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目的探讨双侧胸腔积液病因及临床特点。方法对90例双侧胸腔积液进行回顾性分析。结果(1)结核性50例(55.6%),肿瘤转移30例(33.3%),其他原因10例(11.1%)。(2)血性胸腔积液在恶性胸腔积液和结核性胸腔积液中分别占60%(18/30)和34%(17/50)(P<0.05)。(3)胸腔积液 CEA 在恶性胸腔积液和结核性胸腔积液中阳性率分别占77.3%(17/22)和4.8%(2/42)(P<0.01)。(4)胸腔积液 ADA 值以≥45U/L 为阳性时,恶性胸腔积液和结核性胸腔积液阳性率分别占12.5%(3/24)和42.9%(15/35)(P<0.01)。(5)少量胸腔积液占恶性胸腔积液和结核性胸腔积液中分别占50%(15/30)和74%(37/50)(P<0.05)。结论双侧胸腔积液多见于结核与肿瘤;少量胸腔积液多见于结核性胸腔积液;血性胸腔积液多见于肿瘤转移;胸腔积液 CEA 及 ADA 测定对良恶性有鉴别价值。
Objective To investigate the etiology and clinical features of bilateral pleural effusion. Methods 90 cases of bilateral pleural effusion were retrospectively analyzed. Results (1) Tuberculosis in 50 cases (55.6%), tumor metastasis in 30 cases (33.3%), and other reasons in 10 cases (11.1%). (2) Bloody pleural effusion accounted for 60% (18/30) and 34% (17/50) respectively in malignant pleural effusion and tuberculous pleural effusion (P <0.05). (3) The positive rates of CEA in malignant pleural effusion and tuberculous pleural effusion were 77.3% (17/22) and 4.8% (2/42), respectively (P <0.01). (4) Positive rates of malignant pleural effusion and tuberculous pleural effusion accounted for 12.5% (3/24) and 42.9% (15/35), respectively (P <0.01) when ADA of pleural effusion was≥45 U / L ). (5) A small amount of pleural effusion accounted for 50% (15/30) and 74% (37/50) respectively in malignant pleural effusion and tuberculous pleural effusion (P <0.05). Conclusions Bilateral pleural effusion more common in tuberculosis and cancer; a small amount of pleural effusion more common in tuberculous pleural effusion; bloody pleural effusion more common in tumor metastasis; pleural effusion CEA and ADA determination of benign and malignant differential value.