胸腔置管引流并注入尿激酶治疗结核性渗出性胸膜炎的疗效观察

Efficacy of Combination of Intrathoracic Cannula and Intrapleural Urokinase on Tuberculous Exudative Pleurisy

目的观察胸腔置管引流联合尿激酶注入胸腔治疗结核性渗出性胸膜炎的疗效。方法将62例结核性渗出性胸膜炎患者随机分为治疗组和对照组,两组均常规给予全身抗结核和泼尼松治疗,治疗组在此基础上胸膜腔微创置管引流,间断注入尿激酶10万IU,对照组在此基础上间断胸腔穿刺抽液。分别观察胸水总量,胸水吸收时间,胸膜肥厚、气胸、胸膜反应、血性胸水发生率。结果治疗组胸水总量、胸水吸收时间与对照组相比有显著差异,胸膜厚度、气胸、胸膜反应发生率与对照组相比差异有统计学意义,血性胸水发生率两组相比差异不显著。结论胸腔置管持续引流联合尿激酶注入治疗结核性胸膜炎疗效好,能有效增加胸水排出量、缩短胸水吸收时间、减少胸膜肥厚、减少穿刺并发症,血性胸水未见增加。

Objective To investigate the curative effect of retaining tube for drainage combined with Urokinase in thorax on tuberculous exudative pleurisy. Methods Sixty-two patients with tuberculous exudative pleurisy were randomly divided into treated group and control group, both groups with anti-tuberculosis drug and prdnisone therapy, micro-retaining tube for drainage in thorax and 1 million of Urokinase injected intermittently to treated group, and thoracic drainage intermittently to control group. The total volume of pleural effusion and absorption time, the incidence of pleural thickening and reaction, pneumothorax and hemothorax were observed. Result There were obviously significant differences of the total of pleural effusion and absorption time in treated group compared with control group, the inci- dence of pleural thickening and reaction and pneumothorax in treated group showed statistically significant compared with control group, the incidence of hemothorax had not obvious difference between two groups. Conclusion The retaining tube for drainage combined with Urokinase in thorax to tuberculous exudative pleurisy has a better clinical curative effect, which could effectively increase the output of pleural effusion, shorten absorption time of pleural effusion, and decrease pleural thickening and complication of puncture, meanwhile, there is no increase of hemotborax.