肺癌合并胸腔积液214例临床分析

Clinical Analysis of 214 Cases of Malignant Pleural Effusion with Lung Cancer

目的探讨肺癌合并胸腔积液的特点，以提高其诊断率。方法对我院近6年来住院的有病理学确诊的214例肺癌合并胸腔积液病例的临床资料回顾性分析。结果214例肺癌合并胸腔积液占同期肺癌病例的24．0％；45岁以上（含45岁）180例（84．1％）。主要症状为胸闷、气喘、咳嗽、胸痛、咯血，发生率在67．3％～31．3％；胸水渗出液203例（94．9％），漏出液11例（5．1％）；血性胸液166例（77．6％）。非血性48例（22．4％）；右侧胸液119例（55．6％），左侧胸液74例（34．6％），双侧胸液21例（9．8％）；大量胸腔积液98例，中量75例，少量41例；腺癌126例（58．9％），鳞癌60例（28．0％），小细胞癌9例（4．2％），大细胞癌10例（4．7％），其它病理类型9例（4．2％）；而其中能从胸液中找到癌细胞的有167例（78．0％）。结论对胸腔积液患者进行全面检查，分析肺癌致胸腔积液的特点，可提高肺癌的诊断率，缩短确诊时间。

Objective To investigate the characteristics of malignant pleural effusion with lung cancer, to raise diagnosis rate of malignant pleural effusion with lung cancer. Methods To analyze retrospectivey clinical data of 214 cases of lung cancer complicated with malignant pleural effusion who had been diagnosed explicitly by the pathology in our hospital in the last 6 years. Results 214 cases of the lung cancer complicated with malignant pleural effusion occupied 24.0% of all lung cancer in the same period. Patients who over 45 years of age （ include 45 years old） were 180 cases （ 84. 1% ） Main symptoms of cases were chest distress, asthma, cough, chest pain and hemoptysis,occurrence rate from 67.3% to 31.3%. Cases of exudative hydrops were 203 （94. 9% ）, 1 lcases of transdatory dropsy （ 5.1% ）. Cases of blood effusion were 166 （ 77.6% ）, 48 cases of non - blood effusion （22. 4% ）. Cases of pleural effusion in the right chest were 119 （55.6%）, 74 cases of the left chest （34.6%） ,both chestg were 21 cases （9.8%）. Cases of a great deal of pleural effusion were 98 cases, 75 cases of medium quantity of pleural effusion,41 cases of a little amount of pleural effusion . Cases of adenocarcinoma were 126 （58.9%）, 60 cases of spuamous carcinoma （28.0%）, 9 cases of small cell carcinoma （4.2%）. 10 cases of large cell carcinoma （4. 7% ）, 9 cases of the other pathologic types （4.2%）,Among them found out carcinoma cell from the pleural effusion were 167 cases （78.0%）. Conclusion It＇s must to examine completely for the patients with malignant pleural effusion, and analyze the characteristics of malignant pleural effusion resulted in lung cancer, which can raise the diagnosis rate of lung cancer. The time of diagnosis can be shorten.