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目的:观察胸腔内注射尿激酶治疗结核性脓胸的疗效及安全性。方法:120例结核性脓胸患者随机分成对照组和观察组各60例,对照组采用5%碳酸氢钠冲洗脓腔,观察组采用脓腔内注射尿激酶治疗。观察两组治疗总有效率、症状缓解时间及脓腔闭合时间、胸膜厚度变化以及不良反应发生情况。结果:观察组总有效率为98.3%明显高于对照组的81.7%(P<0.01)。观察组症状缓解时间及脓腔闭合时间均较对照组缩短,治疗后胸膜厚度较对照组变薄(P<0.05)。观察组药品不良反应发生率明显高于对照组(P<0.01)。结论:胸腔内注射尿激酶治疗结核性脓胸疗效优于应用碳酸氢钠,但需注意监测出血、低热等不良反应。
Objective: To observe the efficacy and safety of intrapleural injection of urokinase in the treatment of tuberculous empyema. Methods: 120 patients with tuberculous empyema were randomly divided into control group and observation group of 60 cases, the control group using 5% sodium bicarbonate flush abscess, the observation group was treated with intrapleural injection of urokinase. The total effective rate of treatment, symptom relief, abscess closure time, changes of pleural thickness and adverse reactions were observed. Results: The total effective rate in the observation group was 98.3%, significantly higher than that in the control group (81.7%, P <0.01). The symptom relief time and the closing time of abscess in the observation group were shorter than those in the control group, and the thickness of the pleura was thinner than that in the control group after treatment (P <0.05). The incidence of adverse drug reactions in the observation group was significantly higher than that in the control group (P <0.01). Conclusion: Thoracic injection of urokinase in the treatment of tuberculous empyema is better than the use of sodium bicarbonate, but attention should be paid to monitor bleeding, fever and other adverse reactions.