胸腔内置管注射不同剂量尿激酶引流治疗老年脓胸的效果观察  

Observation on the Effect of intrapleural Tube Injection of Different Doses of Urokinase Drainage in the Treatment of Empyema in the Elderly

作　　者：郭昌[1] 顾振解 孙燕川 宋建民[1] 卢瑞琦[1] Guo Chang;Gu Zhenjie;Sun Yanchuan;Song Jianmin;Lu Ruiqi(Department of RespiratoryMedicine,First Central Hospital of Baoding City,Baoding,Hebei,071000,P.R.China;Outpatient Department,Second Hospital of Baoding City,Baoding,Hebei,071000,P.R.China)

机构地区：[1]保定市第一中心医院呼吸内科,河北保定071000 [2]保定市第二医院门诊部,河北保定071000

出　　处：《老年医学与保健》2020年第6期1018-1020,1029,共4页Geriatrics & Health Care

基　　金：保定市科技计划项目(1951ZF061)。

摘　　要：目的探讨胸腔内置管注入不同剂量尿激酶引流治疗老年脓胸的效果,为治疗脓胸提供方法。方法选取2014年9月-2019年10月在保定市第一中心医院住院治疗的老年脓胸患者120例,根据数字表法随机分为观察组(n=60)和对照组(n=60)。观察组患者每日胸腔内置管注射20万单位尿激酶,对照组患者每日胸腔内注射10万单位尿激酶。治疗4周后,观察并比较2组患者胸腔积液总流量、引流时间、住院时间、体温恢复正常时间、胸水消失时间、出血状况、疼痛状况和止痛药服用情况,以及气胸及脱管发生的情况。结果治疗4周后,观察组的胸腔积液总流量、引流时间、体温恢复正常时间、胸水消失时间、住院时间均明显少于对照组(P<0.05);2组出血、疼痛、气胸及脱管发生率及止痛药服用情况差异均无统计学意义(P>0.05)。结论每日胸腔内置管注射20万单位尿激酶引流治疗老年脓胸,更利于患者脓液的吸收,有效减少脓胸的脓液,达到更好的治疗效果。Objective To investigate the effect of intrapleural tube injection of different doses of urokinase drainage on empyema in the elderly and to provide a reference for the treatment of empyema.Methods A total of 120 elderly patients with empyema hospitalized in First Central Hospital of Baoding City from September 2014 to October 2019 were selected and divided randomly into observation group(n=60)and control group(n=60)according to the number table method.Patients in the observation group were injected with 200000 units of urokinase into the thoracic cavity daily,and patients in the control group were injected with 100000 units of urokinase daily.After 4 weeks of treatment,the total volume of pleural effusion,drainage time,hospitalization time,body temperature returned to normal time,pleural effusion disappearance time,bleeding,pain degree,pneumothorax and extubation,and analgesic drug use were observed and compared between the two groups.Results After 4 weeks of treatment,the total volume of pleural effusion,drainage time,body temperature returned to normal time,pleural effusion disappearance time and hospitalization time of the observation group were significantly less than those of the control group(P<0.05),but there was no statistically significant difference in the incidences of bleeding,pain,pneumothorax and extubation and the use of analgesics between the two groups(P>0.05).Conclusion Daily intrapleural tube injection of 200000 units of urokinase drainage to treat empyema in the elderly is more conducive to the absorption of pus,reduces pus in the chest cavity,and achieves better treatment results.

关 键 词：老年 脓胸 尿激酶 胸腔内置管注射 剂量 

分 类 号：R561.6[医药卫生—呼吸系统]