尿激酶治疗脓胸的研究进展

Research Progress of Urokinase in Treatment of Empyema

脓胸的治疗原则是充分引流积液和应用抗生素,但脓液中含有大量纤维蛋白易造成胸膜粘连形成纤维间隔,传统的胸腔置管无法实现充分引流,导致患者病情延误,而手术并不适用于基础情况差的患者,因此手术治疗儿童脓胸更需谨慎。目前已有大量的文献证实胸腔内注射尿激酶能够有效减少住院时间,降低手术干预率,即使在严重脓胸中仍有较好的疗效,尤其是儿童患者,更应作为其首选治疗方案。近些年尚无相关综述,本文对尿激酶的作用机制、疗效、剂量等进行综述,希望能为脓胸的诊疗提供新的思路。

The treatment principle of empyema is full drainage of effusion and application of antibiotics,but the pus contains a lot of fibrin,which is easy to cause the adhesion of pleura to form fiber septum.Traditional thoracic catheter cannot achieve adequate drainage,resulting in delays in the patient′s condition,and surgery is not suitable for patients with poor basic conditions,there fore surgical treatment of empyema in children should be more cautious.At present,a large number of literatures have confirmed that intrathoracic urokinase injection can effectively reduce the length of hospital stay and reduce the rate of surgical intervention^([1]).Even in severe empyema still has a good effect,especially in children patients,should be the first choice of treatment.There is no relevant review in recent years.This article reviews the mechanism of action,efficacy and dosage of urokinase,hoping to provide new ideas for the diagnosis and treatment of empyema.