尼日利亚伊洛林胸腔积液的病因、临床特征及管理

Etiology, clinical characteristics, and management of pleural effusion in Ilorin, Nigeria.

作者信息

Adeoye Peter Oladapo, Johnson Wahab Rotimi, Desalu Olufemi Olumuyiwa, Ofoegbu Chima Pascal, Fawibe Ademola Emmanuel, Salami Alakija Kazeem, Fadeyi Abayomi, Akin-Dosumu Akingbade Adebayo, Rasheedat Ibraheem M

机构信息

Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria.

Department of Child Health, University of Ilorin Teaching Hospital, Ilorin, Nigeria.

出版信息

Niger Med J. 2017 Mar-Apr;58(2):76-80. doi: 10.4103/0300-1652.219349.

DOI:10.4103/0300-1652.219349

PMID:29269986

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5726178/

Abstract

BACKGROUND

Pleural effusion (PE) is a primary manifestation or secondary complication of many disorders. This study reviews the pattern and management of PE in a Nigerian hospital.

MATERIALS AND METHODS

The medical records of 213 patients with clinical diagnosis of PE over a period of 3 years were reviewed.

RESULTS

PE accounted for 0.5% of the total hospital admissions. The most common cause of PE was tuberculosis (TB) (32.9%), followed by malignancy (29.1%) and pneumonia (15.0%). The male to female ratio was 1.3:1. TB was the leading cause of effusion in males, while it was malignancy in females. Pneumonia accounted for 61.9% of PE in preschool age and 66.7% in school age. Breathlessness (50.0%), cough (39.4%), and chest pain (24.9%) were the common presentations. Most (90.1%) of them were exudative effusion and with half in the right lung. Chest radiography (91.6%), pleural fluid for Ziehl-Neelsen stain (74.7%), cytology (59.2%), and tissue biopsy (57.8%) were the common diagnostic investigations. The majority (92.0%) had closed thoracostomy tube drainage, while 9.9% had chemical pleurodesis. The intra-hospital mortality was 10 (4.7%).

CONCLUSION

TB, malignancy, and pneumonia are the leading causes of PE. A multidisciplinary approach is needed for optimal management.

摘要

背景

胸腔积液（PE）是许多疾病的主要表现或次要并发症。本研究回顾了一家尼日利亚医院中胸腔积液的模式及治疗情况。

材料与方法

回顾了213例在3年期间临床诊断为胸腔积液患者的病历。

结果

胸腔积液占医院总入院人数的0.5%。胸腔积液最常见的病因是结核病（TB）（32.9%），其次是恶性肿瘤（29.1%）和肺炎（15.0%）。男女比例为1.3:1。结核病是男性胸腔积液的主要病因，而女性则是恶性肿瘤。肺炎在学龄前儿童胸腔积液中占61.9%，在学龄儿童中占66.7%。常见症状为呼吸困难（50.0%）、咳嗽（39.4%）和胸痛（24.9%）。大多数（90.1%）为渗出性胸腔积液，且一半位于右肺。胸部X线检查（91.6%）、胸腔积液萋-尼氏染色（74.7%）、细胞学检查（59.2%）和组织活检（57.8%）是常见的诊断检查。大多数（92.0%）患者采用胸腔闭式引流管引流，而9.9%的患者采用化学性胸膜固定术。院内死亡率为10例（4.7%）。