胸膜腔闭式引流治疗结核性脓胸方法研究

目的比较胸膜腔闭式引流治疗结核性脓胸时胸膜腔注入不同药物的疗效，探讨治疗结核性脓胸的理想方法。方法将选入的结核性脓胸患者分为2组：A组（中心静脉导管胸膜腔置入引流加胸膜腔内注入尿激酶法）32例，采用中心静脉导管置入胸膜腔内引流胸液，每日通过引流管注入尿激酶；B组（中心静脉导管胸膜腔置入引流加胸膜腔内注入异烟肼法）32例，采用中心静脉导管置入胸膜腔内引流胸液，每日通过引流管注入异烟肼；2组患者的化疗方案均为2HREZ／10HR。比较2组临床疗效。结果治疗2、12个月时显效率、总有效率A、B2组比较差异有统计学意义（P〈0．05）。结论用中心静脉导管胸膜腔内置入加注入尿激酶是一种治疗结核性脓胸的理想方法。

Therapeutic effect of pleural cavity closed drainage on tuberculous empyema

Objective To compare the therapeutic effect of pleural cavity closed drainage of tuberculous pleural cavity when injected into different drugs on tuberculous empyema in order to explore the ideal method. Methods The patients with tuberculous empyema were randomly divided into 2 groups： in group A （central venous catheter into the pleural cavity pleural drainage and intrapleural urokinase in France）, 32 patients were treated by central venous catheter drainage of pleural fluid into the pleural cavity, daily injection of urokinase through the drainage tube; in group B （ central venous catheter drainage of the pleural cavity into intrapleural isoniazid plus method）, 32 patients were treated by central venous catheter drainage of pleural cavity pleural effusion, the daily drainage tube into the isoniazid. The patients in both groups were treated by chemotherapy with 2HREZ/10HR. The therapeutic effects were compared between the two groups. Results There were significant differences in effective rate and total effective rate at 2,12 months between the two groups （ P 〈 0.05 ）. The therapeutic effect in group A was superior to that in group B. Conclusion The pleural cavity with a central venous catheter placement plus injection of urokinase for the treatment of tuberculous empyema is an ideal method.