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目的探讨双侧胸腔积液病因及临床特点。方法对８６例双侧胸腔积液进行回顾性分析。结果①结核性４８例（５５．８％），肿瘤转移２８例（３２．５％），其他原因１０例（１１．７％）。②血性胸水在恶性胸水和结核性胸水中分别占５７％（１６／２８）和３１％（１５／４８）（Ｐ＜０．０５）。③胸水ＣＥＡ在恶性胸水和结核性胸水中阳性率分别占８０％（１６／２０）和２．５％（１／４０）（Ｐ＜０．０１）。④胸水ＡＤＡ值以≥２６Ｕ／Ｌ为阳性时，恶性胸水和结核性胸水阳性率分别占９％（２／２２）和４２．５％（１４／３３）（Ｐ＜０．０１）。⑤少量胸水占恶性胸水与结核性胸水中分别占５０％（１４／２８）和７５％（３６／４８）（Ｐ＜０．０５）。结论双侧胸腔积液多见于结核与肿瘤；少量积液多见于结核性胸水；血性胸水多见于肿瘤转移；胸水ＣＥＡ及ＡＤＡ测定对良、恶性胸水有鉴别价值。
Objective To investigate the etiology and clinical features of bilateral pleural effusion. Methods 86 cases of bilateral pleural effusion were retrospectively analyzed. Results ① Tuberculosis in 48 cases (55.8%), tumor metastasis in 28 cases (32.5%), and other reasons in 10 cases (11.7%). ② Bloody pleural effusion accounted for 57% (16/28) and 31% (15/48) respectively in malignant and tuberculous pleural effusion (P <0.05). ③ The positive rates of CEA in malignant pleural effusion and tuberculous pleural effusion were 80% (16/20) and 2.5% (1/40) respectively (P <0.01). ④ The positive rates of malignant pleural effusion and tuberculous pleural effusion were 9% (2/22) and 42.5% (14/33), respectively (P <0.01) when the pleural effusion ADA value was ≥26U / L. ⑤ A small amount of pleural effusion accounted for 50% (14/28) and 75% (36/48) respectively in malignant and tuberculous pleural effusion (P <0.05). Conclusions Bilateral pleural effusion more common in tuberculosis and cancer; a small amount of effusion more common in tuberculous pleural effusion; bloody pleural effusion more common in tumor metastasis; pleural effusion CEA and ADA determination of benign and malignant pleural effusion differential value.