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细菌性肺炎并发胸腔积液者约为40％,此种类肺炎性渗液(Parapneumonic effusion,PE)的自然病程可分为3个阶段:渗出期、纤维脓性期和机化期。渗出期为炎症引起无菌性胸液,蛋白性物质和细胞碎屑在胸腔内积聚,纤维蛋白粘附于受累胸膜表面,可迅速出现分隔、包裹,致使引流不畅。PE的特点为pH和葡萄糖含量均减低。在纤维蛋白未机化时,胸腔内注入链激酶能溶解粘附的纤维蛋白,加强各腔之间的沟通,有利于充分引流。患者和方法 12例包裹性非化脓性PE患者,年龄平均40(22～59)岁。基础疾病和易感染因素有酗酒、滥用药物、肺癌、脑外伤、膈下病变、牙周疾病等。胸水葡萄糖含量≤2.24 mmol/L,pH值≤7.0,白细胞计数均值为9×10~9/L。全部患者胸腔均无明显脓液,先采用胸腔插管引流术并负压吸引(-1.96kPa),但引流效果差。后改用胸腔内注射链激酶。给药方法:先经引流管注入1％利多卡因15ml,然后将
Bacterial pneumonia complicated with pleural effusion was about 40%. The natural history of this type of pneumonia (Parapneumonic effusion, PE) can be divided into three stages: exudative period, fibula stage and the mechanization period. Exudative period of inflammation caused by aseptic pleural fluid, proteinaceous material and cell debris accumulation in the thoracic cavity, fibrin adhesion to the affected pleural surface, can be quickly separated, wrapped, resulting in poor drainage. PE is characterized by reduced pH and glucose content. Fibrin in the non-organic, intrathoracic injection of streptokinase can dissolve the adhesion of fibrin, strengthen the communication between the cavity is conducive to full drainage. Patients and Methods Twelve patients with encapsulated non-purulent PE had an average age of 40 (22-59) years. Fundamental diseases and predisposing factors are alcohol abuse, drug abuse, lung cancer, traumatic brain injury, subdiaphragmatic lesions, periodontal disease and so on. Pleural fluid glucose content ≤ 2.24 mmol / L, pH ≤ 7.0, white blood cell count was 9 × 10 ~ 9 / L. All patients had no obvious pus pleural fluid, the first use of chest catheter drainage and suction (-1.96kPa), but poor drainage. After the switch to intrathoracic injection of streptokinase. Method of administration: First infusion of 1% lidocaine via the drainage tube 15ml, and then