The pleura test the inspection in one of laboratories and auxiliary examination _ that accumulates the liquid

The pleura test the inspection in one of laboratories and auxiliary examination _ that accumulates the liquid
The pleura accumulates laboratory and auxiliary examination of the liquid
(1) The X-ray examination of chest is difficult to find when relatively a few thoraxes accumulate the liquid in the X-ray examination of chest. Accumulate the intersection of liquid and quantity, reach 0.3-0.5L as thorax, chest X-ray examination reveal rib diaphragm corner dull, increase thick to distinguish with pleura while being difficult sometimes, need side slope, vary body posture, distinguish slowly until X-ray perspect often. Until thorax accumulate liquid, increase, rib the intersection of diaphragm and corner disappear, reveal concave to face upward, outside high the intersection of inside and low arc accumulate the liquid shadow, it is flat while lying in the location, accumulate the liquid and scatter, make the wild bright degree of whole lung reduce. A large number of thorax, accumulate liquid, suffer from the intersection of side and chest, present dense shadow entirely, and trachea push to, good for side. Limitation parcel accumulate liquid, can take place on the intersection of thorax and position any, have, accumulate liquid among the leaf while being common, take the form of shuttleless loom, does not change and change with the body posture, the edge is smooth and energetic; The lung reveals diaphragm skin is obviously raised or obviously widened between bubble shadow of fundus of stomach and lung bottom flange shadow on one side while accumulating the liquid at bottom. Have levels of liquid to accumulate the liquid at the time of liquid pneumothorax. Accumulate liquid quantity to judge in chest X-ray slice and thorax: Thorax accumulate liquid the following call a few thoraxes accumulate liquid among the rib before 4; Between the rib is that the medium-sized quantity thorax accumulate the liquid before the rib and the second before the 4th; Accumulate liquid lie in front of the second more than rib accumulate the liquid for a large number of thoraxes.
The chest CT accumulates the liquid to diagnose to the thorax that there are their special advantages, are suitable for: A slice of a few thoraxes different to reveal accumulate the liquid in chest X-ray; Observe, can accumulate liquid and lung essence pathological change, distinguish limiting parcelling nature through the intersection of focus and density; Reveal thorax accumulate liquid can understand lung organize, press and the intersection of lung and essence store pathological change in at the same time; Can reveal mediastinal, trachea and lymph node situation.
(2) Ultrasonic inspection The thorax can adopt " A " while accumulating the liquid Type or "B " Type check appearances ultrasonic,it if you can't adopt B -type more by supersound, last appearance at present. Accumulate liquid, present dark district or have the intersection of echo and district in the intersection of Ultrasonography B and picture, distinguish while being easy, accumulate very few liquid, Ultrasonography B picture can't reveal make, discern relatively difficult, inferior to chest to be CT sensitive well. Ultrasonography B check, have thorax accumulate liquid and accumulate the intersection of liquid and quantity, position, localization that thorax punctures, have important value confirming. Ultrasonography B lead lower thorax puncture, can use limitation for thorax accumulate liquid and adhesion separate the thorax accumulate liquid.
(3) Thorax puncture skill and the intersection of chest and liquid check thorax, puncture skill, can use for diagnosing already, can regard as a treatment means, take the intersection of thorax and liquid out in order to relieve thorax, accumulate whom liquid cause, have difficulty in breathing and accelerate the intersection of chest and absorption of liquid,etc.. Thorax puncture take liquid out make, check to accumulate the intersection of liquid and property and cause of disease, diagnose essential clearly while being following.
1.Routine inspection
( 1) Appearance: The liquid is often transparent and clear to leak, mostly faint yellow, quiet put and does not solidify, proportion lt; 1.016-1.018. Ooze out the liquid but because different colors of the cause of disease are different to some extent, muddiness, proportion gt; 1.018. The tuberculosis thorax accumulates the liquid and presents more grasses yellow or deep yellow, minority are rubescent; Courageous and upright thorax accumulate liquid but because bleeding rubescent courage and uprightness, wash the intersection of meat and water sample, naked eye whole blood ' Intravenous blood) Kind; It is yellow suppuration that suppuration accumulates the liquid, the anaerobe infects stench flavor; * amebic the intersection of liver and abscess break routed people thorax that thorax cause accumulate liquid to be chocolate; The milky white liquid of chest is a chyle chest liquid; Song thorax that fungus infect it accumulates liquid to be dark the intersection of chest and liquid very.
( 2) Cells are counted and classified: Have the skin cells or lymphocytes among small quantity in the normal chest liquid, at the time of pleura inflammation, the skin cells among the ones that can see various cells and hyperplasia and degenerate in the liquid of chest. Unless it is it nuclear without being had to leak liquid count less cell, be lasted 100* 106 L often,by lymphocyte and among cells leather, as main fact. The cells which ooze out liquid are counted more, there are nuclear cells that often exceed 500* 106 L, take leucocyte as the core. Pneumonia, and thorax accumulate liquid and cell count can reach 10* 109 more than L at the empyema. It accumulate thorax liquid in exceed erythrocyte 5* 109 /at the time of L,it accumulates that liquid is getting more rubescent very to thorax,erythrocyte l0 * 1010 /at the time of more than of Ls, present the courageous and upright thorax of naked eye and accumulate the liquid, mainly see at traumatism, tumour, pulmonary embolism, but still need to puncture the courageous and upright thorax due to damaging and accumulate the liquid phase to distinguish with the pleura.
The thorax accumulates and takes neutral cells as the core in the liquid, it is detailed to brief on (medical education network is collected and put in order) Fungus pneumonia, pancreatitis,etc. acute pleura inflammation; The tuberculosis thorax due to pleurisy or tumour accumulates the liquid and takes lymphocyte as the core; Have a liking for acid cells and increase, mainly see in parasite infecting, fungal infection and connective tissue disease. Among the malignant pleura at leather tumour or malignant tumour involves the pleura, the thorax accumulates the increase of leather cell among the liquid, can often exceed 5%; It is not the tumour thorax that accumulates the skin cell lt among the liquid; 1% . The thorax can find lupus cells while accumulating the liquid when systemic lupus erythematosus accompanies the thorax to accumulate the liquid.
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