最近审阅: 24 十月 2020
最近更新: 05 六月 2019

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 近期肺炎
  • 全身性症状
  • 发热和寒战
  • 叩诊浊音
  • 呼吸音和语音共振减弱
  • 出现脓毒症体征

其他诊断因素

  • 亚急性起病
  • 排痰性咳嗽
  • 胸膜炎性胸痛
  • 呼吸困难

危险因素

  • 肺炎
  • 胸膜腔内医源性操作
  • 胸部外伤
  • 免疫功能受损状态
  • 合并肺部疾病
  • 男性
  • 年龄较大或较小

诊断性检查

首要检查

  • 血液培养
  • C 反应蛋白 (CRP)
  • 白细胞计数
  • 胸部 X 线检查
  • 胸腔穿刺术:胸水外观
  • 胸腔穿刺术:胸水气味
  • 胸腔穿刺术:胸水 pH 值
  • 胸腔穿刺术:胸水总蛋白质浓度
  • 胸腔穿刺术:胸水 LDH 水平
  • 胸腔穿刺术:胸水葡萄糖浓度
  • 胸腔穿刺术:胸水白细胞分类
  • 胸腔穿刺术:胸水的涂片镜检、培养和药敏试验
  • 胸部超声
更多 首要检查

需考虑的检查

  • 造影剂胸部增强 CT
  • 胸部 MRI
  • PET 扫描
  • 胸腔积液聚合酶链反应 (PCR)
更多 需考虑的检查

治疗流程

撰稿人

Assistant Professor of Respiratory Medicine

Respiratory Failure Unit

G Papanikolaou Hospital Thessaloniki

Aristotle University of Thessaloniki

Thessaloniki

Greece

利益声明

ADP declares that she has no competing interests.

Respiratory Consultant

Royal Infirmary

Edinburgh

Scotland

UK

利益声明

RLR declares that she has no competing interests.

Respiratory Research Registrar

Churchill Hospital

Oxford

UK

利益声明

NMR declares that Roche UK supplied clinical trial supplies and funding for the MIST2 trial that he conducted.

Dr Athanasia D. Pataka, Dr Renata L. Riha, and Dr Najib M. Rahman would like to gratefully acknowledge Dr Eleanor K. Mishra, a previous contributor to this topic. EKM declares that she has no competing interests.

同行评议者展开全部内容

Professor of Medicine and Director

Division of Pulmonary/Critical Care/Allergy/Sleep Medicine

Medical University of South Carolina

Charleston

SC

利益声明

SS declares that he has no competing interests.

Senior Lecturer and Consultant Physician

North Bristol Lung Centre

Southmead Hospital

Bristol

UK

利益声明

NM declares that he has no competing interests.

Consultant Chest Physician and Senior Lecturer

Oxford Centre for Respiratory Medicine and University of Oxford Churchill Hospital

Oxford

UK

利益声明

YCGL declares that he has no competing interests.

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