中心静脉导管引流联合尿激酶治疗结核性胸膜炎胸腔积液的效果  

The efficacy of central venous catheter drainage combined with urokinase in the treatment of tuberculous pleurisy pleural effusion

作　　者：张中 黄华 ZHANG Zhong;HUANG Hua(The Third People′s Hospital of Jiujiang,Jiujiang 332000,China)

机构地区：[1]九江市第三人民医院,江西九江332000

出　　处：《华夏医学》2023年第4期98-102,共5页Acta Medicinae Sinica

基　　金：江西省卫生计生委科技计划项目(20197151)。

摘　　要：目的:探讨中心静脉导管引流联合尿激酶治疗结核性胸膜炎胸腔积液的效果。方法:选取80例结核性胸膜炎胸腔积液患者,按照随机数字表法分为观察组和对照组,每组各40例。对照组在中心静脉导管引流基础上注入地塞米松治疗,观察组在中心静脉导管引流基础上注入尿激酶治疗,比较两组临床疗效、肺功能指标、凝血功能指标和生化指标水平。结果:治疗后,观察组总有效率高于对照组(P<0.05);观察组用力肺活量(FVC)、第1秒用力呼气容积(FEV1)水平及最大通气量(MVV)实测值占预估值的比例均高于对照组(P<0.05);观察组凝血酶时间、凝血酶原时间均长于对照组(P<0.05);观察组IFN-γ水平高于对照组,MCP-1、CCL-3水平低于对照组(P<0.05)。结论:中心静脉导管引流联合尿激酶治疗结核性胸膜炎胸腔积液,效果显著,可有效改善患者的肺功能、凝血功能和生化指标水平,可为临床推广提供理论依据。Objective:To investigate the effects of central venous catheter drainage combined with urokinase injection in the treatment of patients with tuberculous pleurisy pleural effusion.Methods:80 patients with tuberculous pleurisy pleural effusion were randomized into the observation group and control group,with 40 cases in each group.The control group were injected dexamethasone on the basis of the central venous drainage,while the observation group were injected with urokinase on the basis of central venous drainage.The clinical efficacy,indexes of lung function,coagulation function and biochemistry were compared between the two groups.Results:After treatment,the total effective rate of the observation group was higher than that of the control group(P<0.05);the forced vital capacity(FVC),level of the forced expiratory volume in one second(FEV1)and the proportion of the maximal voluntary ventilation(MVV)to the estimated values were significantly higher than those of the control group(P<0.05);the thrombin time and prothrombin time of the observation group was longer than that of the control group(P<0.05);and the level of IFN-r in the observation group was higher than that in the control group,and the levels of MCP-1 and CCL-3 were lower than those in the control group(P<0.05).Conclusion:Central venous catheter drainage combined with urokinase in the treatment of tuberculous pleurisy pleural effusion has a remarkable effect,which can effectively improve the pulmonary function,coagulation function and biochemical index level of patients,and can provide a theoretical basis for clinical promotion.

关 键 词：结核性胸膜炎胸腔积液 尿激酶 中心静脉导管引流 

分 类 号：R521.7[医药卫生—内科学]