超声引导下胸膜腔注射尿激酶治疗结核性胸膜炎临床应用

Clinical application of Ultrasound-guided urokinase intrapleural injection in the treatment of tuberculous pleurisy

目的:观察超声引导下胸膜腔注射尿激酶治疗结核性胸膜炎的临床疗效。方法:对80例多房分隔、胸膜肥厚、包裹性胸膜炎患者经超声引导定位注入100000U尿激酶+异烟肼注射液0.3g+丁胺卡那注射液0.3g+0.9%氯化钠溶液20ml,24h以后抽取积液。每周2次重复上述操作,共1～6次。结果:在超声引导下第1次注入尿激酶多房分隔就全部溶解,抽液量增多直至消失48例;经2～4次分隔大部分溶解,抽液量增多28例,总有效率为95%(76/80)。结论:超声引导下胸膜腔注入尿激酶对多房分隔、肥厚、包裹性的结核性胸腔积液是操作方便安全有效有价值的辅助诊断治疗方法。

Objective： To observe the clinical effeetion of Uhrasound-guided urokinase intrapleural injection in the treatment of tuberculous pleurisy. Methods： 80 eases multi-room separated, pleural thickening, parcel pleurisy patients were given urokinase 100 000 U ＋ Remy sealing injection 0.3 g ＋ amikacin injection 0.3 g ＋ 0.9% saline 20 ml positioning by ultrasound-guided injection, effusion was extracted after 24 hours. Repeat twice a week, a total of 1-6 times. Results： Multi-room separated were all dissolved after the first injection of urokinase, 48 cases＇ pumping volume increased until it disappeared; by 2-4 times multi-room separated most dissolved, 28 cases＇ pumping volume increased, the total effective rate was 95% （76/80）. Conclusion： Ultrasound-guided pleural urokinase for multiple rooms separated by thick, package of tuberculous pleural effusion is safe, effective and convenient operation valuable adjunct to diagnosis and treatment method