Gumaste V, Singh V, Dave P
Department of Medicine, Mount Sinai Services-City Hospital Center, Elmhurst, New York.
Am J Gastroenterol. 1992 Jul;87(7):871-4.
We retrospectively reviewed the charts of all patients with acute pancreatitis admitted to our hospital between July 1987 and June 1991 to determine the relationship of a pleural effusion in patients with acute pancreatitis with the severity of the disease, the etiology of the pancreatitis, pseudocyst formation, and triglyceride levels. Eleven (13.4%) of the 82 patients with acute pancreatitis had evidence of pleural effusion. Eight of 42 patients with alcoholic pancreatitis developed an effusion, compared with one of 33 patients with biliary pancreatitis, indicating that an alcoholic etiology may be a risk factor. Seven (63%) of the 11 patients had associated pseudocysts. Patients with severe disease had a greater incidence of pleural effusion. The effusion was on the left side in six, bilateral in four, and on the right side in one patient. Hypertriglyceridemia did not appear to be an independent risk factor associated with pleural effusions. Diagnostic thoracentesis was performed in three patients because of the presence of fever. Pleural fluid amylase was normal in one case and mildly elevated in the other two. All effusions resolved spontaneously without the need for any therapeutic intervention.
我们回顾性分析了1987年7月至1991年6月间我院收治的所有急性胰腺炎患者的病历，以确定急性胰腺炎患者胸腔积液与疾病严重程度、胰腺炎病因、假性囊肿形成及甘油三酯水平之间的关系。82例急性胰腺炎患者中有11例（13.4%）有胸腔积液证据。42例酒精性胰腺炎患者中有8例出现积液，而33例胆源性胰腺炎患者中有1例出现积液，这表明酒精性病因可能是一个危险因素。11例患者中有7例（63%）伴有假性囊肿。重症患者胸腔积液的发生率更高。积液位于左侧6例，双侧4例，右侧1例。高甘油三酯血症似乎不是与胸腔积液相关的独立危险因素。3例患者因发热进行了诊断性胸腔穿刺术。1例患者胸腔积液淀粉酶正常，另外2例轻度升高。所有积液均自行消退，无需任何治疗干预。
