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目的 观察胸腔注射尿激酶减少结核性渗出性胸膜炎胸膜粘连的效果。方法 收治渗出性胸膜炎74例,随机分为治疗组与对照组各37例。治疗组第1、2、3次抽液后注射尿激酶10万IU+生理盐水20ml,对照组注射生理盐水20 ml,化疗方案等其他治疗方法相同。结果 胸腔积液吸收时间:治疗组(15. 3±6. 6)d,对照组(28. 7±9 8)d(P<0 .05)。抽液总量:治疗组(3738. 2±613. 4)ml,对照组(3114. 5±498 8)ml(P<0 .05)。抽液次数:治疗组(3.1±1 .2)次,对照组(5.7±1.8)次(P<0.05)。形成纤维分隔、多房积液:治疗组2例,对照组9例(P<0.01)。3个月后B超查胸膜厚度:治疗组(0.6±0.1)mm,对照组(1.1±0 .2)mm(P<0.05)。肺功能FEV1%:治疗组(82.6%±2.6%),对照组(75.8%±1.9%)(P<0.05);FVC%治疗组(84.2%±1.2%),对照组(77.1%±2.1%)(P<0.5)。结论 胸腔注射尿激酶能减少胸腔分隔、多房的形成,减轻胸膜增厚,改善肺功能。
Objective To observe the effect of thoracic injection of urokinase on pleural adhesions of tuberculous exudative pleurisy. Methods 74 patients with exudative pleurisy were randomly divided into treatment group and control group, 37 cases each. In the treatment group, the first, second and third injections were injected with 10 000 IU + saline 20 ml and the control group with saline 20 ml. The chemotherapy regimens and other treatments were the same. Results Pleural effusion absorption time: the treatment group (15.3 ± 6. 6) d, the control group (28. 7 ± 9 8) d (P <0 .05). Total fluid extraction: treatment group (3738.2 ± 613.4 ml, control group (3114.5 ± 498 8 ml (P <0.05. Pumping times: the treatment group (3.1 ± 1.2) times, the control group (5.7 ± 1.8) times (P <0.05). The formation of fibroids, multi-room fluid: two cases in the treatment group, nine cases in the control group (P <0.01). After 3 months, the thickness of pleural ultrasonography was detected in the treatment group (0.6 ± 0.1) mm and in the control group (1.1 ± 0.2 mm) (P <0.05). The FEV1% of the lung function was 82.6% ± 2.6% in the treatment group and 75.8% ± 1.9% in the control group (84.2% ± 1.2% vs 77.1% ± 2.1%, P <0.05) ) (P <0.5). Conclusion Thoracic injection of urokinase can reduce the formation of pleural separation, multifarious, reduce pleural thickening and improve pulmonary function.