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目的观察胸腔内注射尿激酶+肝素钠治疗结核性胸膜炎的效果。方法 60例结核性粘连包裹性胸膜炎患者随机分为观察组(尿激酶+肝素钠)20例,尿激酶组20例,肝素钠组20例。胸腔内置入引流导管,抽尽胸水,观察组胸腔内同时注入尿激酶10万U及肝素钠4250 U,尿激酶组注入尿激酶20万U,肝素钠组注入肝素12500 IU,比较3组间的疗效。结果观察组总有效率95.0%,尿激酶组和肝素钠组分别为70.0%和65.0%,和观察组比较有显著差异(P<0.05),且观察组和尿激酶组、肝素钠组比较,胸腔积液吸收时间、胸膜厚度及肺功能情况(FEV1及FVC),均具有显著性差异(P<0.05)。结论胸腔闭式引流并胸内注射尿激酶+肝素钠促进胸水吸收、防止胸膜肥厚、粘连,改善肺功能,效果优于仅注入尿激酶或肝素钠。
Objective To observe the effect of intrapleural injection of urokinase + heparin sodium in the treatment of tuberculous pleurisy. Methods Sixty patients with tuberculous adhesive pleuritis were randomly divided into observation group (urokinase + heparin sodium) 20 cases, urokinase group 20 cases and heparin sodium group 20 cases. In the thoracic cavity, the drainage catheter was drained and the pleural effusion was drained. The thoracic cavity of the observation group was injected with 100,000 U of urokinase and 4250 U of heparin simultaneously. The urokinase group was injected with 200,000 U of urokinase and the heparin sodium group was injected with 125,000 IU of heparin. Efficacy. Results The total effective rate was 95.0% in the observation group and 70.0% and 65.0% in the urokinase group and the heparin sodium group respectively (P <0.05). Compared with the observation group and the urokinase group and the heparin sodium group, Pleural effusion absorption time, pleural thickness and pulmonary function (FEV1 and FVC), were significantly different (P <0.05). Conclusion Thoracic drainage and thoracic injection of urokinase + heparin sodium to promote pleural fluid absorption, to prevent pleural thickening, adhesion, improve lung function, the effect is better than only the injection of urokinase or heparin sodium.