胸腔内注入尿激酶治疗结核性包裹和肥厚性胸腔积液的临床价值

目的：探讨胸膜腔内注入尿激酶(urokinase，UK)对结核性渗出性胸膜炎所致胸膜肥厚和粘连包裹性积液的影响。方法：30例常规抽液不能抽及．B超和／或胸部CT提示为包裹性积液、胸膜肥厚的患．每次抽液后胸腔内注入尿激酶10万IU。全身正规抗结核治疗。结果：胸腔内注入尿激酶后，浓稠的纤维蛋白被溶解，抽液明显畅通，胸水量增多，明显吸收占90％(27／30)，部分吸收占10％(3／30)。结论：在正规抗结核治疗下．配合胸腔内注入尿激酶治疗结核性包裹和肥厚性胸腔积液可增加引流量、减少包裹量、减轻胸膜肥厚、改善肺功能。

The Clinic Effect of Intrapleural Urokinase in the Treatment of Loculated and Pleured Thickening Effusions by Tuberculous Pleurisy

Objective:To investigate the clinic effect of intrapleural urokinase in treatment of pleural thickening and loculated effusions by tuberculous pleural effusion.Methods:Thirty patients who were testified as pleural thickening and loculated pleural effusions by type B ultrasound or thorax CT when pleural effusions could not be drainedout were injected with urokinase 10 000 IU intrapleurally after thoracocentesis.Principled anti tuberculosis treatments were accompanied at meantime.Results:Thick fibers dissolved,thoracocenlesis evidently easy and the volume of fluid increased with the effects of intrapleural urokinase,pleural effusions in 27 patients from 30(90%)were absorbed evidently and 3 of 30(10%)were done partly.Conclusion:For patients with encapsulated tuberculous pleural effusion,regular antituberculousis treatment plus intraplearal urokinase can increase the drainage,drease pleural thichening and improve pulmonary function of patien.