尿激酶治疗结核性包裹性胸腔积液疗效观察

Effect of urokinase on encapsulated tuberculous pleural effusion

目的评估胸腔内注射尿激酶、辅助用泼尼松及单纯胸腔抽胸腔积液(胸液)3种方法对结核性包裏性胸液患者胸液引流量、胸液消退时间及胸膜增厚的影响。方法将78例结核性胸膜炎患者随机分为尿激酶组、泼尼松组和单纯抽胸液组。给予尿激酶组患者胸腔内注射10万单位尿激酶后持续胸腔引流,泼尼松组患者每日服用泼尼松25mg加间断胸腔穿刺抽胸液,给予单纯抽胸液组患者单纯间断胸腔穿刺抽液。观察抽出的胸液量、胸液消退时间、胸液消退后及胸液消退后6个月时胸膜厚度。结果尿激酶组胸液引流量较其他2组明显多,胸液消退时间较其他2组短,胸膜厚度也较其他2组轻。结论胸腔内注射尿激酶治疗结核性包裏性胸液能有效防止胸膜增厚,缩短胸液消退时间。

Objective To evaluate the effects of 3 therapies, intrapleural injection of urokinase, adjuvant prednisone therapy and simple thoracentesis on the volume and dissipation time of pleural effusion and pleural thickening in patients with encapsulated tuberculous pleural effusion. Methods Totally 78 cases of tuberculous pleurisy were randomly divided into 3 groups： urokinase group, prednisone group and simple thoracentesis group. Persistent pleural drainage was performed on the patients in urokinase group after intrapleural injection of 100 000 units of urokinase. Prednisone 25 mg daily plus intermittent simple thoraeentesis was given to the patients in prednisolone group. Thoracentesis was performed to draw pleural effusion on the patients in simple thoracentesis group. The volume and dissipation time of pleural effusion and pleural thickness measured when pleural effusion dissipated and 6 months after pleural effusion dissipated were observed. Results Compared to the other two groups, the volume of pleural fluid drained was significantly larger, the time when pleural effusion dissipated was shorter, and the degree of pleural thickening was slighter in urokinase group. Conclusions Intrapleural injection of urokinase in the treatment of encapsulated tuberculous pleural effusion can effectively prevent pleural thickening, and shorten the dissipation time of pleural effusion.