60例胸腔积液临床分析

摘要

Objective:To study and analyze the pathogenesis and clinical characteristics of pleural effusion systematically.Method:60 patients with pleural effusion and complete clinical data in respiratory department of our hospital from March 2010 to March 2013 were chosen and their clinical data were systematically reviewed. Pathogenesis and clinical characteristics of pleural effusion were summarized and analyzed.Result:Among 60 patients with pleural effusion,malignant pleural effusion was the most(22 cases,36.7%).Age distribution of malignant pleural effusion was 45-92 years old and the average age was 60 years old,age distribution of tuberculous pleural effusion was 21-65 years old and the average age was 40 years old.There were 45 cases(75.0%) of pleural effusion detected by chest X-ray at the first time.Among patients with malignant pleural effusion,there were 3 cases of positive blood tuberculosis antibody,2 cases of positive PPD.Hydrothorax and serum submission for CEA,LDH and hydrothorax exfoliative cytologic examination indicated that,on aspect of serum CEA level and LDH,malignant hydrothorax was obviously higher than the benign,there were significant differences existed between them(P<0.05).Conclusion:The main pathogenesis of pleural effusion are tumor,pneumonia-like diseases and tuberculosis.Early differentiation and diagnosis of pleural effusion and corresponding symtomatic treatment can radically improve clinical effect and prognosis.%目的：对胸腔积液的病因和临床特点进行系统的研究和分析。方法：选择2010年3月-2013年3月就诊于笔者所在医院呼吸科的临床资料完整的胸腔积液患者60例，对入选患者的临床资料进行系统回顾，对胸腔积液发生的病因和临床特征进行总结和分析。结果：60例胸腔积液患者中，恶性胸腔积液占首位(22例，36.7%)；恶性胸腔积液年龄分布在45~92岁，平均60岁；结核性胸腔积液年龄分布在21~65岁，平均40岁；胸腔积液经胸部X线检查首次发现45例(75.0%)，恶性胸水中血结核抗体阳性者3例，PPD阳性者2例，胸水和血清送检CEA、LDH和胸水脱落细胞检查。在血清CEA水平方面，恶性胸水明显高于良性，差异有统计学意义(P<0.05)；恶性胸水LDH与良性比较，差异有统计学意义(P<0.05)。结论：胸腔积液的主要病因为肿瘤、类肺炎症性疾病及结核，尽早对胸腔积液进行鉴别诊断，同时采取相应的对症治疗，从根本上改善治疗的疗效性和患者预后。