CAJ | 학술논문

目的：探讨内科硬质胸腔镜联合尿激酶胸腔注入治疗结核性包裹性胸腔积液的应用价值。方法结核性包裹性胸腔积液病人68例，随机分为治疗组及对照组，每组各34例，治疗组采用内科硬质胸腔镜联合导管留置及尿激酶注入治疗。对照组单纯采用胸腔置管引流联合尿激酶注入治疗。比较两组胸腔积液引流量、胸腔积液控制所需天数、并发症发生率、治疗后胸膜粘连包裹发生率、胸膜增厚情况以及肺功能改善情况。结果在胸腔积液引流量、胸腔积液控制所需天数、治疗2个月后胸膜再粘连包裹发生率、胸膜增厚情况以及肺功能改善方面，治疗组与对照组差异有统计学意义（P <0.05），在并发症的发生率上治疗组与对照组无显著差异（P >0.05）。结论内科硬质胸腔镜联合尿激酶注入可尽快控制胸水，减少胸腔粘连包裹，减轻胸膜肥厚，改善肺功能，而并发症较传统方法无明显增加。
목적：탐토내과경질흉강경연합뇨격매흉강주입치료결핵성포과성흉강적액적응용개치。방법결핵성포과성흉강적액병인68례，수궤분위치료조급대조조，매조각34례，치료조채용내과경질흉강경연합도관류치급뇨격매주입치료。대조조단순채용흉강치관인류연합뇨격매주입치료。비교량조흉강적액인류량、흉강적액공제소수천수、병발증발생솔、치료후흉막점련포과발생솔、흉막증후정황이급폐공능개선정황。결과재흉강적액인류량、흉강적액공제소수천수、치료2개월후흉막재점련포과발생솔、흉막증후정황이급폐공능개선방면，치료조여대조조차이유통계학의의（P <0.05），재병발증적발생솔상치료조여대조조무현저차이（P >0.05）。결론내과경질흉강경연합뇨격매주입가진쾌공제흉수，감소흉강점련포과，감경흉막비후，개선폐공능，이병발증교전통방법무명현증가。
Objective:To explore the treatment of medical thoracoscopy combined urokinase chest injection in encapsu-lated tuberculous pleural effusion. Methods:68 patients with encapsulated tberculous pleural effusion were recruited and randomly divided into two Groups,the treatment group and the control group. Each group had 34 cases. The treatment group treated by medical thoracoscopy combined the chest tube and urokinase injection. The control group only treated by the chest tube drainage joint urokinase injection. Total drainage volume,days of controlling pleural effusion,complica-tions,the pleural adhesion and thickness and pulmonary function two months after treatment were observed. Results:In the pleural effusion,days of controlling pleural effusion,the pleural adhesion and thickness and pulmonary function two months after treatment,the treatment group and control group was statistically significant difference(P < 0. 05),the incidence of complications in treatment group and control group had no significant difference(P > 0. 05). Conclusion:Medical thora-coscopy combined with urokinase injection can control chest water as soon as possible,reduce pleural adhesions packages, lighten the pleura hypertrophy,improve lung function. But there was no obvious increase in complications.