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目的观察胸腔内注射尿激酶治疗包裹性结核性胸膜炎的可行性和安全性。方法对照组30例予以2HRZE/4HRE抗结核方案,B超定位下胸膜腔穿刺抽液,并口服强的松激素。观察组在对照组基础上在每次胸穿抽液后胸腔内注射尿激酶10万单位(用20ml生理盐水稀释)。结果观察组和对照组总有效率分别为96.8%和63.3%,观察组疗效明显优于常规对照组,差异有显著性(P<0.05)。观察组和对照组抽液次数比较,无显著性差异(P>0.05),但两组抽液量、积液吸收时间、胸膜粘连及胸膜厚度比较,差异有显著性(P<0.05)。观察组所有患者均对尿激酶治疗耐受良好,无出血倾向等严重的不良反应。结论胸腔内注入尿激酶治疗包裹性结核性胸膜炎可增加引流量,减轻胸膜肥厚,改善肺功能,减轻患者痛苦,疗效显著。
Objective To observe the feasibility and safety of intrapleural injection of urokinase in the treatment of tuberculous pleurisy. Methods 30 cases of control group were given 2HRZE / 4HRE anti-TB regimen, pleural puncture under B ultrasound and oral prednisone. The observation group was injected intrathoracially with 100,000 units of urokinase (diluted with 20 ml of normal saline) on the basis of the control group. Results The total effective rate of the observation group and the control group was 96.8% and 63.3%, respectively. The curative effect in the observation group was significantly better than that in the control group (P <0.05). There was no significant difference between the two groups (P> 0.05), but there was a significant difference between the two groups in fluid withdrawal time, fluid absorption time, pleural adhesions and pleural thickness (P <0.05). All patients in the observation group were well tolerated by urokinase and had no serious adverse reactions such as bleeding tendency. Conclusion Intrapleural injection of urokinase in the treatment of tuberculous pleurisy can increase drainage, reduce pleural thickening, improve lung function and reduce the pain of patients with significant curative effect.