胸腔内注入纤维蛋白原和凝血酶治疗难治性自发性气胸

Infusion of fibrinogen and thrombin into pleural cavityin the treatment of complicated spontaneous pneumothorax

目的 探讨纤维蛋白原和凝血酶胸腔内注入治疗难治性自发性气胸的疗效。方法 将 46例难治性自发性气胸患者随机分为治疗组和对照组 ,每组各 2 3例 ,治疗组予经胸腔闭式引流管先后注入纤维蛋白原和凝血酶 ,注药后观察疗效及不良反应。对照组予持续胸腔闭式引流 ,部分加用持续负压吸引等常规内科治疗。两组疗程均为 3～ 4周。结果 治疗组有效率为 91.3 0 % ,对照组为 5 2 .17% ,平均住院时间治疗组为 14± 4.71天 ,对照组为 2 9± 5 .5 2天 ,3年内复发率治疗组为 4.3 5 % ,对照组为 3 0 .43 % ,两组比较 ,治疗组有效率显著高于对照组 (P <0 .0 1) ,住院时间显著短于对照组 (P <0 .0 1) ,3年内复发率治疗组显著低于对照组(P <0 .0 5 ) ,两组不良反应极少 ,仅治疗组出现轻微胸痛 1例 ,无发热、呼吸困难 ,无出凝血时间及肝肾功能改变。结论 胸腔内注入纤维蛋白原和凝血酶治疗难治性气胸具有有效率高、复发率低、住院天数少、不良反应极少等优点 ,值得临床推广。

Objective To evaluate the curative effect of fibrinogen and thrombin infusion in the treatment of complicated spontaneous pneumothorax.Methods 46 cases of complicated spontaneous pneumothorax were randomly divided into experiment group and control group. Experiment group have been infused with fibrinogen and thrombin into pleural cavity. Curative effect and side effect were monitored after infusion.Results The effective rate of experiment group was significantly better than that of control group (P<0.01). Hospitalization days of experiment group were fewer than that of control group(P<0.01). The recurrence rate of experiment group was significantly lower than that of control group (P<0.05).Side effect in experiment group was mild.Conclusion Fibrinogen and thrombin infusion is effective and safe in the treatment of complicated spontaneous pneumothorax.