目的探讨胸腔积液的主要病因及鉴别诊断。方法回顾性分析280例胸腔积液患者临床资料。结果通过影像学、病理学及胸腔积液检查并结合临床特征确诊的良性胸腔积液198例,其中结核性124例,其他病因74例,恶性胸腔积液82例。结论结核和恶性肿瘤是胸腔积液的主要病因,临床综合分析对病因鉴别有重要价值。 Objective To investigate the main etiology and differential diagnosis of pleural effusion. Methods The clinical data of 280 patients with pleural effusion were retrospectively analyzed. Results 198 cases of benign pleural effusion diagnosed by imaging, pathology and pleural effusion combined with clinical features were identified, of which 124 were tuberculous, 74 were other causes and 82 were malignant pleural effusion. Conclusions Tuberculosis and malignant tumor are the main causes of pleural effusion. Comprehensive clinical analysis has important value in the identification of etiology.