胸腔置管引流并注入尿激酶治疗结核性胸腔包裹性积液的临床研究

The study of dectained catheter and intrapleural urokinase for tuberculosis loculated effusion

目的探讨胸腔置管引流并注入尿激酶在治疗结核性包裹性胸膜炎的应用价值。方法 90例结核性包裹性胸膜炎病人作为研究对象,并随机分为A、B、C 3组,各30例;A组胸腔置管引流并注入尿激酶;B组胸穿抽液后注入尿激酶;C组单纯胸穿抽液;化疗方案等其它治疗方法相同。结果 A组在胸水消失时间、排液总量、胸膜厚度、肺功能FEV1%和FVC%改善方面均优于B组或C组。结论胸腔置管引流并注入尿激酶治疗结核包裹性积液引流彻底,安全有效,并发症少,能显著减轻胸膜肥厚,改善肺功能。

Objective To study the clinical value of detained catheter and intrapleural urokinase in the treatment of tuberculosis loculated pleural effusion.Methods 90 patients of losis loculated pleural effusion were divided into group A,B and C at random.Group A of 30 cases had drainage in the thorax and was injected with urokinase;Group B of 30 cases had carvy aspiration for pleural effusion and inject urokinase in it two times a week;Group C of 30 cases had carry aspiration for pleural effusion two times a week.The other therapies in the groups were the same.Results Group A was better than Group B and Group C in the aspect of the duration of pleural effusion absorption and the mean volume of fluid drained and the mean thickness of pleura and the lung function（FEV1% and FVC%）.Conclusion It might be feasible and safe to detain catheter and intrapleural urokinase for tuberculosis loculated effusion.It is safe and has little complication.It can not only reduce thickening of the pleura but also improve lung function.