Villena Victoria, López-Encuentra Angel, García-Luján Ricardo, Echave-Sustaeta José, Martínez Carlos José Alvarez
Respiratory Service, Hospital 12 de Octubre, Madrid, Spain.
Chest. 2004 Jan;125(1):156-9. doi: 10.1378/chest.125.1.156.
The aims of this study were to describe the different appearances of pleural fluid during thoracentesis and their frequency in relation to diagnosis, and to evaluate the causes and clinical implications of bloody pleural effusions.
Tertiary care, university-affiliated hospital.
Seven hundred fifteen patients with pleural effusion were prospectively assessed from December 1991 to December 1997.
The appearance of the fluid was assessed in a glass assay tube containing 10 mL of pleural fluid.
The most common presentations were serous and blood tinged, with 80% of the fluids fitting into one of these categories. The most frequent cause of watery fluid was transudate, although most transudates were classified as serous effusions. There were 59 bloody and 656 nonbloody pleural fluids. The most common cause of bloody pleural effusion (BPE) was malignancy (47%). Fluid with a bloody appearance slightly increased the probability of malignancy in our series (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.01 to 2.94; p = 0.04). Nevertheless, only 11% of the neoplastic effusions were BPE. Other common causes of BPE were posttraumatic (12%) or parapneumonic (10%) pleural effusions. Tuberculosis and transudates were uncommon causes of BPE. Fluid that was bloody in appearance decreased the probability for both diseases (OR, 0.15; 95% CI, 0.04 to 0.57; p = 0.003 and OR, 0.25; 95% CI, 0.06 to 0.95; p = 0.04, respectively).
Serous and blood tinged were the most common presentations of pleural fluid at thoracentesis. Almost half of BPEs were secondary to neoplasms, but only 11% of the neoplastic effusions were BPEs. Other common causes of BPE were parapneumonic and posttraumatic.
本研究旨在描述胸腔穿刺术中胸腔积液的不同外观及其与诊断相关的频率，并评估血性胸腔积液的病因及临床意义。
大学附属三级医疗保健医院。
1991年12月至1997年12月，对715例胸腔积液患者进行前瞻性评估。
在装有10 mL胸腔积液的玻璃化验管中评估液体外观。
最常见的表现为浆液性和血性，80%的液体属于这两类之一。水样液体最常见的原因是漏出液，尽管大多数漏出液被归类为浆液性胸腔积液。有59例血性胸腔积液和656例非血性胸腔积液。血性胸腔积液（BPE）最常见的原因是恶性肿瘤（47%）。在我们的系列研究中，外观呈血性的液体略微增加了恶性肿瘤的可能性（优势比[OR]，1.73；95%置信区间[CI]，1.01至2.94；p = 0.04）。然而，只有11%的肿瘤性胸腔积液是血性胸腔积液。血性胸腔积液的其他常见原因是创伤后（12%）或肺炎旁（10%）胸腔积液。结核和漏出液是血性胸腔积液的不常见原因。外观呈血性的液体降低了这两种疾病的可能性（OR分别为0.15；95% CI，0.04至0.57；p = 0.003和OR，0.25；95% CI，0.06至0.95；p = 0.04）。
浆液性和血性是胸腔穿刺术中胸腔积液最常见的表现。几乎一半的血性胸腔积液继发于肿瘤，但只有11%的肿瘤性胸腔积液是血性胸腔积液。血性胸腔积液的其他常见原因是肺炎旁和创伤后。
