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摘要：目的：探讨胸腔穿刺手术时胸腔内注射尿激酶治疗结核性胸膜炎胸膜肥厚、粘连的临床疗效。方法：将30例结核性胸膜炎包裹性胸腔积液、胸膜肥厚、粘连患者分为两组：治疗组15例，采用胸腔穿刺术抽胸水后胸腔注射尿激酶；对照组15例，采用常规胸腔穿刺抽胸水，胸腔内不注射尿激酶。比较两组患者治疗后胸膜肥厚、粘连程度。结果：治疗组胸膜肥厚、粘连程度明显减轻，与对照组差异有统计学意义（P<0.05）。结论：胸腔内注射尿激酶治疗结核性胸膜炎胸膜肥厚、粘连疗效肯定，操作简便，值得推广。
关键词：结核性胸膜炎 尿激酶 胸膜粘连 肥厚
Chest cavity pours into urokinase treatment tubercular pleurisy curative effect observation
Li Xiang
Abstract:Objective:Discusses when the chest cavity puncture surgery in the chest cavity injects the urokinase treatment tubercular pleurisy pleural membrane plump,the adhesion clinical curative effect.Methods：Wraps 30 example tubercular pleurisy the chest cavity to accumulate plump the fluid,the pleural membrane,the adhesion patient divides into two groups:The treatment group 15 examples,after use the chest cavity puncture method to pull out the chest water the chest cavity injection urokinase;The control group 15 examples,use the conventional chest cavity puncture to pull out the chest water,in the chest cavity do not inject the urokinase.Treats the pleural membrane after two group of patients plump,the adhesion degree.Results：Treats the group pleural membrane plump,the adhesion degree reduces obviously,has statistics significance with the control group difference (P<0.05).Conclusion：In the chest cavity injects the urokinase treatment tubercular pleurisy pleural membrane plump,the adhesion curative effect affirmed that,the operation is simple,is worth promoting.
Keywords：Tubercular pleurisy Urokinase Pleural membrane adhesion Plump
【中图分类号】R45【文献标识码】B 【文章编号】1008-1879(2010)11-0057-02
1 资料与方法
1.1 一般资料。本组患者30例，治疗组和对照组各15例，采取随机分组方法，其中治疗组男8例，女7例，年龄21-57岁，平均年龄39岁;对照组男9例，女6例，年龄18～56岁，平均年龄37岁，两组年龄、性别作统计学处理差异无显著性。各组病例均已明确诊断为结核性胸膜炎，经胸水B超检查提示：有少到中量胸腔积液，胸水中可见多条纤维条索影，全部已经形成包裹性胸腔积液、胸膜肥厚。
1.2 方法。两组患者均给与2HREZ/4HR方案治疗（H:异烟肼0.3g，利福平0.45g，乙胺丁醇0.75g，均1次/日，吡嗪酰胺0.5g，3次/日，）治疗组抽尽胸水后胸腔注入尿激酶10万U，24-72小时后复查胸水B超，有胸水时B超定位后继续重复抽尽胸水后注射尿激酶10万U。对照组根据B超定位行胸腔穿刺抽胸水，每周2-3次抽胸水，一周后根据B超结果判断疗效。
2 结果
治疗组15例中胸水吸收、胸膜肥厚、粘连消失8例，明显减轻5例，无变化2例，有效率为86.7%;对照组胸膜肥厚、粘连消失2例，明显减
关键词：结核性胸膜炎 尿激酶 胸膜粘连 肥厚
Chest cavity pours into urokinase treatment tubercular pleurisy curative effect observation
Li Xiang
Abstract:Objective:Discusses when the chest cavity puncture surgery in the chest cavity injects the urokinase treatment tubercular pleurisy pleural membrane plump,the adhesion clinical curative effect.Methods：Wraps 30 example tubercular pleurisy the chest cavity to accumulate plump the fluid,the pleural membrane,the adhesion patient divides into two groups:The treatment group 15 examples,after use the chest cavity puncture method to pull out the chest water the chest cavity injection urokinase;The control group 15 examples,use the conventional chest cavity puncture to pull out the chest water,in the chest cavity do not inject the urokinase.Treats the pleural membrane after two group of patients plump,the adhesion degree.Results：Treats the group pleural membrane plump,the adhesion degree reduces obviously,has statistics significance with the control group difference (P<0.05).Conclusion：In the chest cavity injects the urokinase treatment tubercular pleurisy pleural membrane plump,the adhesion curative effect affirmed that,the operation is simple,is worth promoting.
Keywords：Tubercular pleurisy Urokinase Pleural membrane adhesion Plump
【中图分类号】R45【文献标识码】B 【文章编号】1008-1879(2010)11-0057-02
1 资料与方法
1.1 一般资料。本组患者30例，治疗组和对照组各15例，采取随机分组方法，其中治疗组男8例，女7例，年龄21-57岁，平均年龄39岁;对照组男9例，女6例，年龄18～56岁，平均年龄37岁，两组年龄、性别作统计学处理差异无显著性。各组病例均已明确诊断为结核性胸膜炎，经胸水B超检查提示：有少到中量胸腔积液，胸水中可见多条纤维条索影，全部已经形成包裹性胸腔积液、胸膜肥厚。
1.2 方法。两组患者均给与2HREZ/4HR方案治疗（H:异烟肼0.3g，利福平0.45g，乙胺丁醇0.75g，均1次/日，吡嗪酰胺0.5g，3次/日，）治疗组抽尽胸水后胸腔注入尿激酶10万U，24-72小时后复查胸水B超，有胸水时B超定位后继续重复抽尽胸水后注射尿激酶10万U。对照组根据B超定位行胸腔穿刺抽胸水，每周2-3次抽胸水，一周后根据B超结果判断疗效。
2 结果
治疗组15例中胸水吸收、胸膜肥厚、粘连消失8例，明显减轻5例，无变化2例，有效率为86.7%;对照组胸膜肥厚、粘连消失2例，明显减