612例结核性胸膜炎临床分析

摘要

Objective To summarize the clinical characteristics of tuberculous pleurisy so as to provide the basis for its diagnosis and individualized treatment. Methods The clinical features of 612 diagnosed patients with tuberculous pleurisy were retrospec-tively analyzed. Results The disease course of 313 cases was less than 1 week, accounting for 51.5%, 171 cases 1~2 weeks for 27.9%, 128 cases more than 2 weeks for 20.9%; and the incidence of fever, chest pain, cough, dyspnea after exercise were 76%, 66%, 61.9%, 43%respectively. The unilateral pleural effusion accounted for 91%, bilateral pleural effusion for 9%; small pleural effusion for 91.3%, massive pleural effusion for 8.7%; non-hemorrhagic pleural effusion for 96.2%, hemorrhagic pleural effusion for 3.8%;tuberculous pleurisy complicated with pulmonary tuberculosis for 29.1%, tuberculous pleurisy complicated with extrapul-monary tuberculosis for 7.8%; pleural fluid ADA level more than 45 for 85.9%; strong positivity by PPD Test for 31.5%; erythro-cyte sedimentation rate higher than 20 mm/h for 78.9%. Conclusion Fully grasping the clinical characteristics of tuberculous pleurisy can improve its diagnosis and treatment, which can lead to early treatment and good effect.%目的：总结结核性胸膜炎的临床特点，为临床正确诊断及个体化治疗结核性胸腔积液提供依据。方法回顾性分析612例确诊结核性胸膜炎的临床特征。结果年龄分布，<40岁占69.9%，病程<1周313例(51.1%)，1~2周171例(27.9%)，>2周128例(20.9%)，发热、胸痛、咳嗽、活动后气促发生率分别为76%、66%、61.9%、43%，单侧胸水占91%，双侧胸水占9%，中小量胸水占91.3%，大量胸水占8.7%，非血性胸水占96.2%，血性胸水占3.8%，合并肺结核占29.1%，合并肺外结核占7.8%，胸水ADA>45占85.9%，PPD试验强阳性占31.5%，血沉>20 mm/h占78.9%。结论充分掌握结核性胸膜炎的临床特点，可以提高诊断水平，争取尽早治疗机会，提高治疗疗效。