胸腔内注入肝素或尿激酶治疗结核性胸膜炎的效果研究

Study on the effect of intrapleural injection of heparin or urokinase in the treatment of tuberculous pleurisy

目的探究胸腔内注入肝素或尿激酶治疗结核性胸膜炎的临床效果。方法90例结核性胸膜炎患者,依据治疗方案不同分为对照组与实验组,各45例。对照组采用胸腔内注入尿激酶治疗,实验组采用胸腔内注入肝素治疗。比较两组治疗效果、症状缓解时间、住院时间、胸膜厚度、抽液量、胸液吸收时间、并发症发生情况。结果实验组治疗总有效率为97.8%,高于对照组的84.4%,差异有统计学意义(P<0.05)。实验组症状缓解时间(3.45±1.08)d、住院时间(8.45±1.16)d、胸液吸收时间(10.95±4.83)d,均明显短于对照组的(7.59±2.26)、(16.57±3.57)、(16.85±5.45)d,胸膜厚度(1.09±0.11)mm小于对照组的(1.65±0.17)mm,抽液量(2284.57±325.47)ml大于对照组的(1928.75±317.15)ml,差异均有统计学意义(P<0.05)。实验组胸膜粘连、胸膜增厚发生率分别为2.2%、0,均低于对照组的15.6%、13.3%,差异均有统计学意义(P<0.05)。结论胸腔内注入肝素治疗结核性胸膜炎效果明显优于胸腔内注入尿激酶,其并发症少,安全性较高,且还能缩短治疗时间与症状改善时间,值得推荐。

Objective To investigate the clinical effect of intrapleural injection of heparin or urokinase in the treatment of tuberculous pleurisy.Methods A total of 90 patients with tuberculous pleurisy were divided into control group and experimental group according to different treatment schemes,with 45 cases in each group.The control group was treated with intrapleural injection of urokinase,and the experimental group was treated with intrapleural injection of heparin.Both groups were compared in terms of therapeutic effect,symptom relief time,hospitalization time,pleural thickness,amount of fluid drawn,time of pleural fluid absorption,and complications.Results The total effective rate 97.8% of the experimental group was higher than 84.4% of the control group,and the difference was statistically significant(P<0.05).In the experimental group,the symptom relief time was(3.45±1.08)d,the hospitalization time was(8.45±1.16)d,and the time of pleural fluid absorption was(10.95±4.83)d,which were significantly shorter than(7.59±2.26),(16.57±3.57),and(16.85±5.45)d of the control group;the pleural thickness(1.09±0.11)mm was less than(1.65±0.17)mm of the control group;the amount of fluid drawn(2284.57±325.47)ml was greater than(1928.75±317.15)ml of the control group;all the differences were statistically significant(P<0.05).The incidences of pleural adhesion and pleural thickening in the experimental group were 2.2% and 0,respectively,which were lower than 15.6% and 13.3% in the control group,and the differences were statistically significant(P<0.05).Conclusion Intrapleural injection of heparin is significantly better than intrapleural injection of urokinase in the treatment of tuberculous pleurisy,with fewer complications and higher safety,and can shorten the treatment time and symptom improvement time.It is worth recommending.