胸腔镜配合尿激酶胸腔内注射治疗结核性包裹性胸腔积液

目的探讨胸腔镜清创引流配合术后尿激酶胸腔内注射治疗结核性包裹性胸腔积液的方法及疗效。方法21例结核性包裹性胸积液患者均行常规胸腔镜检查，分离间隔，吸净胸水，胸膜活检后放置闭式引流。术后每日尿激酶胸腔内注射，防止胸腔内分隔的形成，促进胸液吸收。围手术期常规抗结核治疗。结果镜下见脏壁层胸膜充血、糜烂，有粘连带及分隔形成，经治疗后平均9d胸水消失，拔管后未再复发。随访半年，21例患者均治愈，X线检查无明显胸膜肥厚。结论胸腔镜清创引流配合术后胸腔内应用尿激酶能有效治疗结核性包裹性胸腔积液。

Using Video-Assisted Thoracoscopy and Urokinase Intrapleural Injection in the Treatment of Pleural and Tuburculous Effusion

Objective To investigate the value of video-assisted thoracoscopy and urokinase intrapleural cavity injection in patients with loculated tuburculous pleural effusion.Methods Video-assisted thoracoscopic biopsy was performed for biopsy and urkinase was injected trough the thorax drainage tube per day after operation in 21 cases of loculated and tuburculous pleural effusion.Regular anti-tuberculosis drags were used. Results The pleural effusion disappeared in all patients with the average time of 9 days.No severe surgical complications occurred.After following-up for 6 months no recurrence was found.Conclusion Video-assisted thoracoscopy and urokinase intrapleural cavity injection is a safe,effective,and micro-traumatic approach for the diagnosis and treatment of pleural effusion.