留置中心静脉导管加注入尿激酶治疗结核性包裹性胸腔积液疗效观察

Observations of the curative effects in the treatment of tuberculous encapsulated thoracic cavity hydrops by means of indwelling central venous catheter plus injection of abbokinade

目的探讨用中心静脉导管胸腔置管持续引流加胸腔注入尿激酶治疗结核性包裹性胸腔积液的疗效。方法结核性包裹性胸腔积液病人60例,随机分为引流组及穿刺组,每组30例。引流组胸腔内注射50ml生理盐水加尿激酶100,000U;穿刺组胸腔内注射50ml生理盐水加地塞米松10mg。两组均按同样方案抗结核治疗,比较两组治疗疗效。结果引流组胸腔积液引流量平均为2134±203ml,显著多于穿刺组的1356±213ml(P<0.05);治疗后胸膜厚度为2.78±0.24mm,显著低于穿刺组3.24±0.29mm(P<0.05);且肺功能指标明显优于穿刺组(P<0.05),住院时间明显缩短。结论中心静脉导管加注入尿激酶治疗结核性包裹性胸腔积液疗效显著。

Objective To evaluate the effects of central venous catheter with continuous thoracic cavity drainage plus injection of abbokinade in the treatment of tuberculous encapsulated thoracic cavity hydrops.Methods 60 patients with tuberculous encapsulated thoracic cavity hydrops were randomized into drainage group and puncture group,30 cases in each group.50 ml saline and 100,000 U abbokinade were infusioned into thoracic cavity in the drainage group,50ml saline plus 10 mg dexamethasone in the puncture group.Both groups were treated by the same anti-TB method,and the clinical effects were compared.Results The flow rate of thoracic fluid in the drainage group was significantly higher than that in the puncture group（1921±208 ml vs 1256±224 ml,P〈0.05）;after the treatment,the thickness of thorax in the drainage group was significantly lower than that in the puncture group（2.51±0.27 mm vs 3.46±0.31 mm,P〈0.05）;lung function was much better than that in the puncture group（P〈0.05）and the hospitalization course were significantly shortened.The effective rate of the drainage group（93.3%）was significantly better than the puncture group（80.0%）（P〈0.05）.ConclusionThe curative effects of indwelling central venous catheter plus injection of abbokinade in the treatment of tuberculous encapsulated thoracic cavity hydrops is clear.