Himelman R B, Callen P W
Chest. 1986 Dec;90(6):852-6. doi: 10.1378/chest.90.6.852.
Forty-eight patients with pleural effusions who had sonographically directed thoracocentesis were evaluated retrospectively for radiologic findings, pleural fluid chemistries, and outcome. Loculation was found to be a radiologic marker of diagnostic and prognostic significance. The presence of loculations correlated with exudative pleural fluid chemistries, but no radiologic finding was specific for empyema. "Extreme" pleural fluid chemistries were associated with loculation, but not with empyema. Patients with loculated effusions had larger effusions, longer hospitalizations, and more frequent tube thoracostomy procedures than patients with nonloculated effusions. Light's criteria for tube thoracostomy were found to be unreliable in patients with loculated parapneumonic effusions or in patients treated with prolonged antibiotic therapy prior to thoracocentesis.
对48例行超声引导下胸腔穿刺术的胸腔积液患者的影像学表现、胸水化学检查结果及预后进行回顾性评估。发现分隔是具有诊断和预后意义的影像学标志。分隔的存在与渗出性胸水化学检查结果相关，但没有影像学表现对脓胸具有特异性。“极端”的胸水化学检查结果与分隔相关，但与脓胸无关。与无分隔积液的患者相比，有分隔积液的患者积液量更大、住院时间更长、胸腔闭式引流术的操作更频繁。发现Light胸腔闭式引流标准在有分隔的肺炎旁积液患者或在胸腔穿刺术前接受长期抗生素治疗的患者中不可靠。
