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目的研究复治过程中结核性胸腔积液的非经典型表现,避免误诊。方法对1896例肺结核病复治患者的胸腔积液进行细胞病理学检测,部分在治疗中随访观察。结果复治肺结核性胸腔积液的细胞病理学表现可归纳为以下几个类型:淋巴细胞为主型452例(占23.84%),非特异型854例(占45.04%),血性积液368例(占19.41%),间皮细胞为主型129例(占6.80%),间皮细胞增生型56例(占2.95%),脓性积液37例(占1.95%)。结论复治肺结核性胸腔积液以非经典型为主;临床送检较多标本(超过10ml)更易观察到结核性胸腔积液的经典型表现;胸腔积液内细胞不同程度的异型增生可随着疾病的好转而消退。
Objective To study the non-classical manifestations of tuberculous pleural effusion during retreatment and to avoid misdiagnosis. Methods 1896 cases of pulmonary tuberculosis patients with pleural effusion cytopathology, some of the follow-up treatment. Results The cytopathological features of pulmonary tuberculosis pleural effusion were classified into the following types: 452 cases (23.84%) with lymphocyte predominance, 854 cases (45.04%) with non-specific type, 368 cases with bloody effusion (Accounting for 19.41%), mesothelial cell type was 129 (accounting for 6.80%), mesothelial cell proliferation was 56 (accounting for 2.95%) and purulent fluid was 37 (accounting for 1.95%). Conclusion Pulmonary tuberculous pleural effusion in re-treatment is mainly nonclassical. More samples (more than 10ml) are more likely to be observed in classic form of tuberculous pleural effusion. Different degrees of dysplasia in pleural effusion may be observed with The improvement of the disease subsided.