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患者慢性胸腔积液病因及治疗反应(胸膜固定术)的患病率调查

Investigation of the Prevalence of Chronic Pulmonary Effusion Causes and Response to Treatment (Pleurodesis) in Patients.

作者信息

Shirzadi Alireza, Ahmadinejad Izadmehr, Ahmadinejad Mojtaba, Hatami Saeed, Soltanian Ali, Ahmadinejad Yasmina

机构信息

Department of Surgery, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.

Students' Scientific Research Center, Tehran University of Medical Science, Tehran, Iran.

出版信息

Open Respir Med J. 2025 Jan 16;19:e18743064336968. doi: 10.2174/0118743064336968250113102919. eCollection 2025.

Abstract

BACKGROUND

Pleural effusion, the pathological accumulation of fluid in the pleural space, is widespread. This study investigates pleural effusion in terms of malignancy among patients referred to tertiary health care centers and evaluates the response rates to different pleurodesis techniques.

METHODS

This cross-sectional study enrolled all patients with pleural effusion referred to a tertiary health care center. Laboratory data, including White Blood Cell count and differentiation (WBC), Hemoglobin levels (HB), Erythrocyte Sedimentation Rate (ESR), and biochemical analysis results of the pleural fluid (protein, glucose, and lactate dehydrogenase) were recorded. Data from pleural fluid cytopathological examination, including cell count, cell types, gram staining, and pleural fluid culture, were also documented. Patients undergoing pleurodesis were assessed for response rates, which were categorized as complete, partial, or no response based on clinical and radiological criteria. Collected data were subjected to statistical analysis.

RESULTS

The study investigated 144 patients with chronic pleural effusion, with an average age of 47.59 years. Of these, 97 patients (66%) were male and 47 patients (34%) were female. The most common cause of chronic pleural effusion was malignancy, with a prevalence of 65.9%. Among patients treated with pleurodesis, the overall response rate was 78.4%, with chemical pleurodesis achieving a higher complete response rate (65%) compared to mechanical pleurodesis (55%). Other prevalent causes of chronic pleural effusion, in descending order, included heart failure, liver cirrhosis, chronic kidney failure, and unknown factors.

CONCLUSION

This study highlights malignancy and chronic heart failure as the predominant etiologies of chronic pleural effusion in a tertiary healthcare setting. Furthermore, it emphasizes the efficacy of pleurodesis techniques, with chemical pleurodesis demonstrating superior outcomes. These findings offer valuable insights into the pathogenesis and management of chronic pleural effusion.

摘要

背景

胸腔积液是胸腔内病理性液体蓄积,较为常见。本研究调查了转诊至三级医疗保健中心的患者中恶性胸腔积液的情况,并评估了不同胸膜固定术技术的有效率。

方法

这项横断面研究纳入了所有转诊至三级医疗保健中心的胸腔积液患者。记录了实验室数据,包括白细胞计数及分类(WBC)、血红蛋白水平(HB)、红细胞沉降率(ESR)以及胸腔积液的生化分析结果(蛋白质、葡萄糖和乳酸脱氢酶)。还记录了胸腔积液细胞病理学检查的数据,包括细胞计数、细胞类型、革兰氏染色和胸腔积液培养。对接受胸膜固定术的患者评估其有效率,根据临床和放射学标准将有效率分为完全缓解、部分缓解或无缓解。对收集的数据进行统计分析。

结果

该研究调查了144例慢性胸腔积液患者,平均年龄为47.59岁。其中,97例(66%)为男性,47例(34%)为女性。慢性胸腔积液最常见的病因是恶性肿瘤,患病率为65.9%。在接受胸膜固定术的患者中,总体有效率为78.4%,化学性胸膜固定术的完全缓解率(65%)高于机械性胸膜固定术(55%)。慢性胸腔积液的其他常见病因按降序排列包括心力衰竭、肝硬化、慢性肾衰竭和不明因素。

结论

本研究强调恶性肿瘤和慢性心力衰竭是三级医疗环境中慢性胸腔积液的主要病因。此外,它强调了胸膜固定术技术的有效性,化学性胸膜固定术显示出更好的效果。这些发现为慢性胸腔积液的发病机制和管理提供了有价值的见解。

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