277例良恶性胸腔积液的临床特点  

Clinical features of 277 cases of benign and malignant pleural effusion

作　　者：沈慧 易桂生[1] 罗淼[1] Shen Hui;Yi Guisheng;Luo Miao(Affiliated Hospital of Guilin Medical University,Guilin 541000,Guangxi)

机构地区：[1]桂林医学院附属医院,广西桂林541000

出　　处：《右江民族医学院学报》2018年第1期33-37,共5页Journal of Youjiang Medical University for Nationalities

基　　金：广西壮族自治区卫生厅自筹经费科研课题(Z2008267)

摘　　要：目的分析良恶性胸腔积液的临床特征,进一步明确胸腔积液的鉴别诊断。方法回顾性分析2009年10月—2013年12月桂林医学院附属医院呼吸内科收治的临床诊断胸腔积液患者477例,选择资料记录完整的277例作为研究对象,进行良恶性胸腔积液临床特点分析。主要观察指标为患者的临床表现,胸水、血清常规生化指标。结果以胸腔积液内找到癌细胞为金标准,判断胸腔积液的良恶性,有癌细胞为恶性。将277例胸腔积液患者分为良性胸腔积液组(235例,占84.84%)和恶性胸腔积液组(42例,占15.16%);其中主要的临床表现为发热、咳嗽、咳痰、胸痛、气促,而胸痛、气促在恶性胸腔积液组检出率明显升高,发热检出率明显降低,两组比较差异有统计学意义(P<0.001或P<0.05)。良性胸腔积液组两侧呼吸运动检出率和肝功能丙氨酸氨基转移酶检测值低于恶性胸腔积液组,两组比较差异有统计学意义(P<0.05)。结论 (1)发热、胸痛、气促、两侧呼吸运动度和丙氨酸氨基转移酶对鉴别良恶性胸腔积液有临床价值。(2)发热是恶性胸腔积液的保护因素,在胸腔积液患者中,发热的病人比不发热的病人患恶性胸腔积液的风险降低83.3%。Objective To further clarify the differential diagnosis of pleural effusion by analyzing the clinical features of benign and malignant pleural effusion. Methods The data of 477 patients clinically diagnosed with pleural effusion were retrospectively analyzed.All the patients were admitted to Department of Respiratory Diseases of Affiliated Hospital of Guilin Medical University from October 2009 to December 2013 and 277 cases of them with complete patient records were selected as research objects for analyzing the clinical characteristics of benign and malignant pleural effusion.The main observed indexes were clinical symptoms,regular pleural and serum biomarkers. Results Cancer cell in pleural effusion was the golden standard for diagnosing malignant or benign pleural effusion,malignant pleural effusion carried cancer cells.All the 277 cases of pleural effusion were divided into a benign pleural effusion group(235 cases,84.84%)and a malignant pleural effusion group(42 cases,15.16%).The main clinical manifestations were fever,cough,expectoration,chest pain and shortness of breath.The detection rates of chest pain and shortness of breath in the malignant pleural effusion group were significantly higher than those in the benign pleural effusion group,the detection rate of fever was significantly decreased,and the differences between benign and malignant pleural effusion were statistically significant(P<0.001 or P<0.05).Comparing the detection rate of bilateral respiratory motility and the measurements of liver function alanine aminotransferase between benign and malignant pleural effusion groups showed that there were statistically significant differences(P<0.05). Conclusion①Some indexes have clinical values in the identification of benign and malignant pleural effusion,including fever,chest pain,shortness of breath,bilateral respiratory motility degree and alanine aminotransferase.②Fever is a protective factor for malignant pleural effusion.In patients with pleural effusion,the risk of malignant pleural effusio

关 键 词：胸腔积液 鉴别诊断 临床特征 

分 类 号：R561.3[医药卫生—呼吸系统]