河北医学》2006年第4期338-340,共3页Hebei Medicine

摘　　要：目的:观察恶性胸腔积液的病因分布及临床特点,并综合评价各种检查手段的诊断价值。方法:对352例恶性胸腔积液进行回顾性分析。结果:①352例中,呼吸系统肿瘤的比例为54.0%,其他病因依次为消化系统肿瘤(28.0%)、血液系统肿瘤(4.5%)及乳腺-子宫附件肿瘤(2.1%);②常见的临床症状为咳嗽(55.7%)、气促(40.7%)、胸痛(30.7%),右侧、左侧及双侧恶性胸腔积液比例分别占55.1%、31.6%和13.3%(P<0.05);③胸腔积液癌胚抗原均值35μg/L,大于5μg/L 63例(74.3%);④胸腔积液癌细胞检查、胸膜活检、纤维支气管镜(纤支镜)检查的阳性率分别为41.6%、37.8%、43.8%,三者联合阳性率为70.9%。结论:呼吸系统、消化系统、血液系统、乳腺-子宫附件肿瘤是恶性胸腔积液的主要病因;进行性胸痛为恶性胸腔积液较特异性的症状;恶性胸腔积液有一定的右胸选择性;胸腔积液癌胚抗原、胸腔积液细胞学、经皮穿刺胸膜活检、纤支镜、胸腔镜检查对诊断恶性胸腔积液有重要价值,联合应用能提高阳性率。Objective： To investigate the etiology and clinical character of pleural effusion, evaluating the diagnostic value of all kinds of exminations. Method： A retrospective study of malignant pleural effusion in 352 patients was performed. Result： ①The proportion of respiratory carcinoma is 54.0%, other etiologies are gastrointestinal carcinoma （ 28.0% ）, hemaology carcinoma （ 4.5% ） and breast - uterus carcinoma （ 2. 1% ）. ②The common symptoms are cough（55.7% ） ,dyspnea（40.7% ） ,chest pain（ 30.7% ） , The proportion of right ,left and bilateral pleural effusion are55.1% ,31.6% and 13.3% respectively（ P 〈0.05 ） ③The mean value of CEA in pleural effusion is35μg/L,63 cases（74.3% ）over 5μg/L ④The positive incidence of examining cancer cell in pleural effusion,pleura biopsy and fiberbronchoscopy are 41.6% ,37.8%, 43.8%, the combined incidence is 70.9%. Concluson： Respiratory carcinoma, gastrointestinal carcinoma and hemaology Carcinoma are main etiologies of malignant pleural effusion, the progressive chest pain is a symptom in it,examining cancer cell and CEA in pleural effusion,pleura biopsy fiberbronchoscopy,pleurahcopy have important diagnostic value, and comb. ination of them can raise the positive incidence.

关 键 词：胸腔积液 胸膜活检 纤维支气管镜 胸腔镜 

分 类 号：R730.4[医药卫生—肿瘤]