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目的 探讨双侧胸腔积液(BPE) 患者临床表现、病因、诊断及鉴别诊断、发病机制。方法 对双侧胸腔积液病人进行胸透或胸片、CT或MRI、B 超及胸水常规检查。结果 结核性胸膜炎为BPE最常见原因。临床表现无特异性。胸部X 线表现:双侧少量积液35 例;一侧少量,一侧大量积液7 例;双侧中量以上积液16 例。胸水常规:渗出液28 例;漏出液4 例;2 次或2 次以上化验结果不一致3 例。CT或MRI检出率为100 % ,胸部X 线检出率为86 .2 % ,B超检出率为64 .3% 。结论 BPE 临床表现无特异性,胸片表现各异,发病机制与多种因素有关,单纯用渗出液和漏出液鉴别病因可导致误诊。提倡CT检查以提高BPE 诊断的正确率
Objective To investigate the clinical manifestations, etiology, diagnosis, differential diagnosis and pathogenesis of patients with bilateral pleural effusion (BPE). Methods Thoracic or chest radiographs of patients with bilateral pleural effusion, CT or MRI, B ultrasound and pleural effusion routine examination. Results Tuberculous pleurisy was the most common cause of BPE. No specific clinical manifestations. Chest X-ray findings: bilateral a small amount of effusion in 35 cases; a small amount on one side of a large number of effusion in 7 cases; bilateral volume in more than 16 cases of effusion. Pleural effusion routine: exudate in 28 cases; leaking fluid in 4 cases; 2 or more than 2 times the test results inconsistent in 3 cases. CT or MRI detection rate was 100%, chest X-ray detection rate was 86.2%, B-detection rate was 64.3%. Conclusions The clinical manifestations of BPE are nonspecific. The manifestations of BPE are different. The pathogenesis of BPE is related to many factors. It is misdiagnosed that the etiology of exudate and effusion can be misdiagnosed. Promote CT examination to improve the accuracy of BPE diagnosis