低位穿刺冲洗注药治疗结核包裹性胸腔积液对比研究  

Comparison of the curative effect on wrapped hydrothorax between low intrapleural perfusion-diffusion and routine treatment

作　　者：于和平[1] 杨瑞东[1] 

机构地区：[1]大同市第五人民医院,山西大同037006

出　　处：《山西临床医药》2000年第9期657-659,共3页Shanxi Clinical Medicine

摘　　要：目的 :改进结核包裹性胸腔积液的治疗方法 ,提高疗效 ,改善愈后 ,降低费用。方法 :治疗组 34例 ,采用 B超引导下低位穿刺 ,利多卡因生理盐水混合等量冲洗 ,碳酸氢钠生理盐水反复冲洗 ,腔内注入氟美松和抗结核药进行治疗。对照组 34例 ,采用传统常规方法治疗。结果 :治疗组与对照组比较 ,穿刺次数减少 2 / 3,治疗周期缩短 3/ 5 ,费用降低 1 / 4,中重度胸膜肥厚、胸廓凹陷 ,脊柱侧凸、肺功能损害五项并发症显著减少 (P<0 .0 5 )。结论 :低位穿刺冲洗注药治疗结核包裹性胸腔积液 ,可克服常规疗法抽液不彻底的缺点 ,防止多次穿刺造成的医源性院内混合感染 ,降低五项并发症程度 。Objective:In this study,we made a comparison of the curative effect on wrapped hydrothorax between low intrapleural perfusion-diffusion (treated group)and routine treatment(control group).Method:In treated group(n=34),the patients underwent the thoracensis and hydrops-drawing under the guidance of type B ultrasonic detector,and then were perfused with equal volume of the mixed solution of lidocaine and normal saline followed by the repeated irrigation with the mixed solution of NaHCO 3 and normal saline solution,and finally were infused with dexamethasone and antituberculosis drugs. The control group(n=34) were treated with routine mid hydrops-drawing.Result:The episodes of thoracentesis were reduced by 2/3.The curative circles were decreased by 3/5.The expenses were reduced by 1/4 and the complications such as mid and serious pleura hypertrophy,pectus sunken,spina side-protruding and lung function insufficiency were significantly reduced(P<0.05).Conclusion:The treatment might avoid cross-infection within the hospital,and an early use of it could avoid operation.

关 键 词：结核性胸膜炎 包裹性胸腔积液 低位穿刺冲洗 

分 类 号：R521.706[医药卫生—内科学] R561.305[医药卫生—临床医学]