子宫内膜异位症相关复发性单侧血性胸腔积液1例  

Endometriosis-related recurrent unilateral hemorrhagic pleural effusion: a case report

作　　者：康文文 韩贺东 王兆峰 张方 吕镗烽 宋勇 Kang Wenwen;Han Hedong;Wang Zhaofeng;Zhang Fang;Lyu Tangfeng;Song Yong(Department of Pulmonary and Critical Care Medicine,Jinling Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210016,China)

机构地区：[1]南京大学医学院附属金陵医院呼吸与危重症医学科,南京210016

出　　处：《中华结核和呼吸杂志》2024年第5期460-463,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：血性胸腔积液在临床工作中较为常见。我国指南指出,诊治过程中需重点排查常见疾病。通过临床病史、体格检查、实验室及影像学检查、胸膜活检或胸腔镜手术可明确胸腔积液的病因。本文报道1例罕见的病例:32岁女性,因右侧胸闷胸痛起病,先后就诊多家医院,诊治过程中反复出现单侧血性胸腔积液,且与月经周期有高度相关性,排查常见病因后,经胸腔镜病理活检明确诊断为胸腔子宫内膜异位症(TES)。该例患者接受了手术联合长期激素治疗的方案,随访中胸腔积液减少且无胸痛等不适。育龄期女性规律出现单侧血性胸腔积液,需要警惕TES的发生。Hemorrhagic pleural effusion(PE)is common in clinical practice.According to the guidelines,the etiological diagnosis of PE should focus on the identification of common diseases.In most cases,the etiology of PE can be determined by clinical history,physical examination,laboratory and imaging examinations,and pleural biopsy or video-assisted thoracic surgery(VAST).We reported a rare case of a 32‐year‐old woman with recurrent unilateral hemorrhagic pleural effusion(highly correlated with menstrual cycle)and chest pain that was diagnosed as thoracic endometriosis syndrome(TES)by pathological biopsy and immunohistochemistry.Later she underwent surgery combined with hormone therapy.During the follow-up,the right PE decreased,and she had no chest pain.Therefore,women of reproductive age with regular unilateral bloody pleural effusions should be alert to TES.

关 键 词：血性胸腔积液 胸膜活检 临床病史 病理活检 胸腔镜手术 子宫内膜异位症 育龄期女性 月经周期 

分 类 号：R711.74[医药卫生—妇产科学]