超声引导下胸腔穿刺抽液并注入尿激酶治疗结核性包裹性胸腔积液  

Treating tuberculous enveloped pleural effusion with Ultra-sonography guided aspiration and urokinase injection

作　　者：林明贵[1] 黎晓林[2] 张广宇[1] 张韬[1] 李燕峰[1] 刘倩颖[1] 张红艳[1] 

机构地区：[1]解放军总医院第二附属医院全军结核病研究所,北京100091 [2]解放军总医院第二附属医院超声科

出　　处：《临床肺科杂志》2009年第4期469-471,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨尿激酶对结核性包裹性胸腔积液的治疗作用。方法结核性包裹性胸膜炎197例,分成治疗组(125例)及对照组(72例),对照组为足量联合抗结核及胸腔B超引导抽液治疗,治疗组除此之外,还加用胸腔内尿激酶10万单位+生理理水20ml注入治疗1～2次。结果经过2月的治疗,治疗组胸腔抽液量2615±321ml,对照组1908±336ml(P<0.01);胸液吸收时间治疗组26.3±2.1d,对照组37.2±5.2d(P<0.01);胸膜厚度治疗组2.2±0.11mm,对照组4.2±0.28mm(P<0.01)。结论胸腔内注入尿激酶能促进胸水引流、减轻胸膜肥厚,减少胸膜粘连,疗效肯定,值得推广。Objective To explore the effect of pleural injection of urokinase on tuberculous enveloped effusion. Methods The study included 197 cases of tuberculous enveloped pleural effusion. The control group involved 72 cases, treated with standard chemotherapy regime and ultra-sonography guided aspiration; The treating group involved 125 cases, treated with pleural injection of urokinase 10000 u dissolved in 20 ml normal Saline for one or two times in addition to the standard therapy as seen in the control group. Results After 2 month treatment, the pleural aspiration volume in the treating group was 2615±321 ml, while those in the control group was 1908±336 ml （P 〈0. 01 ）. The duration of effusion in the treating group was 26.3±2. 1 days, while those in the control group was 37.2±5.2 days （P 〈 0. 01 ）. The width of pleura in the treating group was 2. 2±0. 11 mm, while those in the control group was 4. 2±0. 28 mm （P 〈 0. 01 ）. Conclusion In treating tuberculous enveloped pleural effusion, injection of urokinase can increase aspirate volume, decrease pleural proliferation, and enhance effusion absorption without any adverse effect, So, it can become synergetic part of the standard therapy.

关 键 词：包裹性胸腔积液 结核 超声波 治疗 尿激酶 

分 类 号：R521.7[医药卫生—内科学] R561[医药卫生—临床医学]