胸腔闭式引流联合尿激酶治疗结核性包裹性胸腔积液的临床疗效

目的探讨胸腔闭式引流联合尿激酶治疗结核性包裹性胸腔积液的临床疗效。方法选择2008年2月—2013年10月我院收治的结核性包裹性胸腔积液患者82例,将其随机分为治疗组和对照组,各41例。两组均予以抗结核、对症支持等综合治疗,对照组患者采用胸腔闭式引流治疗,治疗组采用胸腔闭式引流联合尿激酶治疗,比较两组患者治疗效果。结果治疗组总有效率为90.2%(37/41),高于对照组的65.8%(27/41)(P0.05)。治疗前两组患者胸腔积液中蛋白质及白细胞计数比较,差异均无统计学意义(P0.05);治疗后治疗组胸腔积液中蛋白质及白细胞计数均低于对照组(P0.05)。治疗组患者胸腔积液消失时间及住院天数短于对照组,3个月后胸膜厚度小于对照组(P0.05)。结论胸腔闭式引流联合尿激酶治疗结核性包裹性胸腔积液安全有效,值得临床应用。

Effect of Closed Thoracic Drainage Combined with Urokinase on Encapsulated Tuberculous Pleural Effusion

Objective To investigate the clinical effect of closed thoracic drainage combined with urokinase on encap-sulated tuberculous pleural effusion. Methods 82 encapsulated tuberculous pleural effusion patients were chosen in our hospital from February 2008 to October 2013,and they were randomly divided into groups treatment and control,each of 41 cases. All patients were treated by the conventional anti - tuberculosis,symptomatic and supportive treatment. The control group was given closed thoracic drainage,while the treatment group was given closed thoracic drainage combined with urokinase,the curative effects were compared. Results The total effective rate of treatment group was 90. 2% （37 / 41）,was higher than that of con-trol group of 65. 8% （27 / 41）（P 〈 0. 05）. There was no significant difference in protein and white blood cell count in pleural effusion between the two groups before treatment（P 〉 0. 05）,but the protein and white blood cell count in pleural effusion of treatment group were lower than those of control group after treatment（P 〈 0. 05）. The time of pleural effusion disappearance and time of hospital stay of treatment group were shorter than those of control group,pleural thickness after 3 months less than that of control group（P 〈 0. 05）. Conclusion Closed thoracic drainage combined with urokinase is safe and effective on encapsula-ted tuberculous pleural effusion,which is worthy of clinical application.