心包置管引流注入尿激酶和抗结核药物治疗结核性心包炎疗效观察  

Clinical efficacy of pericardial catheter drainage injection of urokinase and antituberculous drugs in the treatment of tuberculous pericarditis

作　　者：刘建平[1] 廖火城[1] 刘凌[1] 钟思干[1] 肖纯[1] LIU Jian-ping;LIAO Huo-cheng;LIU Ling;ZHONG Si-gan;XIAO Chun(Department of Cardiology,the Third People′s Hospital of Huizhou City,Huizhou 516001,Guangdong Province,China)

机构地区：[1]惠州市第三人民医院心内科,广东惠州516000

出　　处：《新乡医学院学报》2018年第8期712-715,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨心包置管引流注入尿激酶和抗结核药物治疗结核性心包炎的临床疗效。方法将惠州市第三人民医院2011年5月至2016年12月收治的132例结核性心包炎患者分为对照组和观察组,每组66例。全部患者均予以标准抗结核方案治疗,对照组患者在抗结核治疗的基础上予以传统心包穿刺术;观察组患者在对照组治疗的基础上给予心包置管注入尿激酶及抗结核药物治疗。比较治疗前后2组患者的心包积液量、心胸比(心影最大横径与胸廓最大横径之比)及治疗后的心包积液引流量和临床疗效。结果治疗前2组患者心尖部、左心室后壁积液深度及心胸比比较差异无统计学意义(t=0.876、0.973、0.753,P>0.05)。治疗后,2组患者心尖部、左心室后壁积液深度、心胸比显著低于治疗前(对照组:t=9.572、10.727、3.257,P<0.01、P<0.05;观察组:t=15.322、16.962、4.662,P<0.01、0.05),且观察组患者心尖部、左心室后壁积液深度、心胸比显著低于对照组(t=5.322、3.836、3.611,P<0.05)。治疗后观察组患者心包积液引流量显著高于对照组(t=32.671,P<0.01)。对照组和观察组患者治疗总有效率分别为60.6%(40/66)和89.4%(59/66),观察组患者治疗总有效率显著高于对照组(χ2=14.591,P<0.01)。结论心包置管引流注入尿激酶及抗结核药物治疗结核性心包炎对心包积液引流彻底,治疗过程中无明显并发症且临床疗效较好。Objective To evaluate the clinical efficacy of pericardial catheter drainage injection of urokinase and antituberculous drugs in the treatment of tuberculous pericarditis.Methods One hundred and thirty-two patients with tuberculous pericarditis in the Third People＇s Hospital of Huizhou City from May 2011 to December 2016 were selected.All the patients were divided into control group and observation group,with 66 cases in each group.All the patients were given standard anti-tuberculosis treatment,and the patients in the control group were given traditional pericardiocentesis on the basis of anti-tuberculosis treatment.While the patients in the observation group were treated with pericardial catheter infusion of urokinase and antituberculosis drugs on the basis of treatment in the control group.The pericardial effusion volume and the cardiothoracic ratio were compared before and after treatment between the two groups.The drainage volume of pericardial effusion and the clinical efficacy were compared after the treatment.Results There was no statistically significant difference in the pericardial effusion depth of apex of heart and left ventricular posterior wall and cardiothoracic ratio between the two groups before treatment（t=0.876,0.973,0.753;P〈0.05）.After treatment,the pericardial effusion depth of apex and left ventricular posterior wall of heart and cardiothoracic ratio were significantly lower than those before treatment in the two groups（control group：t=9.572,10.727,3.257;P〈0.01,P〈0.05;observation group：t=15.322,16.962,4.662;P〈0.01,P〈0.05）,and the pericardial effusion depth of apex and left ventricular posterior wall of heart and cardiothoracic ratio in the observation group were significantly lower than those in the control group（t=5.322,3.836,3.611,P〈0.05）.After treatment,the drainage volume of pericardial effusion in the observation group was significantly higher than that in the control group（t=32.671,P〈0.01）.The total effective rate of the patients in the control grou

关 键 词：心包置管引流 抗结核治疗 尿激酶 结核性心包炎 

分 类 号：R52[医药卫生—内科学] R542.11[医药卫生—临床医学]