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目的 :研究尿激酶对结核性胸膜炎患者的疗效及对胸膜肥厚和纤溶活性的影响。方法 :选择2012年9月~2014年12月在我院进行诊治的结核性胸膜炎患者106例,随机分为两组,两组抗结核化疗方案相同,均进行胸腔置管引流,观察组在胸穿抽液后注入尿激酶。分别在引流前后检测胸腔积液中组织型纤溶酶原激活物、纤溶酶原激活剂抑制因子-1和Ⅲ型前胶原,并检测胸膜厚度。结果 :观察组的有效率为86.79%,明显高于对照组的69.81%;对照组治疗前后组织型纤溶酶原激活物/纤溶酶原激活剂抑制因子-1无明显变化,Ⅲ型前胶原水平明显降低,观察组的组织型纤溶酶原激活物/纤溶酶原激活剂抑制因子-1和Ⅲ型前胶原均与治疗前有明显差异,且观察组的Ⅲ型前胶原明显低于对照组;观察组的胸膜粘连发生率和胸膜厚度均明显低于对照组。结论 :胸腔内注射尿激酶对结核性胸膜炎患者具有较好的疗效,能提高胸腔积液纤溶活性,减少胸膜粘连并减轻胸膜肥厚,值得应用推广。
Objective: To study the effect of urokinase on patients with tuberculous pleurisy and its effect on pleural hypertrophy and fibrinolytic activity. Methods: A total of 106 patients with tuberculous pleurisy who were diagnosed and treated in our hospital from September 2012 to December 2014 were randomly divided into two groups. The two groups were given the same chemotherapy regimen, After pumping fluid injection urokinase. Tissue plasminogen activator, plasminogen activator inhibitor type 1 and type III procollagen in pleural effusion were detected before and after drainage, and the pleural thickness was measured. Results: The effective rate of the observation group was 86.79%, which was significantly higher than that of the control group (69.81%). There was no significant change in the inhibitor of tissue plasminogen activator / plasminogen activator inhibitor-1 before and after treatment in the control group. The levels of collagen in the observation group were significantly different from those before treatment, and the levels of type Ⅲ procollagen in the observation group were significantly lower In the control group, the incidence of pleural adhesions and pleural thickness in the observation group were significantly lower than those in the control group. Conclusion: Thoracic injection of urokinase has a good curative effect on patients with tuberculous pleurisy, which can improve pleural effusion fibrinolytic activity, reduce pleural adhesions and reduce pleural hypertrophy, which is worth popularizing.