腔内置管联合注入尿激酶和激素治疗包裹性胸腔积液的疗效观察

INDWELLED THORATIC CATHETER AND INFUSION OF UROKINASE AND HORMONE IN TREATING TUBERCULOUS ENAPSULATED HYDROTHORAX

目的观察胸腔内置管联合注入尿激酶和激素治疗包裹性胸腔积液的疗效。方法将初治的有中等量以上结核性包裹性胸腔积液(B超示积液包裹)患者50例,随机分为治疗组30例,对照组20例,两组均行抗结核方案治疗。在此基础上,治疗组行腔内置管抽液后注入尿激酶12 500IU、地塞米松(Dxm)5 mg治疗;对照组行常规胸腔穿刺抽液治疗。结果退热时间治疗组为(4±1)d,对照组为(6±2)d;胸腔积液量治疗组为(2813±570)ml,对照组为(2010±420)ml;胸腔积液吸收时间治疗组为(10±4)d,对照组为(15±5)d;住院时间治疗组为(12±4)d,对照组为(19±6)d;治疗3月后的胸膜肥厚治疗组为(1.3±0.4)mm,对照组为(2.0±0.7)mm;两者比较均有非常显著性差异(P<0.01)。结论胸腔内置管联合注入尿激酶和激素治疗包裹性胸腔积液疗效确切,值得在基层医院推广。

Objective To explore the therapeutic effect of indwelled thoratic catheter and infusion of urokinase and hormone in treating tuberculous encapsulated hydrothorax. Methods 50 cases were randomly divided into the treatment groups （30 eases） and the contrast group （20 cases）. Both groups recived antituberculotic therapy. The treatment group was then treated with 12 500IU of urokinase and 5mg of dexamenthasone after hydrothorax extraction. The contrast group was treated with thoracic puncture and drainage. Results The defervescence lasted（4 ± 1） days and （6 ± 2） days in the treatment groups and the contrast group respectively. The hydrothorax amounts were （2813 ± 570）ml and （2010 ± 420） respectively. The absorption of hydrothorax lasted（10 ± 4） days and （15 ± 5） days respectively. The hospitalization lasted （12 ± 4） days and （19 ± 6） days respectively. The pachynsis pleurae after 3-month treatments was of （ 1.3 ± 0.4）turn and （2.0 ± 0.7）mm in thickness respectively（ P 〈 0.01）. Conclusion The combined use of indwelled thoracic catheter and infusin of urakinase and hormone can produce good effect on tuberculous encapsulated hydrothrax.