内科胸腔镜联合不同方案对结核性包裹性胸腔积液的疗效影响

Therapeutic effects of medical thoracoscopy combined with different regimens on tuberculo-encapsulated pleural effusion

目的探讨内科胸腔镜联合不同治疗方案对结核性包裹性胸腔积液疗效的影响,寻求临床最优化治疗。方法回顾2013年1月至2017年5月收治的结核性包裹性胸腔积液患者203例,根据治疗方案不同区分为治疗组(内科胸腔镜联合微卡菌苗组)、对照1组(内科胸腔镜组)、对照2组(尿激酶溶隔组),观察3组临床症状消失时间、胸水总量、置管天数、转手术例数、胸膜增厚程度、肺功能及免疫情况。结果治疗组在临床症状消失时间、置管天数、胸膜增厚程度、肺功能分度、免疫指标方面均优于对照1组及对照2组(P <0. 05)。结论内科胸腔镜联合微卡菌苗对结核性包裹性胸腔积液治疗整体效果最佳,远期疗效更好。

Objective To explore the therapeutic effect of medical thoracoscopy combined with different treatment regimens on tuberculo-encapsulated pleural effusion, and to seek optimal treatment strategy in clinical settings. Methods A total of 203 patients with tuberculo-encapsulated pleural effusion who were admitted and treated in our hospital from January 2013 to May 2017 were enrolled in the study. According to different treatment schemes ,these patients were divided into treatment group [medical thoracoscopy combined with mycobacterium vaccae vaccine （M. vaccae vaccine） group] and control group 1 （medical thoracoscopy group）, and control group 2 （urokinase dissolution group）. The time of clinical symptom disappearance, total pleural effusion, duration of catheterization, number of cases for operation, degree of pleural thickening, lung function and immune indexes were observed and compared among the three groups. Results The symptom disappearance time, duration of catheterization, degree of pleural thickening, lung function indexes and immune indexes in treatment group were superior to those in control group 1 and control group 2 （ P 〈0.05）. Conclusion The overall therapeutic effect of medical thoracoscopy combined with micro Calmette’s vaccine is optimal in treatment of tuberculo-encapsulated pleural effusion, with a better long-term outcome.