超声电导仪靶向透药联合胸腔内注入尿激酶治疗结核性包裹性胸膜炎的效果  

Curative Effect of Targeted Drug by Ultrasound Conductimeter Combined with Intrapleural Urokinase for Treatment of Encapsulated Tuberculous Pleurisy

作　　者：韩莉 桑杨 刘云 

机构地区：[1]陕西省结核病防治院内三科,西安710100

出　　处：《医学综述》2017年第3期591-593,597,共4页Medical Recapitulate

摘　　要：目的观察超声电导仪靶向透药联合胸腔内注入尿激酶治疗结核性包裹性胸膜炎的临床效果。方法选择2014年3月至2015年8月陕西省结核病防治院收治的70例结核性包裹性胸膜炎患者为研究对象,采用随机数字法将患者分为观察组和对照组,各35例。两组患者均给予抽取胸腔积液、抗结核等常规治疗,对照组患者在此基础上胸腔注入尿激酶(20 mL 0.9%氯化钠注射液+10万U尿激酶),而观察组患者则在对照组基础上采用超声电导仪靶向透药。比较两组患者的临床疗效、胸腔积液引流总量、胸腔积液消失时间以及胸膜厚度;同时根据超声或胸部X线检查结果对两组患者的胸膜肥厚程度及胸膜粘连发生率进行比较。结果观察组患者的总有效率高于对照组[94.29%(33/35)比74.29%(26/35)](P<0.05)。观察组的胸腔积液引流总量明显大于对照组,而胸腔积液消失时间早于对照组、胸膜厚度明显小于对照组[(3 316.5±286.7)mL比(2 234.3±235.8)mL、(8.6±2.4)d比(14.9±4.6)d、(0.56±0.13)cm比(0.81±0.21)cm](P<0.05);两组患者胸膜肥厚程度比较差异有统计学意义(P<0.05);观察组患者胸膜粘连发生率为11.43%(4/35),低于对照组的31.43%(11/35)(P<0.05)。结论超声电导仪靶向透药联合胸腔内注入尿激酶治疗结核性包裹性胸膜炎的疗效优于单独胸腔内注入尿激酶,症状改善早,胸膜肥厚、胸膜粘连的发生率低,值得在临床上积极推广。Objective To observe the curative effect of targeted drug by ultrasound conductimeter combined with intrapleural urokinase for treatment of encapsulated tuberculous pleurisy. Methods A total of 70 tuberculous pleurisy patients were selected in Tuberculosis Control and Prevention Institute of Shaanxi Province from May 2014 to Aug. 2015, according to random number method,the patients were divided into an observation group and a control group,35 cases each. The pleural effusion was extracted in both groups, anti-tuberculosis and other routine treatment was given to both groups, on the basis of which,the control group was added intrapleural urokinase（20 mL 0. 9% NaC1 ＋ 100 K units of urokinase）. On the basis of the control group,the observation group was added with targeted drug by ultrasound conductimeter. The curative effect, the total amount of pleural effusion, the extinction time of pleural effusion and pleura1 thickness of the two groups were compared. According to the results of ultrasound or X-ray examination, the degree of pleural thickening and the incidence of pleural adhesion of the two groups were eompared. Results The total effective rate of the observation group was higher than that of the control group[ 94. 29% （33/35） vs 74. 29% （26/35） ] （P 〈0. 05）. The total pleural effusion of the observation group was significantly higher than the control group, while the extinction time of pleural effusion and pleural thickness were significantly lower than those in control group [ （ 3 316. 5±86. 7 ） mL vs （ 2 234. 3±235.8 ） mL, （ 8. 6±2.4 ） d vs （ 14. 9±4. 6 ） d, （0. 56±0. 13 ） em vs （ 0. 81±0. 21 ） cm ] （ P 〈 0.05 ）. There was statistically significant difference between the degree of pleural hypertrophy of the two groups （ P 〈 0. 05 ）. The incidence of pleural adhesion of the observation group was 11.43 % （ 4/35 ）, lower than that of the control group （ 31.43 %, 11/35 ） （ P 〈 0.05 ）. Conclusion The curative effect of targeted drug by

关 键 词：结核性包裹性胸膜炎 超声电导仪靶向透药 胸腔内注入尿激酶 

分 类 号：R521.7[医药卫生—内科学]