辅助超声电导靶位透药治疗结核性胸膜炎的效果分析

目的分析全身抗结核治疗联合超声电导靶位透药导入异烟肼和利福平局部处理在治疗结核性渗出性胸膜炎中的疗效。方法 120例初治结核性渗出性胸膜炎患者,随机分为对照组和超导组各60例;对照组给予常规规则抗结核治疗、胸穿抽液和胸腔内给药,超导组在对照组治疗基础上联合使用患侧胸部局部超声电导靶位透药导入异烟肼和利福平;分别于治疗15、30及60 d查胸腔B超、胸部X片,观察并记录患者的临床症状、胸水量、胸膜肥厚及包裹的情况。比较治疗15及30 d后两组疗效及胸水吸收情况,比较治疗30及60 d后两组胸膜增厚、粘连、包裹等并发症的发生率。结果治疗30 d后,两组所有病例临床症状均缓解,有效率均为100%,差异无统计学意义。治疗30 d后,超导组胸水完全吸收者56例(93.3%),对照组胸水完全吸收者46例(76.7%),超导组胸水完全吸收患者比例高于对照组(P0.05)。治疗30及60 d后,超导组发生胸膜增厚、粘连、包裹等并发症的发生率分别为6.6%及3.3%,对照组分别为23.3%及16.7%,差异均具有统计学意义(P0.05)。结论治疗结核性渗出性胸膜炎时,加用超声电导靶位透药导入异烟肼和利福平早期局部处理,有助于胸水吸收,并减轻胸膜肥厚、包裹等后遗症发生。

Clinical efficacy of electro-phonophoresis in the treatment of tuberculous exudative pleurisy

Objective To analyze the curative effect of isoniazid and rifampicin through electro-phonophore-sis in the systemic treatment of tuberculous exudative pleurisy. Methods 120 first-treated patients with tuberculous exudative pleurisy were randomly divided into the control group and the treatment group, 60 cases in each group. The control group was given anti-tuberculosis treatment, thoracentesis and intrapleural administration according to conven-tional rules, and the treatment group was locally treated with isoniazid and rifampicin through electro-phonophoresis on the basis of the control group. Their clinical symptoms, absorption of pleural effusion, pleural thickening, and parcel were observed and compared between two groups 15, 30 and 60 days after the treatment. Results At day 30, the effective rate of the two groups were both 100%. The pleural fluid was completely absorbed in 56 cases of the treatment group （93. 3%） and in 46 cases of the control group （76. 7%） （P〈0. 05）. The incidence of complica-tions of pleural thickening and package were 6. 6% and 3. 3% in the treatment group, and 21. 3% and 16. 7% in the control group respectively （ P 〈0. 05 ） . Conclusion The local treatment combined with isoniazid and rifampicin through electro-phonophoresis can reduce the pleural effusion and sequelae such as pleural thickening and package in the treatment of tuberculous pleurisy.