重症监护病房56例胸腔积液相关情况的回顾性分析

目的:回顾性分析安贞医院急诊重症监护病房(EICU)中56例胸腔积液患者的特点及预后,评价对危重患者进行胸腔穿刺的必要性和安全性。方法:对比胸腔积液患者和无胸腔积液患者住院时间,住院费用及转归的差异;观察胸腔穿刺对诊断的影响及并发症。结果:2004年1月至2005年4月EICU收治患者328例,合并胸腔积液者56例,其中双侧积液30例,主要原因是心力衰竭和低蛋白血症,水负荷过重;单侧胸水26例,主要原因是肺癌和炎性胸腔积液。胸腔积液患者与无胸腔积液患者比较住院时间较长(P<0.05),住院费用较高(P<0.05),病死率无差异。34例行胸腔穿刺,其中10例与初步诊断不一致,误诊率29.4%。胸腔穿刺并发症少。结论:EICU中胸腔积液的发生率较高,出现胸腔积液延长住院时间,增加住院费用,但不影响病死率。

Retrospective study of 56 pleural effusions in emergency intensive care unit

To determine the prevalence and causes of pleural effusion in patients admitted to EICU and assess the necessity and safety of routine thoracentesis.Method：The difference was analyzed between patients with pleural effusion and those without pleural effusion in length of ICU stay, cost and mortality. Result：56（17.1%） patients had pleural effusion in 328 patients. patients with pleural effusion had longer length of ICU stay, more cost than those without effusion （P〈0.05）. Thoracentesis was performed in 34 patients. The thoracentesis-based （definite） diagnosis was different from the presumptive diagnosis in 10 patients （29.4%）. Complications of thoracentesis included Pneumothoraces （n=2） and Pulmonary edema （n=1）.Conclusion：Pleural effusion had some relation with longer length of ICU and higher cost. Routine thoracentesis was a simple and safe means of improving the diagnosis.