[Day tuberculous exudative pleurisy: morphological and morphometric aspects].

A E Shirinkina, L V Burukhina, E S Patlusova
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Abstract

Visceral pleural pathomorpholodical changes were studied in 50 patients. Group 1 included 25 patients with isolated tuberculous pleurisy; Group 2 consisted of 7 patients with tuberculous exudative pleurisy in the presence of a specific process in the lung; a comparison group comprised 18 who had not died from diseases of the lung and pleura. The exudative productive type of specific pleural inflammation was prevalent in 15 (60%) and 4 (57.1%) patients, respectively. In Group 1, the pleural thickness was 144.0 +/- 3.3 microm, which was 8.3 times greater (p < 0.01) than that in the comparison group (17.35 +/- 4.78 microm). In Group 2, the visceral pleural thickness was 151.1 +/- 3.4 microm, which was 8.7 times greater (p < 0.01) than that in the comparison group and 1.05 times greater than that in Group 1. The study has established that in both Group 1 and Group 2, exudative pleurisy is accompanied by early visceral pleural fibrosing with a tendency to be more pronounced in Group 2 patients, which raises the question as to whether it is necessary to use resolution therapy at the early stages of treatment, to inject isoniazid lymphotropically, and to apply physical methods to prevent pleural cavity obliteration.

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[日结核性渗出性胸膜炎:形态学和形态计量学方面]。
对50例患者的内脏胸膜病理形态学改变进行了研究。1组25例孤立性结核性胸膜炎;2组7例结核性渗出性胸膜炎,肺内有特殊病变;对照组包括18名未死于肺和胸膜疾病的患者。特异性胸膜炎以渗出型为主,分别为15例(60%)和4例(57.1%)。1组胸膜厚度为144.0 +/- 3.3微米,是对照组(17.35 +/- 4.78微米)的8.3倍(p < 0.01)。2组肺脏胸膜厚度为151.1 +/- 3.4 μ m,是对照组的8.7倍(p < 0.01),是1组的1.05倍。本研究发现,在1组和2组中,渗出性胸膜炎均伴有早期内脏性胸膜纤维化,且2组患者的趋势更为明显,这就提出了是否需要在治疗早期采用溶解治疗,是否需要淋巴性注射异烟肼,是否需要物理方法防止胸膜腔闭塞的问题。
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