pleural cavity hydrops
Introduction
Introduction Hydronephrosis medicine is usually called "pleural hydrops", water is accumulated outside the lungs, it can be caused by infection and inflammation (such as: pneumonia, tuberculosis, etc. can be combined with pleural effusion), but also some autoimmune diseases (such as: lupus erythematosus), there are many lung diseases will be combined with pleural effusion.
Cause
Cause
Cough
It is the most common cause of hydronephrosis. Early cough can be very light, often a single cough, which is our common saying that half-sound cough, no dry cough, affecting the working life is not obvious. When the lesion progresses, the cough can be aggravated. When accompanied by endobronchial tuberculosis, the cough can be aggravated, and sometimes cough can occur. For patients with chronic illness, such as bronchial displacement, the trachea is pulled due to adhesion of the lesion, or When the bronchus is deformed by the surrounding lymph nodes, irritating cough can occur due to poor ventilation. This cough is like coughing and even difficulty breathing when eating food.
Cough
In the early stage of the onset, the cough is not obvious, or there is a small amount of white mucus sputum, but the amount of sputum increases when the lesion is enlarged or even if there is a cavity in the lung. In the case of other pathogenic bacteria infections, the amount of sputum will increase, and yellow purulent sputum may occur, and fever and chills may occur along with systemic symptoms.
3. Chest pain
Chest pain is also the main cause of hydronephrosis, but it is generally necessary for the lesion to spread to the pleura, especially to the parietal pleura. Chest pain can occur. The parietal pleura, the anterior thoracic and pulmonary tuberculosis, is shown in Figures 2 and 3 as the parietal pleura. Sometimes there is a hidden pain in the indefinite part, which is caused by the nerve reflex and is not affected by the lung breathing movement. If the site is fixed with stinging and aggravated with breathing and coughing, this indicates that inflammation is caused by the pleura. Some patients often feel pain in the shoulder or upper abdomen. This is likely that inflammation stimulates the diaphragm through the nerve reflex. To.
Examine
an examination
Related inspection
Chest perspective rib lock extrusion test
1. Immunological examination
With the advancement of cell biology and molecular biology, immunological examination of pleural fluid has attracted attention. It plays a role in the identification of benign and malignant pleural fluids, the study of the pathogenesis of pleural effusion and the future development of pleural effusion. In tuberculous and malignant pleural effusions, T lymphocytes increased, especially in tuberculous pleurisy, which was up to 90%, and mainly T4 (CD+4). The T cell function in malignant pleural effusion is inhibited, and its cytotoxic activity against autologous tumor cells is significantly lower than that of peripheral blood lymphocytes, suggesting that the local immune function of the thoracic layer is inhibited in patients with malignant pleural effusion. In patients with systemic lupus erythematosus and rheumatoid arthritis, the contents of complement C3 and C4 in pleural effusion decreased, and the content of immune complexes increased.
2, pleural biopsy
Percutaneous pleural biopsy can help to identify the presence or absence of tumors and to determine pleural granulomatous lesions. When the tuberculosis is to be diagnosed, the biopsy specimen can be used for tuberculosis culture in addition to pathological examination. Patients with empyema or bleeding tendency should not be used for pleural biopsy. A biopsy can be performed via a thoracoscope if necessary.
3, ultrasound examination
Can identify pleural effusion, pleural thickening, liquid pneumothorax and so on. The cystic effusion can provide a more accurate positioning diagnosis, which is helpful for thoracic puncture drainage.
Diagnosis
Differential diagnosis
The pleural effusion is easily confused with the following symptoms and needs to be identified:
1. Tuberculous pleurisy
2, empyema: empyema refers to the infection of the pleural cavity caused by various pathogenic microorganisms, accompanied by opacity of appearance, chest exudate with pus-like characteristics. Bacteria are the most common pathogens of empyema.
3, malignant pleural effusion: mostly caused by the progress of malignant tumors, is a common syndrome of advanced malignant tumors, such as lung cancer with pleural effusion has been late. Imaging studies can help to understand the extent of lesions in the lungs and mediastinal lymph nodes.
