探究尿激酶联合地塞米松治疗结核性胸膜炎40例的临床疗效

目的：探究尿激酶联合地塞米松治疗结核性胸膜炎的临床效果。方法：选取本院2012年2月-2014年2月收治的80例结核性胸膜炎患者作为研究对象，按照随机数字表法将其分为对照组和研究组各40例。两组均利用中心静脉导管胸腔置入术进行治疗，对照组向胸腔注入地塞米松，研究组在此基础上加注尿激酶。观察比较两组患者的临床疗效、引流量、胸膜厚度及并发症的差异。结果：研究组治疗总有效率85．O％（34／40）明显高于对照组的62．5％（25／40），差异有统计学意义（X2=5．23，P=0．001）。研究组的引流量（1790±78）mL明显多于对照组的（1273±46）mL，胸膜厚度（1．10±0．20）mm明显小于对照组的（1．42±0．28）mm，差异均有统计学意义（t=36．04，P=0．000；t=5．88，P=O．001）。而研究组出现3例胸痛、2例胸膜反应；对照组出现3例胸痛，1例胸膜反应，两组的并发症发生率比较差异无统计学意义（P〉0．05）。结论：尿激酶联合地塞米松治疗结核性胸膜炎临床效果显著，能够有效提高治疗总有效率，增加引流量，值得在临床上推广应用。

The Clinical Effect of Urokinase Combined with Dexamethasone in the Treatment of 40 Cases of Tuberculous Pleurisy

Objective： To explore the clinical effect of urokinase combined with dexamethasone in the treatment of tuberculous pleurisy.Method： 80 tuberculous pleurisy patients admitted in our hospital from February 2012 to February 2014 were selected as the research object, they were divided into the control group and the study group according to the random number table method, 40 cases in each group.The two groups were treated with the center venous intrapleural implantation.The control group was only given the intrapleural injection of dexamethasone, the study group was filled with urokinase on the basis of the control group.The differences in clinical effect, drainage, pleural thickness and complications between the two groups were observed and compared.Result ： The total efficiency of study group was 85.0% （ 34/40 ）, it was significantly higher than 62.5% （ 25/40 ） of control group, the difference was statistically significant （X2=5.23, P=0.001 ） .Total drainage volume of the study group was （ 1790 ± 78 ） mL, it was significantly more than （ 1273 ± 46 ） mL of control group, and the pleural thickness of study group was （ 1.10 ± 0.20 ） mm, it was significantly less than （ 1.42± 0.28 ） mm of control group, the differences were statistically significant （ t=36.04, P=0.000; t=5.88, P=0.001 ） .While the study group had 3 cases of chest pain and 2 cases of pleural reaction, the control group had 3 patients with chest pain and 1 cases of pleural reaction, so there was no significant difference in complication rate between the two groups （P〉0.05） .Conclusion： The clinical effect of urokinase combined with dexamethasone in the treatment of tuberculous pleurisy is significant, and it can effectively improve the treatment efficiency, increase the drainage, is worthy of clinical popularization.