【摘要】 目的观察胸腔内注入尿激酶减少结核性渗出性胸膜炎胸膜粘连的效果。方法收治渗出性胸膜炎248例,随机分成治疗组与对照组各124例。治疗组充分引流后注射尿激酶10万单位+生理盐水20ml,对照组注射生理盐水20ml;化疗方案等其他治疗方法相同。结果胸液吸收时间治疗组(19.8±5.2)d,对照组(19.1±4.1)d(P>0.05)。抽液总量,治疗组(3458±528)ml,对照组(2896±468)ml(P<0.01)。抽液次数,治疗组(5.1±1.8)次,对照组(4.9±1.6)次(P>0.05)。形成纤维分隔、多房积液,治疗组4例,对照组19例(P<0.01)。2个月后B超查胸膜肥厚,治疗组(1.02±0.21)mm,对照组(1.43±0.32)mm(P<0.01)。肺功能FEV1%,治疗组88.9%±1.8%,对照组81.1%±2.3%(P<0.01)。FVC%治疗组94.2%±2.1%,对照组89.9%±2.2%(P<0.01)。结论胸腔内注射尿激酶能减少胸腔分隔、多房的形成。减少胸膜肥厚,改善肺功能。更多还原

【Abstract】 Objective To observe the therapeutic effect of intrapleural urokinase in treatment of tuberculosis pleurisy. Methods Two hundred and forty-eight patients with tuberculosis pleurisy were randomly divided into 2 groups: the treatment group and the control group. The patients in the treatment group were intrapleurally injected with urokinase 100,000IU ofter each drainage session, and the patients in the control group received 20ml physiological saline injection after drainage. Both groups received the same chemotherapeutic regimen. Results The duration of pleural effusion dissolved in the treatment group was 19.8±5.2 days, VS. 19.1±4.1 days in the control group (P>0.05). The total volume of pleurisy fluid drained in the treatment group was 3458±528 ml, VS. 2896±468 ml in the control group (P<0.01). The number of drainages in the treatment group was 5.1±1.8 times, VS. 4.9±1.6 in the control group (P>0.05). Pleural adhesion and compartment formation occurred in 4 cases of the treatment group, VS. 19 cases in the control group (P<0.01). After two months, the mean thickness of pleura in the treatment group was 1.02±0.21 mm by B ultrasonography, VS. 1.43±0.32 mm in the control group (P<0.01). Pulmonary function tests, FEV 1% was 88.9±1.8% in the treatment group, VS. 81.1 ± 2.3% in the control group (P<0.01); FVC% was 94.2±2.1% in the treatment group, VS. 89.9±2.2% in the control group (P<0.01). Conclusion Intrapleural urokinase not only reduces pleural adhesion, loculation and thickening of the pleura, but also improves lung function.更多还原