ETIOLOGIJA PLEURALNIH IZLIVA U KLINICKOJ PRAKSI

 

VARIETY OF PLEURAL EFFUSION IN OUR CLINICAL PRACTICE

 

Gaja Pozojevic

 

Sazetak:

Analizirali smo 339 pacijenata sa pleuralnim izlivom lecenih u Zavodu za plucne bolesti I tuberkulozu u Zrenjaninu u periodu 1990-1996.Odnos izmedju muskih I zenskih bio je 1,51 na prema 1 u korist muskog pola.Etiologija je najvise dokazana biohemijskom,citoloskom I bakterioloskom metodom pleuralnog punktata(36%),potom slepom biopsojim sa pleure(9,1%),bronhologijom(4,4%),a citoloski iz sputuma svega2,4%.U 20% slucajeva od ukupnog broja pacijenata nije dokazana etiologija pleuralnog izliva.Najvise je bilo nespecificnih eksudata(34%)uz visok procenat empijema(16%).Na drugom mestu su transudati(29%)iskljucivo zbog srcane insuficijencije/Trece mesto zauzimaju izlivi maligne etiologije sa 25%.Oni su metastatske prirode uz dominaciju epidermoidnog karcinoma pluca(33%).Najmanji je procenat specificnih izliva(10%)ali uz visoko ucesce specificnih empijema(14%).

Ovakva epidemioloska situacija zahteva aktivno trazenje obolelih,narocito u rizicnim grupama,blagovremenu I adekvatnu terapiju I bolju interdisciplinarnu saradnju.

 

Kljucne reci:Pleuralni izliv,etiologija.

 

Summary:

We examined a sample of 339 patients with pleural; effusion treated at Regional Health Center for Lung Disease and tuberculosis in Zrenjanin for a period of six years 1990-1996.The ratio of men to women in the sample was 1,51 to 1.The etiology was mostly confirmed by both biochemical and cellular as well as bacterial analysis of pleural contents(36%),by blind biopsy of pleura(9,1%),by bronchoskopy(4,4%) and by cellular analysis of a sputum (2,4%).The percentage of patients  with whom the   etiology of pleural effusion could not be confirmed was 20%.The percentage of non-specific exudate was high(34%) with a high percentage of empyema (16%).Twenty nine  percent of had transsudate due exclusiovely to heart  failure.Malignant metastatic caused by epidermoid lung cancer were the third(33%).The percentage of specific effusions was low(10%),but with a high percentage of specific empyema(14%).

On the basis of these data we are of opinion that an active tracing of the diseased,particulary of those belonging to high-risk groups,as wel as adequate therapy along with beter interdisciplinary collaboration are  necessary.

 

Key words:Pleural effusion,etiology.

 

Pneumon,1997;35(1-4):39-44.