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目的探讨结核性胸膜炎发生胸膜肥厚原因。方法回顾性对照分析165例结核性胸膜炎患者中发生与未发生胸膜肥厚的临床资料。结果发生组发病后平均就诊时间延迟的天数明显多于未发生组(t=4.1,P<0.01),两组患者就诊延迟时间在7~14d,15~30d和>30d患者数均有显著性差异(P<0.01),未抽液者发生胸膜肥厚的比例高于抽液者(χ2=33.3,P<0.01)两组患者胸液有核细胞数×106/L在0~500和>2000范围有显著性差异,(χ2=2,14.2,P<0.01)两组患者的胸水蛋白含量≤40g/L和>40g/L的患者数有显著性差异,(χ2=31.9,P<0.01)。结论结核性胸膜炎患者胸水有核细胞数>2000×106/L,胸水蛋白含量>40g/L,就诊延迟超过两周、未抽胸水者更易发生胸膜肥厚、粘连。早期就诊,在抗结核治疗的同时积极抽液是预防胸膜肥厚的关键。
Objective To investigate the causes of pleural thickening in tuberculous pleurisy. Methods A retrospective analysis of 165 cases of tuberculous pleurisy patients with and without pleural thickening clinical data. Results The average number of days delayed after treatment was significantly higher in the incidence group than in the non-occurrence group (t = 4.1, P <0.01). The delay in treatment between the two groups was between 7 and 14 days, and between 15 and 30 days and> 30 days (P <0.01). The rate of pleural thickening in non-irrigated patients was higher than that in liquid-withdrawing patients (χ2 = 33.3, P <0.01) (Χ2 = 2, 14.2, P <0.01). There was a significant difference in the number of patients with pleural fluid protein concentrations ≤40g / L and> 40g / L (χ2 = 31.9, P <0.01) . Conclusions Patients with tuberculous pleurisy have more than 2000 × 106 / L of pleural effusion cells and> 40g / L of pleural effusion. The treatment is delayed for more than two weeks. Pleural thickening and adhesions are more likely to occur in patients without pleural effusion. Early treatment, anti-TB treatment in the active pumping fluid is the key to preventing pleural hypertrophy.