SURVEY OF CLINICAL AND PARACLINICAL CHARACTERISTICS OF PATIENTS WITH EXCURSIVE PLEURAL EFFUSION

Văn Đại Nguyễn, Thế Vinh Nguyễn

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Abstract

Objective: The study has objectives: Describe the clinical and paraclinical characteristics of patients with exudative pleural effusion at the Department of Internal Medicine and Respiratory Medicine, Can Tho Central General Hospital. Methods: A cross-sectional retrospective study design on 97 patients admitted to the Department of Internal Medicine and Respiratory Medicine, Can Tho Central General Hospital with a diagnosis of exudative pleural effusion from January 2023 to January 2024. Result: Clinical and paraclinical characteristics: Patients were admitted to the hospital with the most common reason being chest pain (59.8%) and the onset time was usually ≤15 days. The prominent functional and systemic symptoms were pleuritic chest pain (89.7%) and common symptoms of pleural effusion were dyspnea (80.4%), dry cough (58.8%), and fever (33%). The physical symptoms recorded during examination were mainly trichotillomania (100%) and pulmonary rales (25.8%). Regarding paraclinical characteristics, the majority were unilateral pleural effusion (84.5%), free (95.9%) and moderate in volume (43.3%). Associated lung parenchymal lesions on standard chest X-ray accounted for 61.9%. Most patients with exudative pleural effusion in the study had normal leukocyte formula (61.9%). The majority of pleural effusion in our study was lemon yellow (77.3%) with average protein, LDH, cell count, lymphocyte and neutron ratios of 49.20 g/l, 707.18 U/L, 1348.86 leukocytes/mm3, 81.03% and 18.97%, respectively, 30.9% had the presence of foreign cells in the pleural effusion and a high negative pleural effusion PCR rate (92.8%). In 97 cases that underwent cell-block and biopsy, 49.5% of cases had carcinoma cells in the pleural fluid and the biopsy results mostly showed carcinoma (48.5%), followed by tuberculous inflammation (41.2%) and chronic inflammation (10.3%). The complication rate after blind pleural biopsy was low, with only chest pain at the biopsy site (8.2%) and hematoma at the biopsy site (1%).

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