胸腔内注入尿激酶治疗结核性包裹性胸腔积液的疗效观察

Observation of effects of intrapleural urokinase to treat tuberculous encapsulated pleural effusion

目的探讨结核性包裹性胸腔积液的治疗方法.方法把收治的119例结核性包裹性胸腔积液患者按发病至入院确诊的时间不同分为3组:A组(3周以内),B组(3～6周),C组(6周以上),在正规抗结核治疗的基础上,进行抽液治疗,抽液后3组患者均注入异烟肼0.3 g,地塞米松5 mg,尿激酶10万单位(用生理盐水20ml稀释),共3次.结果A组效果最好,B组次之,C组效果最差,3组患者无明显不良反应.结论对结核性包裹性胸腔积液,在正规抗结核治疗的基础上,可向胸膜腔内注入尿激酶,可以加速消除积液,但宜早期(发病6周以内)用药,该疗法安全,可靠,简便易行.

Objective: To study the therapeutic method for tuberculous encapsulated pleural effusion. Methods: one hundred and nineteen patients with tuberculous encapsulated pleural effusion were divided into three groups by the time from occurrence to being diagnosed: group A(not more than three weeks); group B (between three and six weeks); group C(more than six weeks). On the basis of conventional anti-tuberculosis, all the patients were injected with isoniazid 0.3 g, dexamethasone 5 mg and urokinase 100 000 iu (resolved by physiologic saline 20 ml) intrapleurally after each thoracocentesis, total three times. Results: the therapeutic effect of group A is the best, that of group B is in middle, while that of group C is the worst in the three groups. There are no evident adverse effects in all the patients. Conclusions: For the patients with tuberculous encapsulated pleural effusion, they can be injected with urokianse intrapleurally on the basis of conventional anti-tuberculosis, which can promote the disappearance of the effusion, but this therapy should be executed early (not more than six weeks). This way is safe, reliable and easy.