超声在辅助诊断胸腔积液性质中的价值  

The value of ultrasonography in the diagnosis of pleural effusion

作　　者：白洋 王婷 屈晓一 BAI Yang;WANG Ting;QU Xiaoyi(Xi′an People′s Hospital·Xi′an Fourth Hospital:Department of Ultrasonography,Xi′an 710004,China;Xi′an People′s Hospital·Xi′an Fourth Hospital:Department of Respiratory Medicine,Xi′an 710004,China)

机构地区：[1]西安市人民医院·西安市第四医院超声科,陕西西安710004 [2]西安市人民医院·西安市第四医院呼吸内科,陕西西安710004

出　　处：《西北国防医学杂志》2021年第7期648-653,共6页Medical Journal of National Defending Forces in Northwest China

基　　金：陕西省重点研发计划项目(2018SF-219);西安市科技计划项目(201805093YX1SF27)。

摘　　要：目的:通过对比超声影像图在渗出性胸腔积液和漏出性胸腔积液中的不同表现探究超声在辅助诊断胸腔积液性质中的价值。方法:回顾性分析2016-01-01~2020-12-31我院实验室已确诊的275例渗出性胸腔积液及307例漏出性胸腔积液超声影像图特点,对比两组在回声(无回声、低回声)、分隔(无分隔、有分隔)、光点(无、弱、强)、胸膜厚度(≤3 mm、>3 mm)等方面的差异。结果:在275例渗出性胸腔积液患者中,原发病主要为肺炎、肺结核、肺癌、脓胸,胸腔积液,绝大多数为单侧(214例,77.8%),其中,超声显示131例(47.6%)有分隔,161例(58.5%)为低回声,109例(39.6%)胸膜增厚>3 mm。在307例漏出性胸腔积液患者中,原发病主要为心力衰竭、肾病综合征、肝硬化,胸腔积液绝大多数为双侧(298例,97.1%),其中,超声显示8例(2.6%)有分隔,3例(1.0%)为低回声,6例(2.0%)胸膜增厚>3 mm。两组在上述超声影像学表现有差异(P<0.05)。结论:超声有辅助诊断胸腔积液性质的价值,若超声提示胸腔积液低回声、有分隔、胸膜增厚,则渗出性胸腔积液可能性大。Objective:To explore the value of ultrasound in the auxiliary diagnosis of pleural effusion by comparing the different manifestations of ultrasound images in exudative and transudatory hydrothorax.Methods:The ultrasonographic features of the samples,including 275 patients with exudative pleural effusion and 307 patients with exudative pleural effusion confirmed by laboratory from January 2016 to December 31,2020 were retrospectively analyzed.The differences in echo(no echo,low echo),separation(no separation,with separation),light spot(no,weak,strong),pleural thickness(≤3 mm,>3 mm)between the two groups were compared.Results:In 275 cases of exudative pleural effusion patients,the main primary diseases were pneumonia,tuberculosis,lung cancer,empyema,the vast majority of pleural effusion was unilateral(214 cases,77.8%),of which 131 cases(47.6%)were separated,161(58.5%)cases were hypoechoic,109 cases(39.6%)were pleural thickening>3 mm.In 307 cases of transudatory hydrothorax,the main primary diseases were heart failure,nephrotic syndrome and liver cirrhosis.The vast majority of pleural effusion were bilateral(298 cases,97.1%).Among them,8 cases(2.6%)were separated by ultrasound,3 cases(1.0%)were hypoechoic,and 6 cases(2.0%)were pleural thickening>3 mm.There were significant differences between the two groups(P<0.05).Conclusion:Ultrasound is helpful in the diagnosis of pleural effusion.It is possible to be exudative if the ultrasound indicates that pleural effusion is hypoechoic,separated and the pleura is thickened.

关 键 词：超声 渗出液 漏出液 分隔 回声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R561.3[医药卫生—诊断学]