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胸膜增厚

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概述编辑本段回目录

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胸膜增厚(pleural thickening)指在胸膜病变基础上,纤维蛋白沉着和肉芽组织增生而致纤维化,使胸膜厚度增加的现象。是渗出性胸膜炎胸腔积液的结果,胸膜增厚可为局限性或广泛性的,广泛的脏层胸膜增厚影响肺的呼吸功能,广泛的壁层胸膜增厚可使肋间隙变狭,胸廓缩小。多数胸膜增厚不需要治疗,胸膜粘连症状严重者,则应手术治疗。 医学百科网-MedBaike. com

病因及常见疾病编辑本段回目录

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1.气胸

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干咳、呼吸困难、呼吸音减弱、昏迷、冷汗、咯血、胸膜增厚等。

医学百科网-MedBaike. com

2.弥漫型间皮瘤 医学百科网-MedBaike. com

气短、渗出性胸水、体重减轻、胸壁塌陷、胸膜增厚、胸膜转移等。 医学百科网-MedBaike. com

3.小儿结核性胸膜炎

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低热、高热、呼吸困难、呼吸音减弱、疲乏、气促;大量积液时气管移向健侧,慢性期广泛胸膜增厚,粘连,包裹,可出现病侧胸廓凹陷,呼吸运动及呼吸音减弱。 医学百科网-MedBaike. com

4.结核性胸膜炎

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盗汗、端坐呼吸、发绀、乏力、干咳、呼吸困难;如有胸膜粘连与胸膜增厚时,可见患侧胸廓下陷,肋间隙变窄,呼吸运动受限等。 医学百科网-MedBaike. com

5.慢性化脓性胸膜炎

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低蛋白血症、低热、乏力、呼气时胸口痛、肋间隙变窄、脓胸、胸膜高度增厚,特别是壁层胸膜增厚尤为显著,胸壁内陷等。 医学百科网-MedBaike. com

6.弥漫性恶性间皮瘤

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骨转移、气短、胸壁塌陷、胸膜增厚、胸腔积液等。

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检查编辑本段回目录

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胸腔有炎症积液时可用B超检查。临床表现各不相同,一般均有胸部疼痛或呼吸困难等症状。 医学百科网-MedBaike. com

鉴别诊断编辑本段回目录

医学百科网-MedBaike. com

1.胸膜粘连

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指两层的胸膜粘着在一起。这种病变是由肺结核、胸膜炎以及胸部损伤后引发的。 医学百科网-MedBaike. com

2.胸膜转移 医学百科网-MedBaike. com

主要来源于,其次是乳腺,其他常见原发部位有,卵巢,胰腺等。癌症造成胸膜层毛细血管内压,胶体渗透压,毛细血管通透性和胸腔内压力改变,产生胸腔积液――恶性胸水。恶性胸水又称癌性胸膜炎,恶性胸腔积液是晚期癌症的常见并发症,临床上癌症患者一旦出现胸腔积液,即意味着病变已局部或周身播散。

医学百科网-MedBaike. com

3.胸膜钙化

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胸膜腔内有机化的血块或干酪坏死物质等存在时可有钙盐沉着,形成胸膜钙化。胸膜钙化多见于结核性胸膜炎、化脓性胸膜炎及损伤性血胸后。某些尘肺,如滑石肺及石棉肺也可有胸膜钙化,而且常呈双侧性的。胸膜钙化常和胸膜增厚和粘连同时存在。 医学百科网-MedBaike. com

治疗原则编辑本段回目录

医学百科网-MedBaike. com

胸膜增厚多数不需要治疗,有轻微的胸闷,会因逐渐代偿而减轻或者消失。加强锻炼,扩胸运动,深呼吸是最好的治疗方法。广泛性胸膜增厚影响肺的呼吸功能,胸膜粘连症状严重者,则应手术治疗,可做胸膜剥脱术。但手术治疗效果不能令医患双方满意,患者痛苦大,又容易造成新的胸膜粘连和胸膜钙化。

医学百科网-MedBaike. com

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