Single Center Real World Study On Diagnosis,Treatment And Disease Burden Of Pleural Effusion

Objective To analyze the etiological distribution,diagnosis,treatment status and disease burden of pleural effusion of inpatients in General Hospital of Ning Xia.Methods To collect the clinical data of 1028 patients with pleural effusion admitted to Ning Xia General Hospital from January 2018 to December 2018,and analyzed retrospectively.Results1.Malignant pleural effusion(233 cases 22.7%),pulmonary inflammatory pleural effusion(214 cases 20.8%),congestive heart failure(140 cases 13.6%),tuberculous pleurisy(98 cases 9.5%)and liver cirrhosis(97 cases 9.4%)were the top 5 causes of pleural effusion.2.Among the diagnostic methods of pleural effusion,445 patients(68.15%)received pleural effusion examination,168 patients(25.73%)received fiberoptic bronchoscopy,25patients(3.83%)received pleural biopsy,and 15 patients(2.29%)received medical thoracoscopy.The total positive rate of pleural effusion cytology in the diagnosis of malignant pleural effusion was 81.4%,of which the positive rate was the highest in lung adenocarcinoma(96.6%),ovarian cancer(92.3%)was second only to lung adenocarcinoma,and the positive rate of breast cancer was 77.8%.The ADA activity of PE in tuberculosis group was higher than malignant group(P <0.05).The sensitivity and specificity of pleural effusion ADA in diagnosis of TPE were 83% and 92%,respectively.When 1342.5pg/ml was used as the critical value for the diagnosis of pleural effusion caused by heart failure,the sensitivity was71% and the specificity was 88%.3.Among the 212 patients with malignant pleural effusion,204 patients were treated with pleural catheter drainage,among 214 patients with pulmonary inflammatory pleural effusion treated with anti-infective therapy,170 patients were treated with β-lactam and /or quinolones antibiotics.90 patients with tuberculous pleurisy were treated with chemotherapy,hormone and/or intraluminal urokinase.4.The average hospitalization time of 1028 patients with pleural effusion was 13.46 days,and the average hospitalization cost was 23000 yuan.Conclusion1.The most common diseases causing pleural effusion in Ning Xia are malignant tumor,pneumonia,congestive heart failure,tuberculosis and liver cirrhosis,among which lung cancer,breast cancer and digestive tract malignant tumors are the most common.2.The commonly used method for diagnosing pleural effusion in Ning Xia area is hydrothorax examination,while thoracoscopy is rarely used.Pleural effusion cytology is the most commonly used and sensitive method for the diagnosis of malignant pleural effusion;pleural effusion ADA is a sensitive index to distinguish malignant pleural effusion from tuberculous pleural effusion;serum NT-pro BNP has high clinical diagnostic value for pleural effusion caused by congestive heart failure.3.At present,pleural drainage is the main treatment of malignant pleural effusion;β-lactam and quinolone antibiotics are the most commonly used anti-infective drugs for pneumonia;systemic chemotherapy,hormone and intracavitary injection of urokinase are the main treatment of tuberculous pleural effusion.4.In Ning Xia,the hospitalization time and cost of patients with pleural effusion are heavy.