Mangiapan Gilles, Van Koningsveld Marc, Maitre Bernard
Service de pneumologie, CHIC de Créteil, 94000 Créteil.
Rev Prat. 2007 Mar 15;57(5):489-500.
Pleurisy is a common syndrome revealing or complicating numerous diseases. It is suspected on dyspnea or chest pain, with or without dullness to percussion. Diagnosis is confirmed almost always by chest roentgenogram but CT scan and echography can help in case of small pleural effusion. Etiologic research is based on pleural fluid analysis. The dosages of protein and LDH separate transudate from exsudate. Cellular differential count and bacterial and mycobacterial culture must systematically be performed. Other pleural analysis are discussed when specific illness are suspected. In case of exsudative pleural effusion, histological examination of pleural tissue sample is often necessary. Despite the etiological search, some pleurisy remains without specific diagnosis and necessitate a prolonged follow up with sometimes repeated thoracocentesis or biopsy. Treatment of pleurisy is based on the treatment of the underlying disease and the evacuation of pleural fluid.
胸膜炎是一种常见的综合征，可揭示多种疾病或使多种疾病复杂化。根据呼吸困难或胸痛情况怀疑患有胸膜炎，叩诊可有或无浊音。几乎总是通过胸部X线片确诊，但对于少量胸腔积液，CT扫描和超声检查可能有帮助。病因研究基于胸腔积液分析。蛋白质和乳酸脱氢酶的测定可区分漏出液和渗出液。必须系统地进行细胞分类计数以及细菌和分枝杆菌培养。当怀疑有特定疾病时，会讨论其他胸腔分析。对于渗出性胸腔积液，通常需要对胸膜组织样本进行组织学检查。尽管进行了病因查找，但仍有一些胸膜炎无法明确诊断，需要长期随访，有时需反复进行胸腔穿刺或活检。胸膜炎的治疗基于对基础疾病的治疗以及胸腔积液的引流。
