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胸腔置管联合尿激酶注入治疗结核性胸膜炎的疗效
引用本文:杨仪,陈尊杰,黄钥藩,黄俊明,陈焕彬. 胸腔置管联合尿激酶注入治疗结核性胸膜炎的疗效[J]. 实用全科医学, 2011, 9(5): 707-708
作者姓名:杨仪  陈尊杰  黄钥藩  黄俊明  陈焕彬
作者单位:广东省汕头市第三人民医院结核科,515073
摘    要:目的观察胸腔置管联合尿激酶注入治疗结核性胸膜炎的疗效。方法将100例大中量结核性胸腔积液患者随机分为治疗组和对照组,两组均给予胸腔置管,治疗组在此基础上予每次尿激酶10万U胸膜腔内注入,对照组予每次生理盐水40 ml胸膜腔内注入。全身抗结核和糖皮质激素治疗方法相同。观察引流不畅发生率、第2个月胸膜肥厚发生率和第2个月FEV1.0%≥90%发生率。结果治疗组引流不畅发生率(4.17%)和第2个月胸膜肥厚发生率(10.42%)均低于对照组(分别为17.39%和28.26%,均P〈0.05),第2个月FEV1.0%≥90%发生率治疗组(4.17%)和对照组(6.52%)差异无统计学意义(P〉0.05)。结论胸腔置管联合尿激酶注入治疗结核性胸膜炎疗效好,不良反应少

关 键 词:结核  胸膜/药物疗法  引流术  纤溶酶原激活物

Efficacy of Combination of Intrathoracic Cannula and Intrapleural Urokinase on Tuberculous Pleurisy
Affiliation:YANG Yi,CHEN Zun-jie,HUANG Yao-fan,et al.Department of Tuberculosis Disease,the Third People’s Hospital of Shantou,Shantou 515073,Guangdong,China
Abstract:Objective To observe the efficacy of intrapleural urokinase combined with intrathoracic cannula on treating tuberculous pleurisy(TP).Methods One hundred patients with middle to large pleural effusions of tuberculosis were divided randomly into treatment group and control group.Both groups received oral treatment of intrathoracic cannula,but the treatment group also received intrapleural urokinase 100 000 U each time,and the control group were injected with 40 ml physiological saline each time.The systemic anti-tuberculosis and glucocorticoids treatment were the same.The incidence rate of drainage impeded,2 months residual pleural thickening and 2 months FEV1.0%≥90% were observed.Results The incidence rate of drainage impeded and 2 months residual pleural thickening of treatment group were significantly lower than those of control group(4.17% vs 17.39%,10.42% vs 28.26%,both P〈0.05);The incidence rate of 2 months FEV1.0%≥90% were 4.17% in the treatment group and 6.52% in the control group,the difference between the two groups were not statistically significant(P〉0.05).Conclusion Intrapleural urokinase combined with intrathoracic cannula for TP is effective,and it has less side effects.
Keywords:Tuberculosis pleural/drug therapy  Drainage  Urinary plasminogen activator
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