双侧结核性胸膜炎15例报告

Bilateral tuberculous pleural effusion(15 cases report)

我院１９８４年～１９９４年收治１５例双侧结核性胸膜炎，根据临床特点，双侧结核性胸膜炎可分为三型：Ⅰ型（４例）：双侧胸膜腔积液伴双肺肺结核；Ⅱ型（４例）：双侧胸膜腔积液，但Ｘ线胸片上肺内未见结核病灶；Ⅲ型（７例）：双侧胸膜腔积液伴其它部位浆膜腔积液，其胸水检查倾向于漏出液，或介于漏出液和渗出液之间，推测其胸水产生机制可能系渗出、漏出两种机制并存。最后对双侧结核性胸膜炎的临床意义进行简要讨论。

Fifteen patients with bilateral tuberculous pleural effusion admitted in 1984～1994 were reported. They were classified into three patterns. Pattern Ⅰ(4 cases):bilateral tuberculous pleural effusion with pulmonary tuberculosis over both lung fields; pattern Ⅱ(4 cases):bilateral tuberculous pleural effusion without pulmonary tuberculosis; pattern Ⅲ(7 cases):bilateral tuberculous pleural effusion without pulmonary tuberculosis, but with serositis in other locations. The nature of the pleural effusions was likely a transudate or somewhat an intermediate fluid between exudate and transudate. It was speculated that the mechanism of formation of pleural effusion might be coexistence of transudation and exudation complicated or resulted in many ways. Finally the clinical implication of bilateral tuberculous pleural effusion were discussed briefly.