CAJ | 학술논문

目的：评估胸腔内注入尿激酶对结核性包裹性胸腔积液的疗效。方法通过网络检索收集1989-2015年关于尿激酶治疗结核性包裹性胸腔积液的临床研究文献，并査阅所有纳入文献中的参考文献加以补充。制定严格的纳入及排除标准，采用Rev man 5.1软件对符合条件的所有研究结果进行meta分析：评估纳入研究偏倚风险；对研究结果进行异质性检验，使用固定效应模型或随机效应模型进行合并研究，合并加权均数差及其95%可信区间，绘制森林图分析疗效。结果12篇文献符合纳入标准；meta分析结果显示，常规抗结核、引流(抽液)等治疗的基础上应用尿激酶胸腔内注射治疗的试验组与仅予常规抗结核、引流(抽液)等治疗的对照组比较，治疗有效率、引流(抽液)总量、残留胸膜厚度、胸腔积液吸收时间差异均有统计学意义( P<0．01)。结论在常规抗结核、引流(抽液)等治疗的基础上联合尿激酶胸腔内注射治疗结核性包裹性胸腔积液安全、有效。
목적：평고흉강내주입뇨격매대결핵성포과성흉강적액적료효。방법통과망락검색수집1989-2015년관우뇨격매치료결핵성포과성흉강적액적림상연구문헌，병사열소유납입문헌중적삼고문헌가이보충。제정엄격적납입급배제표준，채용Rev man 5.1연건대부합조건적소유연구결과진행meta분석：평고납입연구편의풍험；대연구결과진행이질성검험，사용고정효응모형혹수궤효응모형진행합병연구，합병가권균수차급기95%가신구간，회제삼림도분석료효。결과12편문헌부합납입표준；meta분석결과현시，상규항결핵、인류(추액)등치료적기출상응용뇨격매흉강내주사치료적시험조여부여상규항결핵、인류(추액)등치료적대조조비교，치료유효솔、인류(추액)총량、잔류흉막후도、흉강적액흡수시간차이균유통계학의의( P<0．01)。결론재상규항결핵、인류(추액)등치료적기출상연합뇨격매흉강내주사치료결핵성포과성흉강적액안전、유효。
Objective To investigate the efficacy of intrapleural urokinase infusion in treatment of loculated tu-berculous pleural effusion. Methods Clinical literatures published from 1989 to 2015 about urokinase in treatment of loculated tuberculous pleural effusion were searched via internet, and the studies as references of eligible articles were al-so collected. The admitting and eliminant criteria were established strictly, and a meta analysis was performed using Rev-man 5. 1 software for the involved literatures. Articles were evaluated with bias risk assessment tool. Alloplastic analysis was performed for study results, and combined study was performed using fixed effect or random effect models. The weighted mean difference (WMD) and 95% confidence interval (CI) were calculated, and the urokinase efficacy was analyzed using drawing forest map in the combined values. Results A total of 12 literatures met all eligible criteria. The control group was treated with conventional therapies such as anti-tuberculosis drugs and drainage ( pumping liquid ) , while the experimental group was treated with intrapleural urokinase infusion based on control group therapy. The meta a-nalysis showed that the differences in therapic effective rate, total drainage ( pumping liquid) volume, reliquus pleural thickness and absorption time of pleural effusion were statistically significant between the two groups ( P<0. 01 ) . Con-clusion The conventional therapies such as anti-tuberculosis and pumping liquid combined with intrapleural urokinase infusion in treatment of loculated tuberculous pleural effusion is safe and effective.