Etiology And Diagnosis Analysis For181Cases Of Pleural Effusion

Pleural effusion is the clinical common signs and symptoms,anysystemic or local lesion damage intrapleural liquid filtration andabsorption of dynamic balance and the pleural cavity liquid form too fastor absorption were too slow which can lead to the emergence of pleuraleffusion.It can be divided into benign and malignant pleural effusion,theformations of the above two are different,treatment and prognosis ofthese patients also have very different results.So pleural effusionetiology diagnosis has important clinical significance.Objective To investigate the etiology and clinical character ofpleural effusion and improve the efficiency of diagnosis and differentialdiagnosis.Methods We made a retrospective analysis of181casesinpatients with pleural effusion from Mar.2011to Aug.2012.Result①There were172cases diagnosed clear in181patientswith pleural effusion,in104cases of pleural effusion with benignorigin,58cases (55.8%) were caused by tuberculosis,33cases(31.7%)were caused by infection,10cases(9.6%) were due tohypoproteinenmia and cardiac insufficiency;68cases(39.5%) wereattribute to malignant pleural effusion.②The diagnosed clear172 cases were divided into three groups according to the age, amongpatients under44years old(including44years old),tuberculouspleuritis was major reason for pleural effusion;in patientsbetween45and60years old and over60years old, most pleuraleffusion were finally diagnosed to be malignant pleural effusion.③Themajor clinical manifestations of tuberculous pleural effusion patientswere fever, cough and chest distress;and the major clinicalmanifestations of malignant pleural effusion were cough, chesttightness, chest pain and blood in phlegm.④Pleural effusion may be inthe unilateral and bilateral,most cases of pleural effusion were located inright chest.⑤The detection rate of carcinoma cells in exudates withblood effusion was signifycantly higher than that in exudates withnon-blood effusion(P＜0.05).⑥The level of LDH in malignant pleuraleffusion was significantly higher than the level in tuberculous pleuraleffusion,but the sensitivity was low.⑦The positive incidence ofcancer cell in pleural effusion was79.4%,the most wereadenocarcinoma(92.6%).Conclusion Tuberculosis and malignant tumor are the majorcauses of pleuraleffusion， tuberculous is the most important etiololgicfactor for pleural effusion in young patients,and malignant pleuraleffusion in old patients. Malignant and tuberculous pleural effusion ismainly unilateral, especially in the right. Bilateral pleural effusion is mainly caused by cardiac dysfunction and low protein.Hemorrhagicwith pleural effusion should be alert to malignant tumor, especiallyadenocarcinoma possibility.