碘伏胸腔内冲洗治疗结核性胸腔积液疗效观察  

Iodophor rinse treatment of intrathoracic tuberculous pleural effusion

作　　者：刘国辉[1] 纪燕华[1] 邓群益[1] 

机构地区：[1]广东省深圳市第三人民医院,518020

出　　处：《中国现代医药杂志》2009年第6期80-82,共3页Modern Medicine Journal of China

摘　　要：目的探讨经留置导管,应用碘伏胸腔冲洗治疗结核性胸腔积液的方法、机制及疗效。方法首先通过内科胸腔镜检查,并离断胸膜粘连带及包裹分隔的胸腔积液,抽净胸水,应用0.5%碘伏冲洗,用以根除胸腔内结核菌感染,常规抗结核治疗,随诊1年,观察有无复发及胸膜肥厚情况。结果①22例常规胸穿抽液加抗结核治疗,10例病情好转,胸水消失时间25.8±6.3天(x±s,下同),1年后胸膜明显肥厚,12例治疗半个月无效,转用胸腔镜治疗,胸水消失时间6.2±2.6天,1年无明显胸膜肥厚;②22例直接采用胸腔镜加抗结核治疗,胸水消失时间为4.8±2.6天,明显短于单纯胸穿组(P<0.05),1年后无明显胸膜肥厚。结论先经内科胸腔镜局部用药治疗,后应用碘伏胸腔内冲洗治疗结核性大量胸腔积液,疗效确切,简单方便实用,可有效避免或减轻胸膜肥厚。Objective To explore the value of iodophors douche in the treatment of tuberculous pleuritis. Methods Firstly, to strip the pleura adhesion and fibrous membrane through videothoracoscopy.Then to discharge the pleural effusion. Secondly,to infuse 0.5% iodophors into thoracic cavity for a douche in order to eradicate tubercle bacillus. All patients should take conventional anti-tuberculosis therapy lasting t year. Results （1）10 of 22 patients under conventional thoracentesis and anti-tuberculosis therapy were improved with apparent pleura plump after 1 year,the period of the disappearance was 25.8± 6.3days （x^-±s）.It＇s inefficient in 12 patients with half a month therapy who turn to be treated by videothoracoscopy with almost no pleura plump 1 year later,the period of the disappearance was 6.2±2.6 days. （2）22 patients under the therapy through videothotacoscopy and conventional anti-tuberculosis . The period of the disappearance was 4.8±2.6 days ,with almost no pleura plump 1 year later . Conclusion The curative effect of the treatment of iodophors effusion through thoracoscope in treating tuberculous pleuritis is certain and worth spreading.It can effectly prevent pleura plump.

关 键 词：结核 胸膜炎 碘伏 

分 类 号：R521.7[医药卫生—内科学] R743.34[医药卫生—临床医学]