【摘要】 目的 :观察胸腔内注射医用透明质酸钠凝胶对结核性胸腔积液胸膜肥厚的治疗作用。方法 :将中等量结核性胸腔积液 (B超示胸液包裹及胸膜肥厚 >2mm)患者 5 2例 ,随机分为治疗组 2 7例和对照组 2 5例 ,两组均按 2HRZS 4HR化疗 ,抽液后治疗组注入透明质酸钠凝胶 2 .5ml,对照组注入生理盐水2 .5ml,分别于注药前后 72h检测胸水常规和蛋白定量。胸腔积液吸收后 2wk及 3mon作肺功能测定。结果 :治疗组较对照组胸穿次数减少 ,胸腔积液完全吸收时间显著变短 (P <0 .0 5 ) ;肺功能指标FEV1%和FVC %明显优于对照组 (P <0 .0 5 ) ;胸膜厚度注药前 0 .92± 0 .11cm与注药后 0 .5 7± 0 .13cm的变化显著 ,与对照组比具有显著的统计学意义 (P<0 .0 5 )。注药后 72h胸水蛋白定量和胸水白细胞数明显低于注药前 (P <0 .0 5 )。治疗中未见不良反应。结论 :胸腔内注射医用透明质酸钠凝胶有防治结核性胸腔积液胸膜肥厚的作用 ,无不良反应更多还原

【Abstract】 AIM: To evaluate the effect of hyaluronate based gel (HAbg) in prevention of pleural thickening and adhesion in patients with tuberculous pleural effusions. METHODS: 52 patients with middle amount of tuberculous thoracic fluid accumulated, fluid bound, and pleura thickened more than 2 mm were divided into two groups at random. The patients of two groups were all given standard treatments with anti tuberculous drugs. HAbg was injected into intra thoracic cavity in treatment group (27 patients), while saline (NS) was introduced into intra thoracic cavity in control group (25 patients). Before and after HAbg injection, thoracic fluid routine and protein quantification were tested respectively. Pulmonary functions were measured after 2 weeks and 3 months of thoracic fluid absorption. RESULTS: Patients treated with HAbg showed significantly thinner pleura, lower proteins and white blood cell count in thoracic fluid, and higher FEV1% and FVC% for their pulmonary function in comparison with the control group. CONCLUSION: Intrathoracic injection of HAbg can prevent pleural thickening and improve the lung function in patients with excess fluid of tuberculous thoracic cavity.更多还原