中心静脉导管胸腔内置管闭式引流并注入尿激酶治疗包裹性结核性胸膜炎  

Application of Intrathoracic Closed Drainage of Central Venous Catheter and Intrapleural Urokinase in Treatment of Encapsulated Tuberculous Pleurisy

作　　者：罗如滢[1] 阳志成[2] 戴爱国 

机构地区：[1]南华大学附属一医院呼吸科,衡阳421001 [2]南华大学生物化学与分之生物学教研室,衡阳421001 [3]不详

出　　处：《现代生物医学进展》2007年第4期580-582,共3页Progress in Modern Biomedicine

摘　　要：观察中心静脉导管胸腔内置管闭式引流并注入尿激酶治疗包裹性结核性胸膜炎的效果。方法:包裹性结核性胸膜炎患者40例,随机分成治疗组(20例)与对照组(20例)。治疗组中心静脉导管胸腔内置管闭式引流并注入尿激酶10万U+生理盐水20ml,对照组注射生理盐水20ml。结果:治疗组引流量增多,治疗组胸膜粘连消失15例,对照组2例(P＜0．01)。2月后B超检查,治疗组胸膜厚度(2．5±0．8)mm,对照组(9．8±1．6)mm(P＜0．01),治疗组胸廓塌陷程度5．3±1．6%,对照组11．1±2．7%。尿激酶治疗前后动脉血气分析及肺功能有显著性差异,治疗前Pao2(83±4．5),治疗后Pao2(95±6．40),(P＜0．01)治疗前TLC% (78．5±2．2)%,治疗后(87．6±1．5)%,,(P＜0．01);治疗前VC%(73．2±4．8),治疗后VC%(84．1±5．6),(P＜0．01);治疗前FVC% 78．1±2．7,治疗后FVC%(86．5±3．5)%,(P＜0．01)。结论:胸腔内注射尿激酶能治疗包裹积液,改善胸膜粘连、肥厚及肺功能。Objective：To investigate the effects of dosed drainage by central venous catheter and intrapleural urokinase in the treatment ,of encapsulated tuberculous pleurisy （ETP）. Methods：40 cases with ETP were randomly divided into two groups： treatment group （20 cases） and control group （20 cases） . The patients in treatment group was intrapleuraUy injected with urokinase 100 ;000 IU plus 20ml of 0. 9 % N. S by central venous catheter ,while the control group was injected with 20ml of 0. 9 % N. S. Results：The mean volume of drainage fluid in the treatment group was more.Pleura adhesion disappearance （PAD） was 15 cases and the control group was only 2 cases of PAD. 2 months later ,guided by B-ultrasonography, the mean thickness of pleura in treatment group Was （2.5±0.8）mm but （9.8±1.6） mm in control group （ P 〈 0.01） .The extent of chest collapse was also different, 5.3±1.6 % in the treatment group and 11.1±2.7 % in the control groupo There were significant differences in arterial blood gas analysis and lung fimcfion before and after trapleural urokinase therapy （ P 〈 0.01）. Conclusion：Intraplearal urokinase injection treatment can effectivdy increase the drainage, decrease pleura adhesion and pleural thickening, and improve pulmonary function of patients.

关 键 词：中心静脉导管 尿激酶 结核 胸膜炎 

分 类 号：R561[医药卫生—呼吸系统]