超声引导置管注入治疗包裹性胸腔积液的临床观察

Clinical observation on ultrasound-guided catheterization and injection in the treatment of encapsulated pleural effusion

目的探讨超声引导胸膜腔置入中心静脉导管(以下简称导管)注入尿激酶治疗结核性包裹性胸腔积液(以下简称积液)的疗效。方法选取确诊积液患者100例,按数字随机法分为2组,治疗组50例采用超声引导导管置入胸膜腔并注入尿激酶;对照组50例,常规穿刺引流。比较2组积液引流的颜色、引流量、积液吸收时间、呼吸改善情况等。结果治疗组引流液颜色逐渐转为橙红色、红色,对照组引流液颜色一直不变;治疗组比对照组积液引流量多(1 425±207)ml vs(743±220)ml,积液吸收快(10.1±1.1)d vs(18.3±1.7)d,呼吸改善快(1.9±0.8)d vs(7.3±1.6)d。2组比较,差异均有统计学意义(P<0.05)。结论超声引导导管置入胸膜腔并注入尿激酶治疗包裹性积液,可以增加引流量,缩短吸收时间,改善患者肺功能,减轻其痛苦,疗效显著。

[ Objective] To discuss the clinical effect of ultrasound-guided pleura] cavity catheterization with urokinase injection in the treatment of tuberculous encapsulated pleural effusion. [ Methods] 100 patients with encapsulated pleura] effusion were randomly divided into two groups. The treatment group （50 cases ） was treated with ultrasound-guided pleura] cavity catheterization and uro-kinase injection, and the control group was given conventional puncture drainage. The effusion color, volume of pleura] effusion, absorption time of effusion and respiratory improvement were compared in two groups. [ Results] The effusion color in the treatment group gradually became orange or red, and that in the control group has not been changed. The volume of pleura] effusion in the treatment group （ 1 425 ± 207 ） ml was more than that in the control group { 743 ± 220） ml, absorption time of effusion in the treat-ment group （ 10.1 ± 1.1 ） days was shorter than that in the control group { 18.3±1.7 ） days, the respiratory improvement in the treatment group （ 1.9 ± 0.8 ） days was faster than that in the control group （ 7.3 ± 1.6 ） days, and all differences were statistically significant （ P 〈0.05）. [ Conclusion]The ultrasound-guided pleura] cavity catheterization and urokinase injection in the treatment of encapsulated pleural effusion can increase the volume of pleural effusion, shorten absorption time, improve lung function and re-duce the pain of patients, which shows an obvious effect.