目的:探讨难治性胸腔积液的临床特点及其常见原因。方法:回顾性分析29例难治性胸腔积液患者的临床资料。结果:29例患者,住院天数最短36 d,最长107 d,提示良、恶性胸腔积液难以鉴别、治疗中病情的特殊演变以及对少见病缺乏认识等是造成难治性胸腔积液的主要原因。结论:造成难治性胸腔积液的因素多样,遵循疾病的诊治原则,重视疗效的评价,根据病情变化及时调整治疗方案。 Objective: To investigate the clinical features and common causes of refractory pleural effusion. Methods: The clinical data of 29 patients with refractory pleural effusion were retrospectively analyzed. Results: The shortest 36 days of hospitalization and the longest of 107 days in 29 patients suggested that it was difficult to distinguish between benign and malignant pleural effusions. The special evolution of the disease and the lack of understanding of rare diseases were the main causes of refractory pleural effusion the reason. Conclusion: The factors causing refractory pleural effusion are diverse, follow the principle of diagnosis and treatment of the disease, pay attention to the evaluation of the curative effect, and timely adjust the treatment plan according to the change of the disease.