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目的：探讨尿激酶治疗结核性包裹性胸腔积液后外科手术治疗的最佳时机。方法结核性包裹性胸腔积液患者120例。依据接受手术前尿激酶治疗时间的不同将120例患者分为两组，A 组60例，为常规抗结核治疗并给予胸腔注射尿激酶治疗1个月左右接受手术治疗；B 组60例，为常规抗结核治疗并给予胸腔注射尿激酶治疗2个月左右接受手术治疗。比较两组患者的临床疗效。结果 A 组患者手术时间为（145.72±38.48）分钟，术中出血量（332.96±108.03）ml，术后24小时引流量（264.67±101.37）ml，引流管放置时间为（4.49±1.22）天；B 组患者分别为（149.14±39.06）分钟、（356.64±106.31）ml、（262.38±97.80）ml 和（4.53±1.26）天，两组比较差异无统计学意义（P >0.05）。A 组患者的治疗总有效率、肺活量（ VC）增加量和最大通气量（MVV）增加量分别为86.67%、（0.32±0.10）ml 和（13.24±2.45）ml，B 组患者分别为96.67%、（0.47±0.14）ml 和（17.03±3.75）ml，两组比较差异有统计学意义（P 0.05）。A 组不良反应发生率显著高于 B 组，两组间比较差异有统计学意义（P 0. 05). There were significant differences in total efficiency(86. 67% vs 96. 67% ),VC improvement[(0. 32 ± 0. 10)ml vs (0. 47 ± 0. 14)ml],and MVV improvement[(13. 24 ± 2. 45)ml vs(17. 03 ± 3. 75)ml]between group A and B(P < 0. 05). The incidence of adverse reactions in group A was significantly higher than that of group B(P < 0. 05). Conclusion If there is no significant improvement of efficacy in anti-tuber-culosis treatment and intrapleural injection of urokinase treatment after 2 months,surgery can obtain better therapeutic effects.