摘要
目的探讨胸腔积液患者的病因分布特征并分析其临床特点,优化胸腔积液病因诊断的流程和临床实践。方法选择住院病例中诊断为胸腔积液的1646例患者,随机抽取334例(20.3%),对患者的基本情况、胸腔积液病因和临床特点进行回顾性分析比较。结果胸腔积液在住院患者中占比为1.5%;在呼吸与危重症医学科住院患者中占比为8.2%。胸腔积液患者的病因依次为感染、低蛋白血症、恶性肿瘤、结核、心力衰竭、肝硬化、结缔组织病、肾脏疾病、药物、肺栓塞等;大约31.1%的胸腔积液患者有多个病因。在60岁以上患者中,感染和恶性肿瘤导致的胸腔积液分别占39.1%和26.4%;而在40岁以下的患者中,结核导致的胸腔积液占38.2%。临床特点分析发现,渗出性胸腔积液患者的比例(72.8%)高于漏出性胸腔积液(27.2%);低蛋白(80.5%)导致的胸腔积液主要发生在双侧,而结核(80.8%)和感染(88.5%)导致的胸腔积液主要发生在单侧。结论胸腔积液患者最主要的病因为感染、低蛋白血症、恶性肿瘤和结核,恶性肿瘤和感染以老年患者居多,结核以年轻患者居多。
Objective To explore the etiology of pleural effusion and analyze its clinical characteristics,so as to optimize the diagnosis process and clinical practice of pleural effusion.Methods Patients were recruited from the in-patients record of Shenzhen People's Hospital from January to December 2018 through the search of HIS system.Among the 1646 cases with the diagnosis of pleural effusion,334 cases(20.3%)were randomized collected for this analysis.The basic situation,etiology and clinical characteristics were analyzed and compared.Results In Shenzhen People's Hospital,pleural effusion accounted for 1.5%of the all causes in-patients and 8.2%of the patients admitted into pulmonary and critical care departments.The etiology of pleural effusion included infection,hypoproteinemia,malignant tumor,tuberculosis,heart failure,cirrhosis,connective tissue disease,kidney disease,and so on.About 30%of patients with pleural effusion had multiple causes.In the patients over 60 years old,the pleural effusion caused by infection and malignant tumor accounted for 39.1%and 26.4%,respectively;while in the patients under 40 years old,the pleural effusion caused by tuberculosis accounted for 38.2%.The analysis of clinical characteristics showed that the proportion of patients with exudative pleural effusion(72.8%)was higher than that of patients with leakage pleural effusion(27.2%).The pleural effusion caused by hypoproteinemia was mainly bilateral(80.5%),while the pleural effusion caused by tuberculosis(80.8%)and infection(88.5%)was mainly unilateral.Conclusion The main etiology of pleural effusion are infection,hypoproteinemia,malignant tumor and tuberculosis,accounting for about 75%of all patients.The majority of patients with malignant tumor and infection are elderly patients,while the majority of patients with tuberculosis are young patients.
作者
吴迪
刘盛国
杨凯
邱锦帆
汪艳
陈荣昌
WU Di;LIU Sheng-guo;YANG Kai;QIU Jin-fan;WANG Yan;CHEN Rong-chang(Department of Respiratory and Critical Care Medicine,Shenzhen Institute of Respiratory Diseases,Shenzhen People's Hospital,Shenzhen 518020,Guangdong,China;不详)
出处
《广东医学》
CAS
2020年第14期1459-1463,共5页
Guangdong Medical Journal
关键词
胸腔积液
病因
诊断
临床特点
pleural effusion
etiology
diagnosis
clinical characteristics
