胸膜腔内注入降纤酶治疗结核性胸膜炎

Intrapleural Injection of Defibrase in Treatment of Tuberculous Pleurisy with Effusion

目的观察胸腔内注入降纤酶对减少结核性渗出性胸膜炎胸膜增厚、粘连的效果。方法渗出性胸膜炎患者59例,随机分成治疗组(30例)与对照组(29例)。治疗组充分引流后注射降纤酶10单位+生理盐水20 ml,对照组注射生理盐水20 ml。结果形成纤维分隔、多房积液的,治疗组1例,对照组5例(P<0.05)。2月后B超查,治疗组胸膜厚度(1.21±0.23)mm,对照组(1.94±0.41)mm(P<0.05);治疗组胸膜粘连6.67%,对照组24.14%(P<0.05);治疗组肺功能FVC%为(87.8±2.2)%,对照组(79.2±2.1)%(P<0.05);治疗组FEV1/FVC%为(86.9±2.7)%,对照组(78.6±2.3)%;两者差异亦有显著性(P<0.05)。结论胸腔内注射降纤酶能减少胸腔分隔、多房的形成,减少胸膜粘连、肥厚,改善肺功能。

Objective To observe the curative effect of intrapleural defibrase for tuberculous pleurisy. Method Fifty-nine paients with tuberculous plleural effusion were randomized into two groups： treatment group and control group.The patients in the treatment group were injected with defibrase intrapleurally each time after thoracocentesis, and the patients in the control group were injected with 20 ml physiological saline each time.The other therapies in both groups were the same. Results There was one patient with pleural adhesion and loculation in the treatment group, but there were 5 cases in the control group （P〈0.05）. Aftre two months, the mean thickness of pleura in the treatment group was （1.21± 0.23） mm by B ultasound wave test, but it was （1.94±0.41） mm in the control group （P〈0.05）. The rate of pleural thickening in the treatment group was 6.67% （2/3）, and 24.14%（7/29） in control group （P〈0.05）. The hmg function （FVC%）examined was （87.8± 2.2）% in the tratment group, while it was （79.2 ±2.1）% in the control group （P〈0.05）. FEV1/FVC% was （86.9± 2.7）% in the treatment group, while it was （78.6 ±2.3）% in the control group （P 〈0.05）. Conclusion Intrapleural defibrase can not only reduce pleural adhesion, loculation and thickening of the pleura, but also improve lung function.