《2010BTS胸膜疾病指南：成人单侧胸腔积液的诊治》内容预览

I***ODUCTION

Pleural effusions are a common medical problemwith more than 50 recognised causes includingdisease local to the pleura or underlying lung,systemic conditions, organ dysfunction and drugs.1Pleural effusions occur as a result of increased?uid formation and/or reduced ?uid resorption.
The precise pathophysiology of ?uid accumulationvaries according to underlying aetiologies. As thedifferential diagnosis for a unilateral pleural effu-sion is wide, a systematic approach to investigationis necessary. The aim is to establish a diagnosi***iftly while minimising unnecessary invasiveinvestigations and facilitating treatment, avoidingthe need for repeated therapeutic aspirations whenpossible.
Since the 2003 guideline, several clinically rele-vant studies have been published, allowing newrecommendations regarding image guidance ofpleural procedures with clear bene?ts to patientcomfort and safety, optimum pleural ?uid samplingand processing and the particular value of thor-acoscopic pleural biopsies. This guideline alsoincludes a review of recent evidence for the use ofnew biomarkers including N-terminal pro-brainnatriuretic peptide (NT-proBNP), mesothelin andsurrogate markers of tuberculous pleuritis.

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