胸膜疾患与胸腔积液的病因很多。可为结核、癌肿、风湿热、霉菌、病毒、梅毒、化脓菌(如肺炎球菌、葡萄球菌、链球菌)等感染所致。或为肾脏疾患、肝硬化、充血性心力衰竭等所造成的胸腔漏出液。少数情况下可由创伤、全身性播散性红斑狼疮、胰腺炎、膈下脓肿等知病所引起。虽然一般意见胸膜炎的病因70—90％是结核性的,惟经肯定证明者寥寥无几。胸腔抽出液中,查到结核菌机会不多,即培养及动物接种的阳性率一般公为40—50％,甚至低到6.6—13.41％;而且须多次培养及等待较长时间。癌肿性胸腔积液,能查到瘤细胞的也只占50％左右。因此往往对年青患者首先考虑为结核性,对老年患者先想到癌肿性;或对所有病人均光按结核治疗,已成为临床上处理胸腔积液病人的习用方法。无疑,这种处理万法常常会出偏差。特别是近年来临床观察证明,老年结核性胸膜炎并不少见,所以根据年龄推断,其错误必多。而某些为风湿执、霉菌及化脓菌感染等之患者亦将因此而耽误及时治疗时机。因此寻求一种更准确可靠的诊断方法乃临床上急待解决的问题。 There are many causes of pleural disorders and pleural effusions. For tuberculosis, cancer, rheumatic fever, mold, virus, syphilis, pyogenic bacteria (such as pneumococcus, staphylococcus, streptococcus) and other infections caused. Or for kidney disease, cirrhosis, congestive heart failure caused by thoracic leakage. In a few cases may be caused by trauma, systemic disseminated lupus erythematosus, pancreatitis, subphrenic abscess and other known diseases. Although the general view of the cause of pleurisy 70-90% is tuberculous, but only a very few confirmed. Thoracic cavity extraction liquid, check the chance of tuberculosis is small, that is, the positive rate of culture and animal inoculation is generally 40-50%, or even as low as 6.6-13.41%; and to be cultured and wait for a long time. Cancer, pleural effusion, can be found only about 50% of tumor cells. Therefore, young patients are often considered first for tuberculosis, elderly patients first think of cancer; or for all patients treated with light tuberculosis, has become clinically treated patients with pleural effusion of the conventional method. Undoubtedly, this method of processing often goes wrong. Especially in recent years, clinical observation shows that older tuberculous pleurisy is not uncommon, so inferred from the age, the error will be more. Some patients with rheumatism, mold and pyogenic bacteria infection will also delay the timely treatment of timing. Therefore, to find a more accurate and reliable diagnostic method is a clinical problem to be solved urgently.