单纯引流与联合尿激酶治疗儿童肺炎旁胸腔积液的比较  

Comparison of simple drainage or drainage combined with urokinase for parapneumonic pleural effusion in children

作　　者：张建江[1] 陈莹华 窦文杰[1] 史佩佩[1] 曾慧勤[1] Zhang Jianfiang Chen Yinghua Dou Wenjie Shi Peipei Zeng Huiqin(Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Chin)

机构地区：[1]郑州大学第一附属医院儿内科,450052

出　　处：《中华实用儿科临床杂志》2016年第17期1329-1331,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的比较单纯引流与联合胸腔内注入尿激酶对儿童肺炎旁胸腔积液（PPE）的有效性、安全性及相关临床指标的影响。方法收集2013年1月至2015年12月郑州大学第一附属医院收治的29例行胸腔引流的PPE患儿的临床资料，按是否胸腔内注入尿激酶分为尿激酶组和单纯组，比较2组患儿总住院天数、总引流量、总置管天数、总费用、发热天数，及治疗有效率、手术发生率和安全性。结果尿激酶组总住院天数[M（P25，P75）]为19（11，30） d，单纯组为30（21，38） d，2组比较差异有统计学意义（Z＝－2.545，P＝0.011）；尿激酶组总胸水引流量[M（P25，P75）]为430（175，1 308） mL，单纯组为110（10，325） mL，2组比较差异有统计学意义（Z＝－2.811，P＝0.005）；尿激酶组总置管天数[M（P25，P75）]为9（7，19） d，与单纯组[20（10，30） d]比较差异有统计学意义（Z＝－2.020，P＝0.043）；尿激酶组总费用[M（P25，P75）]为2（1，3）万元，与单纯组[4（3，5）万元]比较差异有统计学意义（Z＝－2.631，P＝0.009）；尿激酶组和单纯组总发热天数比较差异无统计学意义（Z＝－0.820，P＝0.412）；尿激酶组治疗有效率为76.9%（10/13例），手术发生率为23.1%（3/13例），与单纯组[18.7%（3/16例）、81.3%（3/16例）]比较差异有统计学意义（χ^2＝9.814，P＝0.003）。结论胸腔内注入尿激酶在辅助治疗PPE方面操作简便、经济有效、风险小，可作为临床治疗此类疾病的有效方案之一。Objective To compare the effectiveness, safety and related clinical indicators between simple drainage treatment and drainage treatment combined with intrathoracic urokinase for children with parapneumonic pleural effusion（PPE）.Methods Twenty-nine in patients with PPE given pleural effusion drainage in the First Affiliated Hospital of Zhengzhou University from January 2013 to December 2015 were selected as research subjects, who were divided into a simple group and an urokinase group based on whether intrathoracic urokinase was injected or not.The total number of hospital stay, the total drainage volume, the total number of catheter days, the total cost, the days with fever, efficient rate, operation rate and security of the patients were retrospectively analyzed between two groups.Results The intrathoracic days of hospital stay [M（P25, P75）] of urokinase group[19（11, 30） days ]were less than those of simple group[30（21, 38） days], and the difference was significant （Z=-2.545, P=0.011）; the total drainage volume[M（P25, P75）]of the urokinase group[430（175, 1 308） mL] was more than that of the simple group[110（10, 325） mL], and the difference was significant （Z=-2.811, P=0.005）; the total number of catheter days[M（P25, P75）]of urokinase group[9（7, 19） days ]was less than that of the simple group[20（10, 30） days], and the difference was significant （Z=-2.020, P=0.043）; the total cost[M（P25, P75）]of the urokinase group[20 000（10 000, 30 000） RMB] was less than that of the simple group[40 000（30 000, 50 000） RMB], and the difference was significant （Z=-2.631, P=0.009）; the days with fever between urokinase group and the simple group was not significant（Z=-0.820, P=0.412）. The urokinase group had a higher cure rate[76.9%（10/13 cases）] and a lower surgical rate[23.1%（3/13 cases）] compared with those of the simple group[ 18.7%（3/16 cases）, 81.3%（3/16 cases）], and the difference was significant （χ^2=9.814, P=0.003）.Conclusions Int

关 键 词：肺炎旁胸腔积液 胸腔引流 尿激酶 儿童 

分 类 号：R725.6[医药卫生—儿科]