胸腔穿刺联合尿激酶注入治疗结核性胸腔积液临床分析

目的评价胸腔穿刺联合尿激酶注入治疗伴有中量以上胸腔积液的结核性胸膜炎的疗效。方法将72例大、中量结核性胸腔积液患者分为A、B、C三组。A组实施胸腔穿刺抽液治疗,注入20 mL生理盐水,不含任何药物。B、C两组给予胸腔穿刺引流的同时分别注入10万U、20万U的尿激酶加20 mL生理盐水。所有研究对象的全身抗结核和糖皮质激素治疗方法相同。结果 C组的总有效率为92.86%,显著优于A组的68.42%（P〈0.01）和B组的76.00%（P〈0.05）。与其他两组相比,C组的胸液吸收时间最短,胸膜厚度最小,且不良反应发生率最低。结论胸腔穿刺联合尿激酶注入治疗结核性胸腔积液疗效确切、安全、不良反应少。

Clinical analysis of thoraeenlesis combined with intrapleural Urokinase in the treatment of tuberculous pleurisy

Objective To evaluate the efficacy of thoraeenlesis combined with intrapleural Urokinase in the treatment of the tuberculous pleurisy patients with middle to mass pleural effusions.Methods 72 cases of patients with pleural effusions were divided into group A,B and C.The patents of group A were treated with thoraeenlesis,following an injection of 20 mL physiological saline without any medication.Group B and C were given a thoraeenlesis therapy supplemented with an injection of 20 mL physiological saline containing 100 000 U or 200 000 U Urokinase.All patients were given the same systemic anti-TB and glucocorticoid treatment method.Results The total effective rate of group C was 92.86%,which was significantly higher than 68.42% of control group A(P < 0.01) and 76.00% of group B(P < 0.05).Compared with group A and B,the patients of group C had the shortest absorption time,the thinnest pleural thickness and the fewest complications.Conclusion Thoraeenlesis combined with intrapleural Urokinase is effective and safe in the treatment of tuberculous pleural effusions and few complications.