生理盐水联合尿激酶治疗早期结核性渗出性胸膜炎的临床观察

目的：观察生理盐水胸腔冲洗联合尿激酶胸腔注射治疗早期结核性渗出性胸膜炎的疗效。方法：将187例早期结核性渗出性胸膜炎患者，随机分为治疗组（94例）和对照组（93例），治疗组在胸腔穿刺抽液基础上给予生理盐水胸腔冲洗配合尿激酶胸腔注射，对照组仅给予常规胸腔穿刺抽液，两组其他治疗相同。结果：治疗组胸腔积液吸收时间短于对照组．胸膜厚度明显小于对照组（P〈O．01），治疗组与对照组治疗前肺活量比较，差异无统计学意义（P〉O．05）。治疗9个月后，治疗组肺活量明显大于对照组（P〈0．01），治疗组胸腔积液结核菌培养阳性率高于对照组（P〈O．05）。结论：该方法可降低胸膜肥厚、粘连的发生，提高胸腔积液结核菌培养阳性率。值得临床推广。

Clinical observation of normal saline combined with urokinase for treatment of early tuberculous exudative pleurisy

Objective： To observe the effects of pleural lavage with normal saline and intrapleural injection of urokinase for early tuberculous exudative pleurisy. Methods： 187 cases of patients with early tuberculous exudative pleurisy randomly divided into two groups, treatment group （94 cases） and control group （93 cases）. The same conventional treatment of fluid extraction were given by pleural puncture, the treatment group adds normal saline and intrapleural injection of urokinase. Results： Compared with control group, the treatment group had shorter pleural fluid absorption time and less pleural thick- ness （P〈0.01）. There was no significant difference in vital capacity before treatment between two groups （P〉0.05）, but after 9 months treatment ,the treatment group＇s vital capacity was larger than that of the control group （P〈0.01）, and the positive rate of pleural tuberculosis culture was also higher than that of the control group （P〈0.05）. Conclusion： This method helps to reduce the occurrence of pleural thickening, and increase the positive rate of pleural tuberculosis culture, which is worth clinical application.