包裹性结核性胸膜炎的临床治疗观察

Observation of Clinical Treatment of Encysted Tuberculous Pleurisy

目的观察胸腔内注射尿激酶治疗包裹性结核性胸膜炎的可行性和安全性。方法对照组30例予以2HRZE/4HRE抗结核方案,B超定位下胸膜腔穿刺抽液,并口服强的松激素。观察组在对照组基础上在每次胸穿抽液后胸腔内注射尿激酶10万单位(用20ml生理盐水稀释)。结果观察组和对照组总有效率分别为96.8%和63.3%,观察组疗效明显优于常规对照组,差异有显著性(P<0.05)。观察组和对照组抽液次数比较,无显著性差异(P>0.05),但两组抽液量、积液吸收时间、胸膜粘连及胸膜厚度比较,差异有显著性(P<0.05)。观察组所有患者均对尿激酶治疗耐受良好,无出血倾向等严重的不良反应。结论胸腔内注入尿激酶治疗包裹性结核性胸膜炎可增加引流量,减轻胸膜肥厚,改善肺功能,减轻患者痛苦,疗效显著。

Objective To observe the feasibility and safety of intrapleural injection of urokinase treatment of encysted tuberculous pleurisy.Methods The control group of 30 cases used 2HRZE/4HRE anti-TB regimens.Pleural cavity puncture pumping fluid under B-sonography location,took prednisone hormone by mouth.The observation group took intrapleural injection of urokinase of 10 million units after each pleural cavity puncture pumping fluid based on the control group（diluted with 20ml saline）.Results The total effective rates of observation group and control group were 96.8% and 63.3%,the effect of observation group was better than that of conventional control group,there was a significant difference（P0.05）.The number of pumping liquid compared between the observation group and control group,there was no significant difference（P0.05）,but pumping fluid quantity,pleural effusion absorption time,pleural adhesion and pleural thickness of the two groups compared,there were significant differences（P0.05）.Conclusion Intrapleural injection of urokinase can increase drainage volume,reduce pachynsis pleurae,has remarkable curative effect.