双腔中心静脉导管胸腔置入联合胸腔内注药治疗渗出性结核性胸膜炎临床探讨

Clinical exploration on inserting double cavity central venous catheters in thoracic cavity of patients with pleural effusion combined with injeoting medicine

目的探讨双腔中心静脉导管胸腔置入联合胸腔内注药治疗渗出性结核性胸膜炎临床疗效。方法将80例中或大量胸腔积液的结核性胸膜炎患者，随机分为治疗组41例，对照组39例。治疗组采用双腔中心静脉导管胸腔置入持续胸腔引流联合胸腔内注药（异烟肼注射液0．3g、丹参注射液10ml、生理盐水10ml混合后注入胸腔）.对照组单用反复多次胸腔穿刺抽液治疗，胸腔内不注药。对这两种治疗方法的效果、出现并发症情况、住院费用进行比较。结果治疗组和对照组对比：胸水吸收时间、住院费用、治疗后第三个月的胸膜厚度及并发症（胸膜反应率、气胸发生率、胸水包裹发生率）等各项指标对比，差异均有显著性（P〈0．05）。结论双腔中心静脉导管胸腔置入联合胸腔内注药治疗渗出性结核性胸膜炎，方法简单、方便、安全、经济，患者痛苦少、临床效果好，可作为渗出性结核性胸膜炎的一种治疗方案。

Objective To observe the clinical effects of inserting double cavity central venous catheters in the thoracic cavity of patients with pleural effusion combined with injecting medicine. Methods 80 cases of medium or large amounts of pleural effusion were randomly divided into treated group（n=41） and control group（n=39）. In the treated group, double cavity central venous catheterization was put into the thoracic cavity to drain the pleural effusion combined with injecting medicine （the mixture of isouiazid injection 0.3g, Dansben injection 10 ml and normal saline 10 ml）.The control group was given the simple repeated thoracic cavity puncture pumping fluids without injecting medicine. The comparisons were made on the treatment effects, its complications and the medical expenses. Results There were significant differences between the two groups in the average time of pleural effusion absorption ,the pleural thickness and the complications （pleura reaction rate, pneumothorax rate and pleural fluid pkg incidence rate）. Conclusion Inserting double cavity central venous catheters in the thoracic cavity of patients with plenral effusion combined with injecting medicine has the advantage of easy and safe operation, reducing hospitalization time and cost, with better treatment effects. It can be a cure for patients with pleural effusion.