目的：探讨胸腔置管引流并注入尿激酶治疗结核性渗出性胸膜炎的临床疗效。方法将80例确诊为结核性渗出性胸膜炎患者随机分为治疗组和对照组，两组均常规给予抗结核治疗，治疗组在抗结核治疗的同时胸腔置管引流并注入尿激酶10万 IU（用20 mL 生理盐水稀释）。比较两组患者胸腔积液引流量、积液吸收时间、住院时间、总有效率及治愈率。结果与对照组比较，治疗组患者胸腔积液引流量明显增多（t ＝5．88，P ＜0．05）；积液吸收时间及住院时间缩短，差异有统计学意义（t ＝2．18，P ＜0．05；t ＝2．52，P ＜0．05），总有效率及治愈率提高，差异有统计学意义（χ2＝5．16，P ＜0．05；χ2＝4．18，P ＜0．05）；随访3个月，治疗组胸膜粘连及胸膜增厚发生率降低（χ2＝4．11，P ＜0．05；χ2＝4．50，P ＜0．05）。结论胸腔置管引流并注入尿激酶治疗结核性渗出性胸膜炎疗效好，能有效增加胸腔积液排出量，缩短病程，减少胸膜粘连及肥厚，促进肺功能恢复，且方法安全有效。%Objective To explore the clinical efficacy on the treatment of tuberculous exudative pleurisy with conventional anti-tuberculosis treatment line with central venous catheter after intrapleural injection of urokinase.Methods 80 patients diagnosed with tuberculosis exudative pleurisy were randomly divided into treatment group and control group,two groups were routinely given anti-TB treatment,the treated group were given intrapleural injection of urokinase (UK)100 000 IU (20 mL saline dilution)with the central venous catheter.Results Compared with the control group,The total amount of pleural effusion of the treatment group increased significantly (t =5.88,P <0.05),the pleural effusion absorption and hospi-talization time of the treatment group was significantly shorter than the control group (t =2.18,P < 0.05;t=2.52,P <0.05);Following three months,the control group developed hemothoraxhas less (χ2 =4.11,P< 0.05;χ2 =4.50,P <0.05).Conclusion The rataining tube for drainage combined with Urokinase in tho-rax to tuberculous exudative pleurisy could effectively increase the output of pleural effusion,shorten ab-sorption time of pleural,and decrease pleural thickening and complication of puncture,meanwhile there is no increase of hemothoraxhas and have a better clinical curative effect.
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