结核包裹性胸膜炎的治疗方法探讨

目的探讨结核性包裹性胸膜炎的治疗方法。方法对88例收治的结核性粘连包裹性胸膜炎随机分为治疗组45例和对照组43例。治疗组于每次抽液后胸腔内注入尿激酶10万单位加异烟肼0.2克和丁胺卡那霉素0.4克;对照组43例采用每次抽液后胸腔内注入异烟肼0.2克和丁胺卡那霉素0.4克,其它治疗相同。结果治疗组胸腔积液吸收。胸膜肥厚的完全好转率为77.8%,对照组为41.9%,经统计学处理差异有显著性(P<0.01)。部分好转率治疗组为17.8%,对照组为20.9%。经统计学处理差异无显著性(P>0.05)。结论在规则抗结核治疗下,配合胸膜腔内注入抗痨药加尿激酶治疗结核性包裹性胸膜炎可减轻胸水渗出,减轻胸膜粘连、肥厚,并改善肺功能。

Clinical Observation of lntra- pleural Injection of Urokinase plus Drug for Patients with Encapsulated Tuberculosis Pleural Effusion

Objective To study the treatment pattern for tuberculosis localated effusisons.Methods 88 patients wih tuberculosis pleural effusion were randomized into 2 groups.treatment group(45 cases) and control group(43 cases).ln treatment group,intra-pleural injecion of 10~5U urokinase plus INS 0.2g plus Amikacin 0.4g after drawing pleural fluid.In control group,intra-pleural injection of INH 0.2g plus Amikacin 0.4g after drawing pleural fluid.Other therapies were similar to treatment group.Results The pleural adhesive and thicken complete improvement rate was 77.8% in treatment group,and in control group was 41.9%.The difference was significant(P<0.01).The partial improvement was 17.8% in treatment group,and in control group was 20.9%,the difference was not significant(P>0.05).Conclusion For patients with encapsulated tuberculosis pleural effusion,regular anti-tuberculosis treatment plus urokinase plus anti-tuberculosis drug injection into the pleural cavity can decrease the effuse,decrease pleural thickening and adhesion.