口服糖皮质激素联合抗痨药对结核性胸膜炎患者临床症状和胸膜增厚粘连的影响

Effect of Oral Glucocorticoid Combined with Antituberculosis Drugs on Clinical Symptoms and Pleural Thickening and Adhesion in Patients with Tuberculous Pleurisy

目的对比研究口服糖皮质激素联合抗痨药对结核性胸膜炎患者临床症状和胸膜增厚粘连的影响。方法选取卧龙区疾控中心2017年9月至2019年1月收治的130例结核性胸膜炎患者患者作为研究对象,将研究对象随机分为对照组(n=65)和观察组(n=65),对照组予以利福平、异烟肼、吡嗪酰胺、乙胺丁醇等抗痨药治疗,观察组予以口服糖皮质激素联合抗痨药治疗。比较两组临床疗效、胸水完全消退时间、住院天数、并发症发生率、临床症状改善情况、治疗后胸膜增厚及黏连情况。结果观察组与对照组临床有效率分别为96.92%,80.00%(P<0.05);观察组与对照组总肥厚黏连率分别为24.62%,46.15%(P<0.05);对照组胸水完全消退时间、住院天数均长于观察组(P<0.05);观察组与对照组并发症发生率分别为10.77%,30.77%(P<0.05);观察组临床症状改善时间均明显短于对照组(P<0.05)。结论口服糖皮质激素联合抗痨药治疗结核性胸膜炎能有效缩短治疗时间,促进胸水吸收,减少胸膜肥厚粘连,降低并发症发生率,值得临床上进一步推广。

Objective To study the effect of oral glucocorticoids combined with antituberculosis drugs on the clinical symptoms and pleural thickening and adhesion in patients with tuberculous pleurisy.Methods 130 patients with tuberculous pleurisy admitted to our Hospital from September 2017 to January 2019 were randomly divided into control group(n=65)and observation group(n=65).The control group was treated with rifampin,isoniazid,pyrazinamide,ethambutol and other antituberculotic drugs,and the observation group was treated with oral glucocorticoids Antituberculotic treatment.The clinical effect,time of complete disappearance of pleural effusion,days of hospitalization,incidence of complications,improvement of clinical symptoms,pleural thickening and adhesion after treatment were compared between the two groups.Results the clinical effective rate of the observation group and the control group was 96.92%,80.00%(P<0.05),the total hypertrophic adhesion rate of the observation group and the control group was 24.62%,46.15%(P<0.05),the time of complete disappearance of pleural effusion and the days of hospitalization in the control group were longer than those in the observation group(P<0.05),the complications rate of the observation group and the control group were 10.77%,30.77%(P<0.05),and the clinical symptoms of the observation group were improved They were significantly shorter than those in the control group(P<0.05).Conclusion the treatment of tuberculous pleurisy with oral glucocorticoid and antituberculosis drugs can effectively shorten the treatment time,promote the absorption of pleural fluid,reduce pleural thickening and adhesion,and reduce the incidence of complications,which is worthy of further promotion in clinical practice.