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中心静脉导管引流加尿激酶胸腔内注射治疗结核性胸腔积液的疗效观察
引用本文:杨寅,郎雅珍. 中心静脉导管引流加尿激酶胸腔内注射治疗结核性胸腔积液的疗效观察[J]. 中国现代医生, 2018, 56(16): 106-108
作者姓名:杨寅  郎雅珍
作者单位:杭州市红十字会医院结核内科
基金项目:浙江省中医药科技计划项目(2016ZA157)
摘    要:目的观察中心静脉导管引流加尿激酶胸腔内注射治疗结核性胸腔积液的疗效。方法选取我院2016年1月~2017年1月收治的结核性胸腔积液患者60例,采用随机数字表法随机分为观察组及对照组,每组各30例,观察组予中心静脉导引流加尿激酶胸腔内注射治疗,对照组在确定穿刺点后予常规胸腔穿刺引流,比较两组的临床治疗效果及两组患者的胸腔穿刺时间、胸液引流量、胸液消失时间及不良反应发生率。结果治疗后,观察组患者治疗后的有效率为93.3%(28/30),明显高于对照组的70.0%(21/30),差异具有统计学意义(P0.05)。观察组的胸腔穿刺次数少于对照组,平均胸液消失时间明显短于对照组,观察组的胸液引流量明显少于对照组(P0.05)。观察组的不良反应发生率为10.0%、显著低于对照组的不良反应发生率50.0%,差异存在统计学意义(P0.05)。结论中心静脉导管引流加尿激酶胸腔内注射治疗结核性胸腔积液疗效确切,安全性好,值得推广和应用。

关 键 词:结核性胸腔积液;中心静脉导管;尿激酶;胸腔内注射

Observation on the curative effect of central venous catheter drainage combined with urokinase intrathoracic injection in the treatment of tuberculous pleural effusion
Abstract:Objective To observe the curative effect of central venous catheter drainage combined with urokinase intrathoracic injection in the treatment of tuberculous pleural effusion. Methods 60 patients with tuberculous pleural effusion who were admitted to our hospital from January 2016 to January 2017 were selected. All the subjects were randomly divided into observation group and control group according to the random number table method, with 30 cases in each group. The observation group was given central venous catheter drainage combined with urokinase intrathoracic injection therapy. The control group was given the routine thoracentesis drainage after the puncture site was determined.The clinical effects, as well as the time of thoracentesis, the drainage volume of pleural fluid, the disappearance time of pleural effusion and the incidence rate of adverse reactions were compared between the two groups. Results After treatment, the effective rate in the observation group after treatment was 93.3%(28/30), which was significantly higher than that in the control group(70.0%, 21/30), The difference was statistically significant (P<0.05). The number of thoracentesis in the observation group was less than that in the control group, and the average disappearance time of pleural effusion was significantly shorter than that in the control group. The observation group had significantly less pleural effusion than the control group(P<0.05). The incidence rate of adverse reactions in the observation group was 10.0%, significantly lower than the incidence of adverse reactions in the control group(50.0%), the difference was statistically significant(P<0.05). Conclusion Central venous catheter drainage combined with urokinase intrathoracic injection in the treatment of tuberculous pleural effusion has an exact curative effect, which safe and worthy of promotion and application.
Keywords:Tuberculous pleural effusion   Central venous catheter   Urokinase   Intrathoracic injection
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