Brown S E, Light R W
Clin Chest Med. 1985 Mar;6(1):77-81.
Pulmonary embolization should be considered as a possible cause of any pleural effusion of unknown etiology. This disorder may be the one that is most commonly overlooked in the work-up of patients with pleural effusions. Although para-embolic effusions have classically been considered to be bloody exudates with a predominance of polymorphonuclear leukocytes, many such effusions have none of these characteristics. Up to 25 per cent may be transudates and the RBC count exceeds 100,000 per mm3 in fewer than 20 per cent of such effusions. The WBC may range from less than 100 to more than 50,000 cells per mm3. Characteristics of these effusions are so variable that no diagnostic patterns can be said to occur. Paraembolic effusions usually begin to resolve within a few days after institution of anticoagulant therapy, although those that are associated with parenchymal infiltrates may resolve more slowly. Unless complications occur (which are rare), pulmonary embolism with associated pleural effusion is treated no differently than is pulmonary embolism without effusion.
肺栓塞应被视为任何病因不明的胸腔积液的可能病因。这种病症可能是胸腔积液患者检查中最常被忽视的一种。尽管传统上认为栓塞旁积液是血性渗出液，以多形核白细胞为主，但许多此类积液并无这些特征。高达25%的积液可能是漏出液，且此类积液中红细胞计数超过每立方毫米100,000的情况不到20%。白细胞计数每立方毫米可能少于100个至超过50,000个。这些积液的特征变化很大，以至于无法说存在诊断模式。栓塞旁积液通常在开始抗凝治疗后的几天内开始消退，尽管那些与实质浸润相关的积液消退可能更慢。除非发生并发症（这种情况很少见），伴有胸腔积液的肺栓塞的治疗与无积液的肺栓塞并无不同。
