国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2008年
13期
783-786
,共4页
结核/胸膜%透明质酸%中心静脉导管%胸膜肥厚
結覈/胸膜%透明質痠%中心靜脈導管%胸膜肥厚
결핵/흉막%투명질산%중심정맥도관%흉막비후
Tuberculosis/Pleural%Hyaluronic acid%Central venous catheter%Pleural thickening
目的 观察中心静脉导管联合透明质酸钠防治结核性胸膜炎胸膜肥厚的疗效,探讨其作用机制.方法 64例符合结核性胸膜炎诊断标准、中至大量游离性胸腔积液患者,采用随机化原则分为治疗组和对照组.治疗组采用微创置管方法于患侧胸腔内插入中心静脉导管,胸腔积液完全引流后,注入透明质酸钠凝胶2.5 ml;对照组常规胸膜腔穿刺抽液,第2次抽液后注入2.5 ml生理盐水作对照.第1次抽液当日两组均给予标准抗痨方案,即2HRZE/4HR,注药前、注药后72 h、注药后3个月分别测量患侧胸膜厚度.结果 59例患者参与最后结果分析.治疗组患者呼吸困难开始缓解的时间、发热时间、胸腔积液完全引流时间、住院天数短于对照组(P＜0.01或P＜0.05),治疗组胸腔积液引流量高于对照组(P＜0.05);治疗组较对照组可降低胸腔积液中乳酸脱氢酶、总蛋白(P值均＜0.01)及白细胞水平(P＜0.05);治疗组在注药后72 h及注药后3个月胸膜厚度F(5.75±2.10)mm,(3.81±2.42)mm]均小于对照组[(8.29±2.62)mm,(7.47±2.85)mm,P值均＜0.01].结论 胸腔置入中心静脉导管联合透明质酸钠可较快地缓解患者因胸腔积液压迫肺造成的呼吸困难,缩短住院时间,减轻胸膜肥厚的程度.
目的 觀察中心靜脈導管聯閤透明質痠鈉防治結覈性胸膜炎胸膜肥厚的療效,探討其作用機製.方法 64例符閤結覈性胸膜炎診斷標準、中至大量遊離性胸腔積液患者,採用隨機化原則分為治療組和對照組.治療組採用微創置管方法于患側胸腔內插入中心靜脈導管,胸腔積液完全引流後,註入透明質痠鈉凝膠2.5 ml;對照組常規胸膜腔穿刺抽液,第2次抽液後註入2.5 ml生理鹽水作對照.第1次抽液噹日兩組均給予標準抗癆方案,即2HRZE/4HR,註藥前、註藥後72 h、註藥後3箇月分彆測量患側胸膜厚度.結果 59例患者參與最後結果分析.治療組患者呼吸睏難開始緩解的時間、髮熱時間、胸腔積液完全引流時間、住院天數短于對照組(P＜0.01或P＜0.05),治療組胸腔積液引流量高于對照組(P＜0.05);治療組較對照組可降低胸腔積液中乳痠脫氫酶、總蛋白(P值均＜0.01)及白細胞水平(P＜0.05);治療組在註藥後72 h及註藥後3箇月胸膜厚度F(5.75±2.10)mm,(3.81±2.42)mm]均小于對照組[(8.29±2.62)mm,(7.47±2.85)mm,P值均＜0.01].結論 胸腔置入中心靜脈導管聯閤透明質痠鈉可較快地緩解患者因胸腔積液壓迫肺造成的呼吸睏難,縮短住院時間,減輕胸膜肥厚的程度.
목적 관찰중심정맥도관연합투명질산납방치결핵성흉막염흉막비후적료효,탐토기작용궤제.방법 64례부합결핵성흉막염진단표준、중지대량유리성흉강적액환자,채용수궤화원칙분위치료조화대조조.치료조채용미창치관방법우환측흉강내삽입중심정맥도관,흉강적액완전인류후,주입투명질산납응효2.5 ml;대조조상규흉막강천자추액,제2차추액후주입2.5 ml생리염수작대조.제1차추액당일량조균급여표준항로방안,즉2HRZE/4HR,주약전、주약후72 h、주약후3개월분별측량환측흉막후도.결과 59례환자삼여최후결과분석.치료조환자호흡곤난개시완해적시간、발열시간、흉강적액완전인류시간、주원천수단우대조조(P＜0.01혹P＜0.05),치료조흉강적액인류량고우대조조(P＜0.05);치료조교대조조가강저흉강적액중유산탈경매、총단백(P치균＜0.01)급백세포수평(P＜0.05);치료조재주약후72 h급주약후3개월흉막후도F(5.75±2.10)mm,(3.81±2.42)mm]균소우대조조[(8.29±2.62)mm,(7.47±2.85)mm,P치균＜0.01].결론 흉강치입중심정맥도관연합투명질산납가교쾌지완해환자인흉강적액압박폐조성적호흡곤난,축단주원시간,감경흉막비후적정도.
Objective To investigate the effect of intrathoraeic injection sodium hyaluronie acid on prevention of residual pleural thickening(RPT)of pleural effusions of tuberculous pleurisy after central venous catheter were inserted into thoracic cavity and pleural fluid were completely drained and to discuss its mechanisms.Methods Sixty-four patients with tuberculous pleurisy,defined as middle to large plerural effusions,were randomized into two groups.Patients in treat group were inserted into central venous catheter and after complete drainage,sodium hyaluronic acid 2.5 ml was put into pleural cavity.Patients in control group rcecived routine thoracentesis and 2.5 ml normal saline was introduced into pleural cavity as the second thoracentesis.The patients of two groups all received identical standard antituberculosis drug treatment including 2HRZE/4HR.Before HA use and after 72 hours of HA use and after three months of HA use,residual pleural thickening of patients in both groups were measured respectively.Results Fifty-nine patients were finally introduced into analysis.The beginning relieving time of dyspnoea,fever time,pleural fluid complete drainage time and the days of hospital stay in treat group were lower than those in control group(P＜0.01 or P＜0.05).Drainage amount of pleural fluid in treat group was higher than that in control group(P＜0.05).Compared with control group,therapeutic regimen of treat group can significantly reduce the level of LDH,TP and WBC of pleural effusion.RPT after 72 hours and three months of HA use in treat group were lower than those in control group[(5.75±2.10)mm vs(8.29±2.62)mm,(3.81±2.42)mm vs(7.47±2.85)mm](all P＜0.01).Conclusions Central venous catheter inserted into thoracic cavity combining with sodium hyaluronie acid can release dyspnoea due to pleural effusion,shorten the days of hospital stay,reduce the degree of RPT of tuberculous pleurisy.
