超声引导穿刺抽液并注入尿激酶治疗结核性多房性胸腔积液

Treatment of encapsulated tuberculous pleural effusion with ultrasound-guided drainage and urokinase injection

目的观察尿激酶对结核性多房性胸腔积液的治疗作用。方法在内科常规方案治疗下,对22例结核性多房性胸腔积液患者穿刺抽液并在胸膜腔内注入100,000IU尿激酶(用40ml生理盐水稀释),另外20例患者常规抗结核治疗及行胸膜腔穿刺抽液治疗作对照。24小时后,再次超声引导下抽液,并记录首次注药前后的抽液量、壁层胸膜厚度、纤维素分隔积分。结果治疗组与对照组相比,用药后抽液量增多、胸膜厚度变薄、纤维素分隔减轻(P<0.05)。结论胸膜腔穿刺引流并注入尿激酶能促进胸水引流,减轻胸膜肥厚、粘连,疗效肯定。

Objective To observe the effects of intrapleural injection of urokinase for patients with encapsulated tuberculous pleural effusion. Methods Regular antituberculosis treatment was given to all patients observed. Forty-two patients with encapsulated tuberculous pleural effusion were randomly divided into treatment（ n = 22） and control（ n = 20） groups, patients in treatment group were treated with ultrasound-guided drainage,followed by intrapleural injection of 100,000IU urokinase（ diluted by 40ml normal saline）. The 20 patients in control group were treated with ultrasound-guided drainage , followed by intrapleural injection of 100mg hydrocortisone. After 24 h , the chest drainage was repeated, and the volume of the chest drainage, the thickness of pleura and the integral of cellulose septation were measured. Results The efficacy in treatment group was better than in control group , such as increase of the volume of chest drainage, thickness of pleura and decrease of cellulose septation after cure. Conclusion The therapy with chest drainage and injection of urokinase into the chest is a good measure for draining the pleural effusion and reducing the pleural thickness.