胸膜腔内置引流管注入尿激酶治疗结核性包裹性胸液的临床研究(1)
【摘要】目的：探讨胸膜腔内置引流管注入尿激酶治疗结核性包裹性胸液的临床疗效。方法：回顾性分析2016年1月1日～2018年1.2月31日我院收治的46例结核性包裹性胸腔积液患者的临床资料，按照1：1的比例分为对照组与观察组，每组2.3例，所有患者均采用中心静脉导管胸腔置入术，对照组通过引流管反复抽取胸液。观察组患者在不能再抽出胸腔积液时每日经导管向胸腔内注入20万IU尿激酶与20mL生理盐水混合液，第二日再抽取残余的胸液，如此反复，直至胸液无法引流，对比两组并发症发生几率及相关指标变化。结果：观察组患者胸膜增厚、胸膜粘连以及胸廓畸形的发生率为1.304%，明显低于对照组发生率的391.3%。观察组D-二聚体水平显著高于对照组，比较差异显著(P<005)。结论：结核性包裹性胸液患者采用胸膜腔内置引流管注入尿激酶治疗，疗效显著，能够更快地缓解患者呼吸困难症状，降低胸膜增厚、胸膜粘连以及胸廓畸形的发生率，具备推广价值。
【关键词】胸膜腔;引流管;尿激酶;结核性包裹性胸液;临床疗效
, 百拇医药
[Abstract] Objective：To investigate the clinical efficacy of intrapleural drainage tube injected urokinase in the treatment of tuberculous encapsulated pleural effusion.Methods：The clinical data of 46 patients with tuberculous encapsulated pleural effusion treated in our hospital from Jan.1，2016 to Dec.31，2018 were retrospectively analyzed.According to the ratio of 1：1，they were divided into control group and observation group，2.3 cases in each group.All patients were treated with central venous catheter thoracic implantation，while the control group was treated with repeated drainage tube to extract pleural effusion.The patients in the observation group were injected with 200 thousand IU urokinase and 20mL normal saline mixture into the chest via the catheter every day.After second days，the residual pleural fluid was extracted again，so repeated until the chest fluid could not be drained，and the incidence of complications and related indicators in the two groups were compared.Results：the incidence of pleural thickening，pleural adhesion and thoracic deformity in the observation group was 1.304%，which was significantly lower than that in the control group (391.3%).The level of D-dimer in the observation group was significantly higher than that in the control group (P<005).Conclusion：the treatment of patients with tuberculous encapsulated pleural effusion by urokinase is effective and effective in relieving dyspnea symptoms，reducing pleural thickening，pleural adhesion and chest deformity.
, 百拇医药
[Key words] pleural cavity;drainage tube;urokinase;tuberculous encapsulated pleural effusion;clinical efficacy
【中圖分类号】R766.1
【文献标识码】A
【文章编号】2095-6851(2019)10-2.31-01
我国是肺结核的多发国家，该病的潜伏期约为1～1个半月[1]，40～60岁中老年人是多发群体，患者通常伴有乏力、咳嗽、咯血、低热等症状。本研究选取了46例结核性包裹性胸液患者作为观察对象，分别采用胸膜腔内置引流管引流及注入尿激酶再引流两种方式进行治疗，现将治疗情况报告如下。
1 资料与方法
1.1 资料
本次研究对象为2016年1月1日～2018年1.2月31日我院收治的46例结核性包裹性胸液患者，所有患者均符合以下相关诊断标准：①抗结核治疗有效。②PPD(5TU)强阳性;胸液结核DNA呈阳性。③胸部X线片、B超、CT以及临床症状都有典型的结核性胸膜炎的表现。⑤胸液腺苷脱氨酶(ADA)>30U/L。⑥胸液或者胸膜组织的病理学检查证实为结核病变。⑦胸液或者胸膜组织的抗酸杆菌涂片结果呈阳性。符合①～4中的任何三项或者⑥～⑦中的任何一项即可确诊[2]。排除标准：①凝血功能障碍。②合并支气管胸膜瘘。③年龄>80岁。④精神疾病。⑤重大器官功能障碍。⑥病程>8周。⑦对抗结核药物和尿激酶过敏。⑧少量胸腔积液呈包裹性，或者胸膜肥厚、广泛粘连。, 百拇医药(龚勇 吴旭)
【关键词】胸膜腔;引流管;尿激酶;结核性包裹性胸液;临床疗效
, 百拇医药
[Abstract] Objective：To investigate the clinical efficacy of intrapleural drainage tube injected urokinase in the treatment of tuberculous encapsulated pleural effusion.Methods：The clinical data of 46 patients with tuberculous encapsulated pleural effusion treated in our hospital from Jan.1，2016 to Dec.31，2018 were retrospectively analyzed.According to the ratio of 1：1，they were divided into control group and observation group，2.3 cases in each group.All patients were treated with central venous catheter thoracic implantation，while the control group was treated with repeated drainage tube to extract pleural effusion.The patients in the observation group were injected with 200 thousand IU urokinase and 20mL normal saline mixture into the chest via the catheter every day.After second days，the residual pleural fluid was extracted again，so repeated until the chest fluid could not be drained，and the incidence of complications and related indicators in the two groups were compared.Results：the incidence of pleural thickening，pleural adhesion and thoracic deformity in the observation group was 1.304%，which was significantly lower than that in the control group (391.3%).The level of D-dimer in the observation group was significantly higher than that in the control group (P<005).Conclusion：the treatment of patients with tuberculous encapsulated pleural effusion by urokinase is effective and effective in relieving dyspnea symptoms，reducing pleural thickening，pleural adhesion and chest deformity.
, 百拇医药
[Key words] pleural cavity;drainage tube;urokinase;tuberculous encapsulated pleural effusion;clinical efficacy
【中圖分类号】R766.1
【文献标识码】A
【文章编号】2095-6851(2019)10-2.31-01
我国是肺结核的多发国家，该病的潜伏期约为1～1个半月[1]，40～60岁中老年人是多发群体，患者通常伴有乏力、咳嗽、咯血、低热等症状。本研究选取了46例结核性包裹性胸液患者作为观察对象，分别采用胸膜腔内置引流管引流及注入尿激酶再引流两种方式进行治疗，现将治疗情况报告如下。
1 资料与方法
1.1 资料
本次研究对象为2016年1月1日～2018年1.2月31日我院收治的46例结核性包裹性胸液患者，所有患者均符合以下相关诊断标准：①抗结核治疗有效。②PPD(5TU)强阳性;胸液结核DNA呈阳性。③胸部X线片、B超、CT以及临床症状都有典型的结核性胸膜炎的表现。⑤胸液腺苷脱氨酶(ADA)>30U/L。⑥胸液或者胸膜组织的病理学检查证实为结核病变。⑦胸液或者胸膜组织的抗酸杆菌涂片结果呈阳性。符合①～4中的任何三项或者⑥～⑦中的任何一项即可确诊[2]。排除标准：①凝血功能障碍。②合并支气管胸膜瘘。③年龄>80岁。④精神疾病。⑤重大器官功能障碍。⑥病程>8周。⑦对抗结核药物和尿激酶过敏。⑧少量胸腔积液呈包裹性，或者胸膜肥厚、广泛粘连。, 百拇医药(龚勇 吴旭)