胸腔内注入尿激酶加地塞米松和异烟肼预防胸膜粘连肥厚的作用

目的观察胸腔留置中心静脉导管闭式引流并注入尿激酶+地塞米松+异烟肼对无包裹性结核性胸腔积液胸膜粘连肥厚的预防作用。方法将120例中等量以上无包裹性结核性胸腔积液患者随机分为每次引流胸腔积液后注入尿激酶+地塞米松+异烟肼的治疗组60例和胸腔内注入地塞米松+异烟肼的对照组60例,分别于治疗3个月复查胸部CT。结果治疗组胸膜粘连发生率6.7%较对照组的28.3%明显减少(P0.01),胸膜肥厚(1.9±0.6)mm较对照组的(3.7±0.8)mm明显减轻(P0.01)。结论胸腔留置中心静脉导管闭式引流并注入尿激酶+地塞米松+异烟肼在治疗无包裹性结核性胸腔积液中有很好的预防胸膜粘连肥厚的作用。

Preventive effect of intrapleural urokinase on pleural adhesions thickening

Objective To observe of preventive effect of intrapleural urokinase and dexamethasone and iso- niazid on pleural adhesions thickening. Methods 120 patients with unloculated tuberculous pleural effusion were randomly divided into two groups. The treatment group was given urokinase, dexamethasone and isoniazid, and the control group was given dexamethasone and isoniazid. 3 months after the treatment, their chest CT was re-examined. Results The incidence of pleural adhesion was 6. 7% in the treatment group, which was obviously lower than that in the control group of 28.3% （P 〈0.01）. The pleural thickening was slighter in the treatment group than that in the control group （P 〈 0. 01 ）. Conclusion Pleural indwelling central venous catheter closed drainage combined with intrapleural urokinase and dexamethasone and isoniazid has good prevention of pleural adhesions hypertrophy in the treatment of unloculated tuberculous pleural effusion.