Study On200Cases Of Pleural Effusion Etiology And Diagnosis Method

Objective:Discusses the etiology of pleural effusion and the characteristic ofclinical diagnosis and treatment.Method: Retrospective studyon200cases clinical data of pleural effusion from2009to2011,performed a systematicanalysisoftheetiologyanddiagnosis.Results:1、Etiological factors distributed120cases of benign pleural effusions,53casesoftuberculous(26.5%), heart failurecaused by pleural effusion16cases (8%), pneumonia pleurisy15cases (7.5%), lungabscess7cases(3.5%), liver cirrhosis8cases(4%), renal6cases(3%), rheumatoiddisease4cases(2%), hypothyroidism1cases(0.5%), mitralstenosis1cases(0.5%),otherbenignunexplained9cases.72casesof malignant pleural effusion(36%),including60cases ofprimary lung cancer(30%),3casesofmalignant pleuralmesothelioma(1.5%),4casesofbreast cancer(2%), ovarian tumorsin4cases(2%),and1case of malignant lymphoma(0.5%),8cases suspectedmalignant pleuraleffusionbutundiagnosed.2、Clinical manifestationsChest tightness, shortness of breath152cases(76%), cough115cases(57.5%),fever of77cases(38.5%), chest pain72cases(36%), weight loss14cases(7%),hemoptysis13cases(6.5%), voice hoarse6cases(3%).3、Imaging examinationAmong200cases ofpleural effusion102cases was first discovered byX-ray(51%),80cases was first discoveredby CT (40%),18cases was first discoveredby B-ultrasoundexamination(9%),amongunilateral pleuraleffusion in164cases,36casesofbilateral pleural effusion. 4、Laboratory ExaminationsResults show that exudate in168cases, transudate32cases,53cases oftuberculous pleural effusion are all exudate,among71patients with malignant pleuraleffusion69cases are exudative pleural effusion, among transudative pleural effusion2cases. The color of57cases pleular effusion is light yellow (28.5%), hemorrhagic28patients (14%), between two composes115cases (57.5%). Benign pleuraleffusion CEA,serum CEA was significantly lower than the malignant, both more significant difference(P <0.05).Malignant pleural effusion LDH＞200， benign pleural effusion wassignificantly lower than the malignant, both more significantdifference (P <0.05).Tuberculosis hydrothorax ADA was significantly higher than the malignant pleuraleffusion assessment, which shows a significant difference (P <0.05). PleuraleffusionTBPCRdetected6cases ofpositive(8.8%of tuberculous pleural effusion). Pleuraleffusion tuberculosis bacterium check0cases with positive, pleural effusiongeneralbacteria testing positive for3cases (1.3%).Conclusion:1、TB and cancer is the major cause of pleural effusion, diagnosis of the causeshould be analysed by medical history and related comprehensive analysis of laboratorytests.2、CEAisagoodtumor marker fordiagnosisofmalignant pleural effusionswithhig-hsensitivityandspecificity. Benign and malignant pleural effusion are different deg-ree of LDH, malignant effusion rise significantly higher than benign and malign-ant pleural effusion.Tuberculous pleural effusionADAwere significantlyhigherthant-hatofmalignant pleural effusionsand other benignpleural effusion,higher specificity.Pleural fluid cytology has certain false-positive rate, if necessary,shouldberepeate-d several times.3、ChestX-rayistheprimarymethod for diagnosingpleural fluid.Pleural fluidexhau-stedunderwentCT scan to have the important meaning todiagnosis andidentificationofpleural effusion. To X-ray, Bultrasonography, CT istodeterminetheparapneumoniceffusion(PE)existsand guide treatmentcommonlyusedimaging method.4、The etiology of pleural effusion are widely distributed, involving almostvarioussystems of the body, a variety of cases of clinical symptoms and signs. In clinical workshould be comprehensive and systematic collection and analysis of clinical data andaccurate collection of the pleural fluid laboratory data, active use of the differential diagnosis of new technologies as soon as possible to clarify the cause of pleural effusionand targeted treatment.