Plevral efüzyonlarda sıvı miktarı ile etyolojinin ilişkisi

AMAÇ: Çalışmamızda masif plevral efüzyonlar ile masif olmayan plevral efüzyonların etyolojisini ve sıvı özelliklerini karşılaştırmak. GEREÇ-YÖNTEM: 2004-2006 yılları arasında PA Akciğer Grafisinde efüzyon saptanan 159 olgu retrospektif olarak incelendi. BULGULAR: 32 (%20.1) olguda masif plevral efüzyon (hemitoraksın 2/3?ünden fazlasını kaplayan opasite), 127 (%79.9) olguda masif olmayan efüzyon (hemitoraksın 1/3 ve 2/3?nü kaplayan opasite) saptandı. Masif efüzyonu olan olgularda eksüda oranı daha yüksek bulunmasına rağmen, sıvı miktarı ile transüda eksüda olma arasında anlamlı fark saptanmadı (p>0.05). Efüzyon miktarı ile hücre tipi dağılımı arasında anlamlı ilişki bulunmadı (p>0.05). Masif efüzyonların masif olmayanlara göre pH ve glukoz düzeyleri daha düşük, LDH düzeyleri ise daha yüksek bulundu ve fark istatistiksel olarak anlamlıydı (p

Relationship between amount of pleural effusion and etiology

We compared etiological factors and fluid properties in massive and nonmassive pleural effusions. Study population consisted of 159 cases having pleural effusion in chest-X-ray diagnosed between 2004-2006. 32(20.1%) cases had massive pleural effusion(fluid in more than 2/3 of a hemithorax) whereas 127(79.9%) had nonmassive effusion(fluid in 1/3 or 2/3 of a hemithorax). Massive effusions were found to have exuda dominancy, however amount of effusion was not significantly correlated with fluid characteristics (p>0.05). Amount of effusion was not correlated with cell type (p>0.05). In massive effusions pH and glucose levels were lower and LDH levels were higher with statistical significance (p<0.05). 44.4% of massive and 17.6% of nonmassive effusions were hemorrhagic (p=0.004). The predominant diagnosis was malignancy in massive effusions (%46.9). TB effusions were nonhemorrhagic with statistically significant difference (p=0.004). 30% of malignant cases and 14.4% of benign cases were massive (p=0.025). None of the effusions due to systemic disease were massive. As a conclusion, first diagnosis to be considered in massive effusions are malignancy. The probability of malignancy significantly increases when fluid is hemorrhagic.

Kaynakça

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