胸腔内置中心静脉导管行闭式引流并注入尿激酶治疗结核包裹性胸腔积液36例临床疗效观察

目的探讨胸腔内置中心静脉导管行闭式引流并注入尿激酶（UK）治疗结核性粘连包裹性胸腔积液的临床疗效。方法72例结核性胸腔积液病例,经胸腔B超证实胸水中等量以上且呈粘连包裹性,将其分为随机分为治疗级和对照组,治疗组36例,胸腔内置管行闭式引流,且予尿激酶10万U加入生理盐水20mL中注入胸腔,每日或隔日1次,连续1～3次。对照组36例,常规反复穿刺抽液。治疗前后胸片或B超对比胸腔情况。结果治疗组明显较对照组的胸水引流更彻底,且胸膜肥厚粘连情况减轻。结论胸腔内置中心静脉导管行闭式引流并注入尿激酶治疗结核性粘连包裹性胸腔积液是一种简单、安全并且疗效肯定的治疗方法,值得推广应用。

OBSERVATION 18 PATIENTS OF CURATIVE EFFECT OF MICRO-CATHETER DRAINAGE COMBINED WITH UROKINASE INJECTION IN TREATMENT OF TUBERCULOSIS THORAX EFFUSION WITH ADHESION ENCAPSULATION

Objective： To discuss the clinical efffects of chest built-in central venous catheter closed drainage combined with urokinase injection in treatment of tuberculosis thorax effusion with adhesion encapsulation. Methods： 72 cases of tuberculosis pleurisy patients having above medium-size of effusion and adhesion encapsulation were selected as the subject patients in the study. The patients were divided into two groups randomly as treatment group and control group. In treatment group （n=36）, the thorax was inserted catheter for drainage and injected with urokinase, one time every day or every other day. In control group （n=36）, the thorax was tapped repeatedly. Pleural condition before and after treatment on chest X-ray or B ultrasound was compared. Results： Hydrothorax drainage was more thorough in treatment group than that in control group, and pleural thickening and adhesion were lightened in treatment group. Conclusions： The method of chest built-in central venous catheter closed drainage combined with urokinase injection in treatment of tuberculosis thorax effusion with adhesion encapsulation is convenient, safe and has satisfying curative effects, it is worth of application and dissemination.