胸腔积液273例临床分析

Clinical Analysis of Pleural Effusions: A Report of 273 cases

目的 探讨胸腔积液的病因分布及癌胚抗原的测定对鉴别良恶性胸腔积液的参考价值。方法 回顾性分析 2 73例胸腔积液的临床资料。结果 良性胸液 12 9例 ,其中结核性 5 5例 ( 4 2 .64 % ) ,心功能不全 2 7例 ( 2 0 .93 % ) ,糖尿病及其合并症 12例( 9.3 % ) ,其他 3 5例。恶性胸腔积液 14 4例 ,其中原发性支气管肺癌 114例 ( 79.17% ) ,乳腺癌 18例 ( 12 .5 % ) ,其他 12例。良恶性两组胸腔积液CEA水平测定 ,差异显著 (P <0 .0 1)。结论 原发性支气管肺癌是导致恶性胸腔积液的主要原因 ;胸液CEA水平的测定不失为初步鉴定良恶性胸液的方法之一。

Objectives To study the pathogeny distribution in pleural effusions and evaluate the value of CEA in differentiating malignant pleural effusion from benign origin. Methods The clinical data of 273 cases with pleural effusions were analyzed retrospectively. Results In 129 cases of pleural effusions with benign origin, 55cases (42.64%) were caused by tuberculosis, 27 cases (20.93%) were caused by heart failure, 12 cases (9.3%) were caused by diabetes, 35 cases were caused by other diseases. In 144 cases with malignant pleural effusion, 114 patients (79.17%) were original bronchogenic carcinomas of lung, 18 patients (12.5%) were breast cancer, 12 patients were other cancers. The levels of the CEA in malignant pleural effusions were higher than in benign origin pleural effusions (P<0.01). Conclusions Original bronchogenic carcinoma was the most important cause of malignant pleural effusions; CEA assay was useful for differentiating malignant pleural effusions from benign origin.