结核性胸膜炎患者胸腔置管及巩固期加用乙胺丁醇治疗187例临床研究  

The clinical study of adding ethambutol in the treatment of187 cases of tuberculous pleuritis with thoracic catheterization

作　　者：唐先梅[1] 曹平虎 曾鑫[1] Tang Xianmei;Cao Pinghu;Zeng Xin(Hanzhong Central Hospital,Hanzhong 723000)

机构地区：[1]陕西省汉中市中心医院感染科,汉中723000

出　　处：《陕西医学杂志》2018年第9期1134-1136,1140,共4页Shaanxi Medical Journal

基　　金：陕西省汉中市科研项目(9612016Y0897)

摘　　要：目的:探讨胸腔置管及巩固期加用乙胺丁醇在结核性胸膜炎患者治疗中的效果。方法:选择初治结核性胸膜炎患者187例,分为A、B、C、D组。A组45例患者治疗方案为2HRZE+7HR,并行常规抽液;B组53例患者治疗方案为2HRZE+7HR,并行胸腔置管;C组55例患者治疗方案为2HRZE+4HRE+3HR,并行胸腔置管;D组34例患者治疗方案为2HRZE+4HRE+6HR,并行胸腔置管。B、C、D组患者行胸腔置管,经引流管注入生理盐水20ml加尿激酶10万U。结果:A组与B组、B组与C组比较,差异有统计学意义;C组与D组比较,差异无统计学意义。结论:对于初治的结核性胸膜炎患者,在巩固期加用乙胺丁醇,并且治疗总疗程延长到1年,并行胸腔置管并注入尿激酶,证明此种治疗方案能明显提高结核性胸膜炎的治愈率,促进胸腔积液的排出,防止胸膜肥厚、粘连及包裹,发挥最大的治疗作用。Objective:To investigate the effect of intrathoracic tube placement and combined use of ethambutol in the treatment of tuberculous pleurisy.Methods:187patients of department with initial treatment for tuberculous pleuritis were assigned to groups A,B,C and D.Group A included 45 patients receiving the 2HRZE+7HR regimen combined with conventional drainage;Group B included 53 patients receiving the 2HRZE+7HR regimen combined with thoracic catheterization;Group C included 55 patients receiving the 2HRZE+4HRE+3HR regimen combined with thoracic catheterization;and Group D included 34 patients receiving the 2HRZE+4HRE+6HR regimen combined with thoracic catheterization.For patients in groups B,C and D receiving thoracic catheterization,normal saline 20ml and urokinase 100,000U were given through the drainage tube.Results:There were statistically significant differences between groups A and B,between groups B and C.There were not statistically significant differences between groups C and D.Conclusion:For initial treatment of patients with tuberculous pleuritis,ethambutol was added during the consolidation period,and the total course of treatment was extended to one year,followed by chest catheterization and injection of urokinase.could significantly improve the clinical symptoms and recovery rate of tuberculous pleuritis.It could significantly improve the recovery rate of tuberculous pleuritis,as it could facilitate drainage of pleural effusion and prevent pleural thickening,adhesion or encapsulation.So it could play the biggest therapeutic role.

关 键 词：结核 胸膜炎/药物疗法 乙胺丁醇/治疗应用 导管 留置 @尿激酶 

分 类 号：R523[医药卫生—内科学]