肺癌合并胸腔积液214例临床分析杨钰贤陈志明江艺邱希辉林丹霞汕头大学医学院附属肿瘤医院肿瘤内科汕头市515031摘要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。关键词肺癌胸腔积液诊断中图分类号:R734.2文献标识码:B文章编号:1672-3422(2006)10-0021-03ClinicalAnalysisof214CasesofMalignantPleuralEffusionwithLungCancerYANGYuxian,CHENZhiming,JIANGYi,etalDepartmentofChemotherapy,TumorHospital,ShantouUniversityMedicalCollege,Shantou515031,ChinaABSTRACTObjectiveToinvestigatethecharacteristicsofmalignantpleuraleffusionwithlungcancer,toraisediagnosisrateofmalignantpleuraleffusionwithlungcancer.MethodsToana-lyzeretrospectiveyclinicaldataof214casesoflungcancercomplicatedwithmalignantpleuraleffusionwhohadbeendiagnosedexplicitlybythepathologyinourhospitalinthelast6years.Results214casesofthelungcancercomplicatedwithmalignantpleuraleffusionoccupied24.0%ofalllungcancerinthesameperiod.Patientswhoover45yearsofage(include45yearsold)were180cases(84.1%).Mainsymptomsofcaseswerechestdistress,asthma,cough,chestpainandhemoptysis,occurrenceratefrom67.3%to31.3%.Casesofexudativehydropswere203(94.9%),11casesoftransdatorydropsy(5.1%).Casesofbloodeffusionwere166(77.6%),48casesofnon-bloodeffusion(22.4%).Casesofpleuraleffusionintherightchestwere119(55.6%),74casesoftheleftchest(34.6%),bothchest'swere21cases(9.8%).Casesofagreatdealofpleuraleffusionwere98ca-ses,75casesofmediumquantityofpleuraleffusion,41casesofalittleamountofpleuraleffusion.Casesofadenocarcinomawere126(58.9%),60casesofspuamouscarcinoma(28.0%),9casesofsmallcellcarcinoma(4.2%).10casesoflargecellcarcinoma(4.7%),9casesoftheotherpatho-logictypes(4.2%),Amongthemfoundoutcarcinomacellfromthepleuraleffusionwere167cases(78.0%).ConclusionIt'smusttoexaminecompletelyforthepatientswithmalignantpleuraleffu-sion,andanalyzethecharacteristicsofmalignantpleuraleffusionresultedinlungcancer,whichcanraisethediagnosisrateoflungcancer.Thetimeofdiagnosiscanbeshorten.KEYSORDSLungcancer;Malignantpleuraleffusion;Diagnosis肺癌是最常见的恶性肿瘤之一,严重威胁人类健康和生命,WHO1999年报告肺癌是癌症第一位死亡原因,约15%肺癌在首诊时即伴有胸腔积液,是恶性胸腔积液的常见病因[1],但肺癌合并胸·21·JournalofMedicalForumVol.27No.10May2006腔积液,特别是中大量积液时,由于胸液掩盖了肺部病灶,而不易明确其原发病灶,从而给诊断带来了一定的困难,为此对2000年1月～2006年2月我院住院的214例肺癌合并胸腔积液的病例进行回顾性分析,报告如下:1资料与方法1.1一般资料本组214例占同期肺癌总病例数24.0%(214/893),其中首诊时发现胸腔积液133例,占同期肺癌14.9%。男性129例,女性85例。年龄27～81岁,中位年龄57岁,其中27～44岁34例(15.9%),45～60岁88例(41.1%)60岁以上92例(43.0%),而45岁以上(含45岁)占84.1%。入选标准:①病理确诊为肺癌;②合并胸腔积液。排除标准:原发胸膜肿瘤;转移性肺癌;其他原因所致的胸腔积液(如感染性,心源性等)。1.2临床表现...
