胸腔内尿激酶注射联合胸腔穿刺引流治疗结核性胸膜炎患者的效果  

Effects of intrathoracic urokinase injection combined with thoracic puncture and drainage in treatment of patients with tuberculous pleurisy

作　　者：李新军 LI Xinjun(Department of Tuberculosis Differential Diagnosis of Sixth People’s Hospital of Zhengzhou,Zhengzhou 450000 Henan,China)

机构地区：[1]郑州市第六人民医院结核病鉴别诊断科,河南郑州450000

出　　处：《中国民康医学》2022年第21期25-28,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨胸腔内尿激酶注射联合胸腔穿刺引流治疗结核性胸膜炎(TP)患者的效果。方法:回顾性分析2018年4月至2020年4月该院收治的96例TP患者的临床资料,按照治疗方案不同分为对照组、观察组各48例。两组均给予常规抗结核化疗,对照组在此基础上采用胸腔穿刺引流治疗,观察组在对照组的基础上联合胸腔内注射尿激酶治疗。比较两组临床疗效、胸腔积液引流量、退热时间、引流管拔除时间、胸闷消失时间、治疗前后肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)]水平、炎性因子[γ干扰素(IFN-γ)、白细胞介素-2(IL-2)、白细胞介素-10(IL-10)]水平,以及不良事件发生率。结果:观察组治疗总有效率为91.67%(44/48),高于对照组的77.08%(37/48),差异有统计学意义(P<0.05);观察组治疗后FVC、FEV1、IL-10水平均高于对照组,差异有统计学意义(P<0.05);观察组胸腔积液引流量多于对照组,引流管拔除时间、退热时间及胸闷消失时间均短于对照组,差异有统计学意义(P<0.05);观察组治疗后血清IFN-γ、IL-2水平均低于对照组,差异有统计学意义(P<0.05);两组不良事件发生率比较,差异无统计学意义(P>0.05)。结论:胸腔内尿激酶注射联合胸腔穿刺引流治疗TP患者效果显著,可有效提高肺通气功能,加快临床症状改善,缓解炎症状态,安全性良好。Objective: To explore effects of intrathoracic urokinase injection combined with thoracic puncture and drainage in adjuvant treatment of patients with tuberculous pleurisy(TP). Methods: The clinical data of 96 patients with TP admitted to the hospital from April 2018 to April 2020 were retrospectively analyzed. According to different treatment options, they were divided into control group and observation group, 48cases each. Both groups were given conventional anti-tuberculosis chemotherapy. On this basis, the control group was treated with thoracic puncture and drainage, while the observation group was treated with intrathoracic urokinase injection on the basis of that of the control group. The clinical efficacy, the pleural effusion drainage volume, the antipyretic time, the drainage tube removal time, the chest distress disappearance time, the lung function index levels [forced vital capacity(FVC), forced expiratory volume in one second(FEV1)] before and after the treatment, the inflammatory factor levels [interferon-γ(IFN-γ), interleukin-2(IL-2), interleukin-10(IL-10)], and the incidence of adverse events were compared between the two groups. Results: The total effective rate of treatment in the observation group was 91.67%(44/48), which was higher than 77.08%(37/48) in the control group, and the difference was statistically significant(P<0.05). After the treatment, the levels of FVC, FEV1 and IL-10 in the observation group were higher than those in the control group, and the differences were statistically significant(P<0.05). The total drainage volume in the observation group was more than that in the control group;the drainage tube removal time, the antipyretic time and the chest distress disappearance time were shorter than those in the control group;and the differences were statistically significant(P<0.05). After the treatment, the levels of serum IFN-γ and IL-2 in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). However, the

关 键 词：尿激酶注射 胸腔穿刺引流 结核性胸膜炎 肺功能 炎性因子 

分 类 号：R521.7[医药卫生—内科学]