中心静脉导管引流加尿激酶胸腔内注射治疗结核性包裹性胸腔积液临床研究

摘要

Objective To observe the therapeutic effect of encapsulated pleural effusion with the central venous catheter drainage and intrapleural urokinase in order to find the best way to improve the clinical outcome. Methods From February 2011 to October 2014, 96 patients with encapsulated pleural effusion were divided into two groups.48 patients in control group were treated with conventional methods, and 48 cases in observation group were treated by central venous catheter drainage and intrapleural urokinase.Results In the control group, the markedly effective rate was 31.25% and the total effective rate was 77.08%.In the observation group, markedly effective rate was 47.92% and the total effective rate was 89.59%.There were statistical differences between these two groups (P<0.05) in the incidence of adverse reaction, such as the Pleural effusion drainage, the hospitalization time , the hydrothorax disappearance time , the incidence of pleural thickening and pneumohemothorax.After treatment, there were significant differences (P<0.05) between two groups in the comparison of survival quality, such as symptoms, psychological and emotional distress, physiological function,daily life and social activities.The curative effect, incidence of adverse reaction and survival quality of the observation group were better than those of the control group.Conclusions The central venous catheter drainage and intrapleural urokinase for encapsulated pleural effusion are markedly effective.%目的：探讨中心静脉导管引流加尿激酶胸腔内注射治疗结核性包裹性胸腔积液临床效果，以期寻找最佳方法，提高临床水平。方法选取2011年2月至2014年10月96例结核性包裹性胸腔积液患者为研究对象，分成两组，对照组48例，予常规方法治疗，观察组48例，中心静脉导管引流加尿激酶胸腔内注射治疗，观察治疗后相关指标变化情况。结果疗效上，对照组显效率31．25％、总有效率77．08％，观察组显效率47．92％、总有效率89．59％，两组比较差异有统计学意义（P＜0．05）；两组在胸腔积液引流量、住院时间、胸水消失时间、胸膜肥厚发生率、气血胸等不良反应发生率比较差异有统计学意义（ P＜0．05）；两组治疗后在自觉症状、心理情绪、躯体生理功能、日常生活、社会活动等生存质量上比较差异均有统计学意义（P＜0．05）。结论中心静脉导管引流加尿激酶胸腔内注射治疗结核性包裹性胸腔积液临床效果显著。