结核性胸膜炎发生脓胸的临床分析

Clinical analysis of tuberculous pleurisy complicated with empyema

目的分析结核性胸膜炎发生、发展为结核性脓胸的因素。方法分析2016年6月至2020年6月太原市第四人民医院收治的32例结核性脓胸患者资料,分析患者临床表现、影像学特征、演变及治疗转归。结果32例患者年龄22~68岁,平均(36±7)岁。其中29例结核性胸膜炎患者为不规律用药,不及时引流胸腔积液,病程迁延7个月至5年,病变部位左侧占18例,右侧占12例。有耐药结核存在者3例。3例患者年龄≥65岁,病程≥3年,合并慢性糖尿病,血清白蛋白≤40 g/L,体质量指数(BMI)≤18.5 kg/m^(2)。结论结核性胸膜炎患者应及早进行规律全程抗结核治疗,短期内控制感染,尽早引流胸腔积液,避免病情迁延发生结核性脓胸。

Objective To analyze the factors that contribute to the development of tuberculous pleurisy in-to tuberculous empyema.Methods The data of 32 patients with tuberculous empyema admitted to Taiyuan Fourth People′s Hospital from June 2016 to June 2020 were analyzed,focusing on their clinical manifestations,imaging characteristics,evolution,and treatment outcomes.Results The age of the 32 patients ranged from 22 to 68 years old,with a mean age of(36±7)years.Twenty-nine of them were patients with tuberculous pleurisy as ir-regular medication,untimely drainage of pleural effusion,the course of the disease was delayed from 7 months to 5 years,the site of the lesion on the left side accounted for 18 cases,and the right side accounted for 12 cases.Drug-resistant tuberculosis was present in 3 cases.Three patients were≥65 years of age and had a disease dura-tion of≥3 years.Three patients were≥65 years old,with a disease duration of≥3 years.They had chronic dia-betes mellitus,serum albumin≤40 g/L,and body mass index(BMI)≤18.5kg/m^(2).Conclusion Regular and com-plete antituberculosis treatment is needed for patients with tuberculous pleurisy to control the infection in a short period of time,and to drain pleural effusion as early as possible to avoid tuberculous pusothorax in a prolonged period of time.