胸腔镜治疗联合尿激酶局部应用在急性包裹性胸腔积液中的疗效评价

doi:10.6040/j.issn.1671-7554.0.2015.1217

摘要/Abstract

摘要： 目的评价胸腔镜联合尿激酶胸腔内注射治疗急性包裹黏连性胸腔积液的疗效。方法急性包裹黏连性胸腔积液患者58例,按照处理方法不同分为治疗组(n=27)、对照组(n=31),治疗组采用胸腔镜检查、治疗后放置胸腔闭式引流管,同时给予胸腔内注入尿激酶(10万U)保留24~48 h后引流,每周2次(可根据引流液的颜色增减次数);对照组常规胸腔置管引流。比较两组患者胸腔积液的引流量、积液蛋白含量、积液消失时间、胸膜厚度、治疗效果及并发症发生率。结果治疗组胸腔积液引流量为(1141.51±411.66)mL,显著多于对照组(751.93±605.53)mL(P<0.05);治疗组胸腔积液消失时间和胸膜厚度分别为(6.18±1.88)d和(2.09±0.50)mm,低于对照组(7.54±2.28)d和(2.90±0.57)mm(P<0.05);治疗组胸腔积液蛋白含量为(26.45±12.09)g,显著低于对照组(34.33±10.99)g(P<0.05)。治疗组有效率为96.3%(95%CI:58.5%~100%),高于对照组77.4%(95%CI:41.3%~100%)(P<0.001)。在并发症的发生率上两组差异无统计学意义(P>0.05)。结论内科胸腔镜联合尿激酶治疗包裹黏连性胸腔积液,患者胸腔积液引流量多、引流彻底、干净,积液消失快,胸膜增厚减轻,治疗效果好,且并发症无明显增加。

关键词: 包裹黏连性胸腔积液, 尿激酶, 胸腔镜

Abstract: Objective To evaluate the value of medical thoracoscope combined with urokinase treatment on loculated pleural effusion. Methods Fifty-eight patients with loculated pleural effusion were recruited and divided into the treatment group(n=27)and the control group(n=31). The treatment group was treated with medical thoracoscope and urokinase(1×10⁵ U, twice a week)while the control group was given routine drainage. The total drainage volume, pleural thickness, protein content of pleural effusion, duration of pleural effusion, incidence of complication and therapeutic effect were compared. Results The total drainage volume in the treatment group was higher than that in the control group［(1141.51±411.66)vs(751.93±605.53)mL, P<0.05］; duration of the pleural effusion, pleural thickness and protein content of pleural effusion in the treatment group were lower than those in the control group［(6.18 ±1.88)vs(7.54±2.28)days,(2.09±0.50)vs(2.90±0.57)mm,(26.45 ±12.09)vs(34.33±10.99)g, all P<0.05］; medical effective rate in treatment group was higher than that in the control group(96.3% vs 77.4%, P<0.001). The incidence of complications in the two groups had no significant difference(P>0.05). Conclusion The value of the medical thoracoscopy combined with urokinase treatment on loculated pleural effusion is significant. The pleural effusion is drained thoroughly and rapidly. This method can increase the duration of the pleural effusion, relieve pleural thickening, and cause no obvious increase in complications.

Key words: Urokinase, Thoracoscope, Loculated pleural effusion

中图分类号:

R561.6

闫迪,马卫霞,姜淑娟,石欣雨,王娜. 胸腔镜治疗联合尿激酶局部应用在急性包裹性胸腔积液中的疗效评价[J]. 山东大学学报（医学版）, 2016, 54(11): 32-35.

YAN Di, MA Weixia, JIANG Shujuan, SHI Xinyu, WANG Na. Value of thoracoscope combined with urokinase treatment on loculated pleural effusion[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(11): 32-35.

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