CAJ | 학술논문

目的：探讨胸腔置管引流并注入尿激酶治疗结核性渗出性胸膜炎的临床疗效。方法将80例确诊为结核性渗出性胸膜炎患者随机分为治疗组和对照组，两组均常规给予抗结核治疗，治疗组在抗结核治疗的同时胸腔置管引流并注入尿激酶10万 IU（用20 mL 生理盐水稀释）。比较两组患者胸腔积液引流量、积液吸收时间、住院时间、总有效率及治愈率。结果与对照组比较，治疗组患者胸腔积液引流量明显增多（t ＝5．88，P ＜0．05）；积液吸收时间及住院时间缩短，差异有统计学意义（t ＝2．18，P ＜0．05；t ＝2．52，P ＜0．05），总有效率及治愈率提高，差异有统计学意义（χ2＝5．16，P ＜0．05；χ2＝4．18，P ＜0．05）；随访3个月，治疗组胸膜粘连及胸膜增厚发生率降低（χ2＝4．11，P ＜0．05；χ2＝4．50，P ＜0．05）。结论胸腔置管引流并注入尿激酶治疗结核性渗出性胸膜炎疗效好，能有效增加胸腔积液排出量，缩短病程，减少胸膜粘连及肥厚，促进肺功能恢复，且方法安全有效。
목적：탐토흉강치관인류병주입뇨격매치료결핵성삼출성흉막염적림상료효。방법장80례학진위결핵성삼출성흉막염환자수궤분위치료조화대조조，량조균상규급여항결핵치료，치료조재항결핵치료적동시흉강치관인류병주입뇨격매10만 IU（용20 mL 생리염수희석）。비교량조환자흉강적액인류량、적액흡수시간、주원시간、총유효솔급치유솔。결과여대조조비교，치료조환자흉강적액인류량명현증다（t ＝5．88，P ＜0．05）；적액흡수시간급주원시간축단，차이유통계학의의（t ＝2．18，P ＜0．05；t ＝2．52，P ＜0．05），총유효솔급치유솔제고，차이유통계학의의（χ2＝5．16，P ＜0．05；χ2＝4．18，P ＜0．05）；수방3개월，치료조흉막점련급흉막증후발생솔강저（χ2＝4．11，P ＜0．05；χ2＝4．50，P ＜0．05）。결론흉강치관인류병주입뇨격매치료결핵성삼출성흉막염료효호，능유효증가흉강적액배출량，축단병정，감소흉막점련급비후，촉진폐공능회복，차방법안전유효。
Objective To explore the clinical efficacy on the treatment of tuberculous exudative pleurisy with conventional anti-tuberculosis treatment line with central venous catheter after intrapleural injection of urokinase.Methods 80 patients diagnosed with tuberculosis exudative pleurisy were randomly divided into treatment group and control group,two groups were routinely given anti-TB treatment,the treated group were given intrapleural injection of urokinase (UK)100 000 IU (20 mL saline dilution)with the central venous catheter.Results Compared with the control group,The total amount of pleural effusion of the treatment group increased significantly (t =5.88,P <0.05),the pleural effusion absorption and hospi-talization time of the treatment group was significantly shorter than the control group (t =2.18,P < 0.05;t=2.52,P <0.05);Following three months,the control group developed hemothoraxhas less (χ2 =4.11,P< 0.05;χ2 =4.50,P <0.05).Conclusion The rataining tube for drainage combined with Urokinase in tho-rax to tuberculous exudative pleurisy could effectively increase the output of pleural effusion,shorten ab-sorption time of pleural,and decrease pleural thickening and complication of puncture,meanwhile there is no increase of hemothoraxhas and have a better clinical curative effect.