中心静脉导管引流联合尿激酶胸腔注入治疗结核性包裹性胸腔积液的效果分析

Effect Analysis of Central Venous Catheter Drainage Combined with Urokinase Injection in the Treatment of Tuberculous Encapsulated Pleural Effusion

目的:探讨中心静脉导管引流联合尿激酶胸腔注入治疗结核性包裹性胸腔积液的效果。方法:选取2017年1月-2020年1月于本院就诊并进行治疗的结核性包裹性胸腔积液患者100例为此次研究的对象。根据患者入院时间的先后顺序,将其分为观察组和对照组,每组50例。两组患者均给予常规的抗结核治疗,在此基础上,对照组给予胸腔穿刺以抽取积液,观察组给予B超引导下中心静脉导管引流联合尿激酶胸腔注入治疗。比较两组患者相关的临床指标、治疗效果、治疗前后的胸腔积液生化指标、并发症发生情况。结果:观察组的住院时间短于对照组,胸膜厚度小于对照组,胸腔积液抽取、引流总量多于对照组,差异均有统计学意义(P<0.05)。观察组的总有效率为94.00%,明显高于对照组的80.00%,差异有统计学意义(χ2=4.332,P=0.037)。治疗后,观察组的IL-12、TNF-α、ADA水平均低于对照组,差异均有统计学意义(P<0.05)。观察组的并发症发生率为8.00%,虽低于对照组的18.00%,但两组比较差异无统计学意义(χ2=2.210,P=0.137)。结论:中心静脉导管引流联合尿激酶胸腔注入治疗结核性包裹性胸腔积液的效果更好,可有效改善患者的相关生化指标,缩短住院时间,临床应用价值较高。

Objective:To investigate the efficacy of central venous catheter drainage combined with Urokinase injection in the treatment of tuberculous encapsulated pleural effusion.Method:A total of 100 patients with tuberculous encapsulated pleural effusion who visited our hospital and received treatment from January 2017 to January 2020 were selected as the subjects of this study.According to the order of admission time,the patients were divided into observation group and control group,with 50 patients in each group.Both groups were given routine anti-tuberculosis treatment,on this basis,the control group was given pleural puncture to extract effusion,while the observation group was given B-ultrasound-guided central venous catheter drainage combined with Urokinase pleural injection.The clinical indexes,treatment effect,biochemical indexes of pleural effusion before and after treatment,and complications were compared between the two groups.Result:The length of hospitalization in the observation group was shorter than that in the control group,the pleural thickness was smaller than that in the control group,and the total amount of pleural effusion extraction and drainage was higher than that in the control group,all the differences were statistically significant (P<0.05).The total effective rate of the observation group was 94.00%,significantly higher than 80.00% of the control group,with statistically significant difference (χ~2=4.332,P=0.037).After treatment,the levels of IL-12,TNF-α and ADA in the observation group were all lower than those in the control group,the differences were statistically significant (P<0.05).The complication rate of the observation group was 8.00%,lower than 18.00% of the control group,but there was no statistically significant difference between the two groups (χ~2=2.210,P=0.137).Conclusion:Central venous catheter drainage combined with Urokinase pleural injection in the treatment of tuberculous encapsulated pleural effusion has a better effect,can effectively improve the relevant biochemical indicators of patients,shorten the length of hospital stay,and has higher clinical application value.