肺结核并多浆膜腔积液17例临床分析

目的探讨肺结核并多浆膜腔积液的临床特点。方法：选择在我院接受治疗的肺结核并多浆膜腔积液患者作为研究对象，对其临床资料进行回顾性分析。结果：17例患者主要症状有发热（70．6％）、腹胀（52．9％）、咳嗽（23．5％）、乏力、纳差（35．3％）、胸闷、气促（353％）、盗汗（23．5％）、等。发病部位包括胸腔、腹腔、和心包。可单侧发生，也可多则发生。可单部位发生，也可多部位发生。17例患者中9例（52．9％）为浸润型肺结核，8例（47．1％）为急性血行播散型肺结核。17例胸腔积液中，少量积液者4例，中量积液者11例，大量积液者2例。17例患者诊断完全符合率为47．1％（8／17），其中4例被误诊为上呼吸道感染、2例被误诊为伤寒、2被误诊为风湿病、1被误诊为肺炎。17例患者中接受INH、RFP、PZA、SM、EMB等抗结核药物联合激素治疗效果较好，其浆膜腔积液吸收效果较为满意，结论：肺结核并多浆膜腔积液患者多表现出重症结核的症状，但因为临床表现缺乏典型性和特异性，临床上容易误诊。治疗时应该以积极抗结核治疗为主，增加使用激素治疗。

Objective To investigate the clinical characteristics of tuberculosis and more serous effusions, Methods： In ourhospital treated 17 cases of tuberculosis and more effusion patients as research subjects, the clinical data were retrospectivelyanalyzed. Results： 17 patients main symptoms are fever （70.6%）, abdominal distension （52.9%）, cough （23.5%）, fatigue,anorexia （35.3%）, chest tightness, shortness of breath （35.3%）, night sweats （23.5%）, and the like. Diseased parts including thechest, abdomen, and pericardiaL Unilateral can occur, but also more occurs. Single-site can occur, but also multi-site occur.17 patients in 9 cases （52.9%） of pulmonary tuberculosis in 8 cases （47.1%） of acute hematogenous disseminated tuberculosis.17 cases of pleural effusion, effusion in 4 cases, the amount of fluid in 11 cases, a lot of fluid in 2 cases. Diagnosis of 17cases of patients in full compliance was 47.1% （8/17）, four cases were misdiagnosed as upper respiratory tract infection, 2cases were misdiagnosed as typhoid, 2 misdiagnosed as rheumatism, 1 was misdiagnosed as pneumonia. 17 patients receivingINI-I, RFP, PZA, SM, EMB and other anti-TB drug combination hormone therapy is better, its effusion absorption effect issatisfactory. CONCLUSION： Tuberculosis and more effusion in patients showing symptoms of severe tuberculosis more, butbecause the lack of typicality and specificity of clinical manifestations, clinical easily misdiagnosed. TB treatment should bebased on active therapy, increase the use of hormone therapy.