尿激酶治疗结核性包裹性胸腔积液的临床研究

The Clinic Study of Intrapleural Injection of Urokinase to Treating Loculated Effusions by Tuberculous Pleurisy

目的研究胸膜腔内注入尿激酶 (urokinase,UK)对结核性包裹性胸腔积液的治疗效果。方法将 1 3 4例结核性包裹性胸腔积液病人 ,随机分为治疗组 (73例 )和对照组 (61例 ) ,治疗组于每次抽液前 2小时胸膜腔内注入尿激酶 1 0万IU ,其它治疗两者相同。结果治疗组抽液总量 2 763± 64 1ml、胸膜厚度1 .7± 0 .4mm、胸膜粘连发生率 1 9.1 8% (1 4 /73 ) ,对照组分别为 1 984± 60 7ml、2 .5± 0 .5mm和 4 7.5 4 %(2 9/61 ) ,两组比较均有显著性差异 (P <0 .0 1 ) ;治疗组B超下观察到分隔光带明显减少。结论胸膜腔内注入尿激酶 ,能有效溶解结核性包裹性胸腔积液中的纤维分隔 。

Objective To study the effects of intrapleural urokinase injection to treating loculated effusions by tuberculous pleurisy.Methods 134 patients with loculated effusions by tuberculous pleural effusions were randomly divided into two groups:urokinase treatment group(73 cases) and conventionally treated group(61 cases).The patients in urokinase group were intrapleurally injected with urokinase 100,000IU 2 hours before each thoracocentesis,while the conventional group were injected with 50ml of 0.9% N.S,other therapies were similar.Results The mean volume of fluid drained in urokinase group was 2763±641ml,vs 1984±607ml in conventional group (P&lt;0.01).The mean thickness of pleura in urokinase group was 1.7±0.4mm but 2.5±0.5mm in conventional group(P&lt;0.01).The incidence of pleural adhesion loculation in urokinase group was 19.1%(14/73),it was 47.54%(29/61) in conventional group (P&lt;0.01).Two hours after intrapleural urokinase injection,the partition band in ultrasonogram was evidently rarter in urokinase group than in conventional group(P&lt;0.01).Conclusion The intrapleural urokinase injection can effectively dissolves the fiber partition in loculated effusions by tuberculous pleurisy and prevent pleural thickening and adhesion.