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目的探讨留置导管引流联合腔内冲洗、注药治疗结核性胸膜炎的疗效。方法选取结核性胸膜炎患者126例,随机分成,单纯引流组(A组)、引流冲洗加注射抗结核药物和激素组(B组)、引流冲洗加注入抗痨药+激素+尿激酶组(C组),三组全身抗痨方案相同,比较其发热持续时间、胸水消退时间、治疗15 d和3个月时胸膜厚度、治疗3个月时肺功能情况。结果 A组和B、C组在发热持续时间上差异均有统计学意义,P值<0.01,B、C组间差异具有统计学意义,B组发热持续时间略短于C组;A组和B、C组在胸水消退时间上差异具有统计学意义,P<0.01,B、C胸水消退时间均短于对照组,而B、C组间差异无统计学意义;在治疗15 d和3个月时,B、C组胸膜厚度均较A组小,差异具有统计学意义,P值<0.01,B组与C组间无统计学意义;但治疗3个月时,C组胸膜厚度低于B组,差异也有统计学意义,P值<0.01;治疗3个月时,B、C组肺功能对照A组差异有统计学意义,P值<0.01,而B、C两组之间差异无统计学意义。结论留置导管引流联合腔内冲洗、注药治疗结核性胸膜炎,可以缩短病程,减轻胸膜肥厚,注射尿激酶对改善远期肺功能有利。
Objective To investigate the curative effect of indwelling catheter drainage combined with intracavitary irrigation and drug injection in the treatment of tuberculous pleurisy. Methods One hundred and sixty-six patients with tuberculous pleurisy were randomly divided into three groups: group A (group A), group B (group B), group C (group C) Group), the same three groups of systemic anti-tuberculosis programs, compared the duration of fever, pleural effusion, treatment of 15 d and 3 months when the pleural thickness, 3-month lung function. Results There were significant differences in duration of fever between group A and group B and group C, P <0.01, the difference between group B and C was statistically significant, while the duration of fever in group B was slightly shorter than group C; Group A and B, C group in the regression time of pleural effusion was statistically significant, P <0.01, B, C pleural effusion were shorter than the control group, while the B, C group was no significant difference between the treatment of 15 d and 3 Month, the thickness of pleura in group B and C were smaller than that in group A, the difference was statistically significant (P <0.01), while there was no significant difference between group B and C B group, the difference was also statistically significant, P value <0.01; 3 months of treatment, B, C group lung function control group A difference was statistically significant, P <0.01, while B, C between the two groups were no difference Statistical significance. Conclusion indwelling catheter drainage combined with intracavitary flushing, drug injection treatment of tuberculous pleurisy, can shorten the course of disease, reduce pleural hypertrophy, injection of urokinase to improve long-term lung function.