胸膜腔注射尿激酶治疗结核性胸膜炎疗效观察

    Effect of intrapleural injection of urokinase on tuberculous pleurisy

    • 摘要: 目的:观察胸腔内注射尿激酶对减少结核性渗出性胸膜炎胸膜增厚、粘连的效果。方法:渗出性胸膜炎患者96例,随机分成治疗组50例与对照组46例。治疗组每次抽胸腔积液(胸液)后注入尿激酶10万u+0.9% NS20ml,对照组仅注射0.9% NS20ml。两组其余治疗相同。结果:治疗组胸液吸收时间、胸穿次数、胸膜粘连发生率、胸膜厚度均低于对照组(P<0.01),治疗组第一秒用力呼气容积占预计值的百分比(FVC%)、一秒率/用力肺活量(FEV1.0/FVC%)、肺活量和肺活量占预计值的百分比均高于对照组(P<0.01)。治疗组在注药后凝血酶时间、凝血酶原时间、活化部分凝血激酶时间变化差异均无统计学意义(P>0.05)。结论:胸腔内注入尿激酶治疗结核性胸膜炎可以促进胸液吸收,减轻胸膜肥厚、粘连,改善肺功能。

       

      Abstract: Objective:To investigate the effect of intrapleural injection of urokinase in treatment of tuberculous pleural effusion.Methods:Ninety-six cases of exudative tuberculous pleurisy were randomly divided into treatment group and control group.The cases in treatment group were treated with 100 000 IU urokinase (diluted by 20 ml normal saline) after effusion drainage,while the cases in control group were given normal saline only.The other therapies in both groups were the same.Results:In the treatment group,the time of pleural effusion absorption,the frequency of stetho-prick,the incidence of pleural adhesion,and the mean thickness of pleura all decreased significantly as compared with those of the control group (P<0.01).The lung function indexes FEV1% and FEV1.0/FVC% in the treatment group were significantly superior to those of the control group (P<0.01).The changes of thrombin time,prothrombin time and activated partial thromboplastin time after administration had no significant difference in the treatment group.Conclusions:The therapy of thoracic injection of urokinase can promote the absorption of pleural effussion,lessen the pachynsis pleurae and adhesion,and improve the lung function.

       

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