内科硬质胸腔镜联合尿激酶注入治疗结核性包裹性胸腔积液的临床研究  

Clinical research of medical thoracoscopy combined with urokinase injection in the Treatment of encapsulated tuberculous pleural effusion

作　　者：单伟玉[1] 田磊[1] 张广花[1] 邓彦荣[1] 于志敏[1] 

机构地区：[1]中国人民解放军第八十八医院,山东泰安271000

出　　处：《泰山医学院学报》2015年第6期615-617,共3页Journal of Taishan Medical College

摘　　要：目的探讨内科硬质胸腔镜联合尿激酶胸腔注入治疗结核性包裹性胸腔积液的应用价值。方法结核性包裹性胸腔积液病人68例,随机分为治疗组及对照组,每组各34例,治疗组采用内科硬质胸腔镜联合导管留置及尿激酶注入治疗。对照组单纯采用胸腔置管引流联合尿激酶注入治疗。比较两组胸腔积液引流量、胸腔积液控制所需天数、并发症发生率、治疗后胸膜粘连包裹发生率、胸膜增厚情况以及肺功能改善情况。结果在胸腔积液引流量、胸腔积液控制所需天数、治疗2个月后胸膜再粘连包裹发生率、胸膜增厚情况以及肺功能改善方面,治疗组与对照组差异有统计学意义(P<0.05),在并发症的发生率上治疗组与对照组无显著差异(P>0.05)。结论内科硬质胸腔镜联合尿激酶注入可尽快控制胸水,减少胸腔粘连包裹,减轻胸膜肥厚,改善肺功能,而并发症较传统方法无明显增加。Objective：To explore the treatment of medical thoracoscopy combined urokinase chest injection in encapsu-lated tuberculous pleural effusion. Methods：68 patients with encapsulated tberculous pleural effusion were recruited and randomly divided into two Groups,the treatment group and the control group. Each group had 34 cases. The treatment group treated by medical thoracoscopy combined the chest tube and urokinase injection. The control group only treated by the chest tube drainage joint urokinase injection. Total drainage volume,days of controlling pleural effusion,complica-tions,the pleural adhesion and thickness and pulmonary function two months after treatment were observed. Results：In the pleural effusion,days of controlling pleural effusion,the pleural adhesion and thickness and pulmonary function two months after treatment,the treatment group and control group was statistically significant difference（P 〈 0. 05）,the incidence of complications in treatment group and control group had no significant difference（P 〉 0. 05）. Conclusion：Medical thora-coscopy combined with urokinase injection can control chest water as soon as possible,reduce pleural adhesions packages, lighten the pleura hypertrophy,improve lung function. But there was no obvious increase in complications.

关 键 词：胸腔镜 尿激酶 结核 胸腔积液 

分 类 号：R521[医药卫生—内科学]