地塞米松联合尿激酶治疗结核性胸膜炎的临床效果分析

Analysis of the Clinical Effect of Dexamethasone Combined with Urokinase on the Tuberculous Pleurisy

目的:探讨地塞米松联合尿激酶对结核性胸膜炎的临床效果。方法:选择2013年8月到2016年5月在我院进行诊治的结核性胸膜炎患者190例,根据随机信封抽签原则分为观察组与对照组各95例,两组都给予标准抗结核治疗方案,对照组在抗结核治疗的同时给予尿激酶治疗,观察组再给予地塞米松治疗,两组都治疗1个月。治疗后,比较两组的总有效率、不良反应的发生情况、胸腔积液完全引流时间、抽出胸腔积液总量、凝血酶原时间和凝血酶时间。结果:所有患者都注射耐受良好,未见严重并发症;观察组的总有效率(88.4%)明显高于对照组(72.6%);观察组胸腔积液完全引流时间和抽出胸腔积液总量分别为7.56±2.44d和2867.33±456.10 m L,对照组分别为9.44±2.89d和1989.92±444.20 m L,观察组胸腔积液完全引流时间明显短于对照组,且抽出胸腔积液总量显著高于对照组(P<0.05)。治疗后,两组的凝血酶原时间和凝血酶时间都明显高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05)。结论:地塞米松联合尿激酶治疗结核性胸膜炎能延长凝血酶时间和凝血酶原时间,缩短胸腔积液引流时间,增加抽出胸腔积液总量,安全性和临床疗效均较好。

Objective： To investigate the clinical effect of dexamethasone combined with urokinase on the tuberculous pleurisy. Methods： From August 2013 to May 2016, 190 cases of tuberculous pleurisy patients in our hospital were selected. All the patients were randomly divided into the observation group and control group with of 95 patients in each group, both groups were treated with anti tuberculosis treatment, the control group was given urokinase treatment, the observation group was given dexamethasone combined with urokinase treatment, both groups were treated for 1 month. After treatment, the total effective rate, incidence of adverse reactions, total drainage time of pleural effusion, total amount of pleural effusion, thrombin time and prothrombin time of two groups were compared. Results： All patients were well tolerated with injection during the treatment and there was no severe complication after treatment; the total effective rates in the observation group and the control group were 88.4% and 72.6%, which was significantly higher in the observation group than that of the control group （P〈0.05）. The total drainage time and total amount of pleural effusion in pleural effusion in the observation group were 7.56± 2.44 d and 2867.33± 456.10 mL, the control group were 9.44± 2.89 d and 1989.92± 444.20 mL, the total drainage time in the observation group was significantly shorter than that of the control group, and the total amount of pleural effusion was significantly higher than that of the control group（P〈0.05）. After treatment, the pleural effusion thrombin time and prothrombin time in both groups were significantly higher than those before treatment （P〈0.05）, which were higher in the observation group than those of the control group （P〈0.05）. Conclusion： Dexamethasone combined with urokinase could prolong the thrombin time and prothrombin time, shorten the time of drainage of pleural effusion, increase the pleural effusion amount, with good safety and clinical effect in the treatment of tuberculous pleurisy.