86例双侧胸腔积液临床分析

目的探讨双侧胸腔积液病因及临床特点。方法对８６例双侧胸腔积液进行回顾性分析。结果①结核性４８例（５５．８％），肿瘤转移２８例（３２．５％），其他原因１０例（１１．７％）。②血性胸水在恶性胸水和结核性胸水中分别占５７％（１６／２８）和３１％（１５／４８）（Ｐ＜０．０５）。③胸水ＣＥＡ在恶性胸水和结核性胸水中阳性率分别占８０％（１６／２０）和２．５％（１／４０）（Ｐ＜０．０１）。④胸水ＡＤＡ值以≥２６Ｕ／Ｌ为阳性时，恶性胸水和结核性胸水阳性率分别占９％（２／２２）和４２．５％（１４／３３）（Ｐ＜０．０１）。⑤少量胸水占恶性胸水与结核性胸水中分别占５０％（１４／２８）和７５％（３６／４８）（Ｐ＜０．０５）。结论双侧胸腔积液多见于结核与肿瘤；少量积液多见于结核性胸水；血性胸水多见于肿瘤转移；胸水ＣＥＡ及ＡＤＡ测定对良、恶性胸水有鉴别价值。

Clinical analysis of 86 cases with bilateral pleural effision

Objective To study the cause and clinical characteristics of bilateral pleural effusion. Method Ret- rospective analysis of 86 cases of bilateral pleural effision. Results (1)Of the 86 cases of bilateral pleural effusion, There were 48 cases caused by tuberculosis with a rate of 55.8%, 28 cases caused by tumor metastasis with a rate of 32.5%, and 10 cases caused by other causes with a rate of 11.7%. (2) 0f malignant effusion, bloody effusion have a rate of 57%(16/ 28). Of effusion caused by tuberculosis, bloody effusion have a rate of 31%(15/48).(P<0.05)(3)The abnormal value of CEA have a rate of 80% (16/20) in malignant effusion and have a rate of 2.5% (1/40) in effusion caused by tuberculo- sis. (P<0.01) (4) The positive ADA value is in excess of 26U/L, the positive rate of malignant effusion and tuberculosis effusion are respectively 9%(2/22) and 42.5%(14/33)(P<0.01)(5) The pencentages of cases with a small amount or effusion were 50%(14/28) in malignant effusion and 75%(36/48) in tuberculosis effusion respectively. Conclusions Tuberculosis and tumor were the most common of bilateral pleural effusion. In tuberculosis effusion a small amount of effusion had a higher rate; Bloody effusion hed a higher rate in tumor metastasis cases; The determination of CEA and ADA in effusion is of significance in differentiating benign effusion from malignant effusion.