α糜蛋白酶治疗胸膜腔感染所致胸膜肥厚的研究

目的观察α糜蛋白酶局部用药对胸膜腔感染所致胸膜肥厚的治疗效果.方法选择40例胸膜肥厚患者,随机分为治疗组和对照组(各20例),两组均行胸腔微管引流术.治疗组给予α糜蛋白酶4 000 U加入生理盐水20 mL注入胸膜腔,对照组仅予微管引流治疗.测量并记录治疗前及治疗后胸膜厚度、残腔大小及带管时间.结果治疗组应用α糜蛋白酶胸膜腔内注射后胸膜厚度显著减低,与对照组相比差异有统计学意义(t=3.071,P<0.01);治疗组治疗后胸膜残腔大小与对照组相比差异有统计学意义(t=-8.82,P<0.05);治疗组平均带管时间为(7.25±2.53)d,比对照组(5.90±2.07)d延长,两组对比差异有统计学意义(t=2.339,P<0.05).结论经胸腔微管引流注入α糜蛋白酶治疗胸膜腔感染所致胸膜肥厚疗效显著,方法简便,安全高效,费用低廉,值得临床推广.

On the Curative Effect of α-Chymotrypsin on the Residual Pleural Thickening Caused by Pleural Cavity Infection

Objective To observe the local curative effect of α-chymotrypsin on the residual pleural thickening(RPT)caused by pleural cavity infection.Method Forty cases of RPT patients were randomly divided into treatment group and control group,(20 cases in each group).Microtubule drainage in the pleural cavity was performed in two groups.The patient in the treatment group were given 4 000 U α-chymotrypsin dissolved in 20mL sodium chloride and the patients in the control group were only treated with the microtubule drainage.The thickness of pleura,the size of residual cavity and the time with the tube were measured and recorded before and after the treatment.Results The pleural thickness of the patients in the treatment group after the injection of α-chymotrypsin was significantly reduced compared with that in the control group(t=3.071,P<0.01);the size of residual cavity in the treatment group after the treatment was significantly different from that in the control group(t=-8.82,P<0.05).The mean time with the catheterization in the treatment group was 7.25±2.53 days and that in the control group was 5.90±2.07 days,which showed that the difference in the mean time between two groups was significantly different(t=2.339,P<0.05).Conclusion The curative effect of α-chymotrypsin on the pleural thickening caused by pleural cavity infection is significant,the method is simple,safe and efficient,and low-cost.The method is worthy to be popularized in clinic.