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目的 :观察胸腔内注射医用透明质酸钠凝胶对结核性胸腔积液胸膜肥厚的治疗作用。方法 :将中等量结核性胸腔积液 (B超示胸液包裹及胸膜肥厚 >2mm)患者 5 2例 ,随机分为治疗组 2 7例和对照组 2 5例 ,两组均按 2HRZS 4HR化疗 ,抽液后治疗组注入透明质酸钠凝胶 2 .5ml,对照组注入生理盐水2 .5ml,分别于注药前后 72h检测胸水常规和蛋白定量。胸腔积液吸收后 2wk及 3mon作肺功能测定。结果 :治疗组较对照组胸穿次数减少 ,胸腔积液完全吸收时间显著变短 (P <0 .0 5 ) ;肺功能指标FEV1%和FVC %明显优于对照组 (P <0 .0 5 ) ;胸膜厚度注药前 0 .92± 0 .11cm与注药后 0 .5 7± 0 .13cm的变化显著 ,与对照组比具有显著的统计学意义 (P<0 .0 5 )。注药后 72h胸水蛋白定量和胸水白细胞数明显低于注药前 (P <0 .0 5 )。治疗中未见不良反应。结论 :胸腔内注射医用透明质酸钠凝胶有防治结核性胸腔积液胸膜肥厚的作用 ,无不良反应
Objective: To observe the therapeutic effect of intrapleural injection of medical sodium hyaluronate gel on pleural hypertrophy of tuberculous pleural effusion. Methods: Fifty-two patients with moderate tuberculous pleural effusion (B-pleural effusion and pleural thickening> 2mm) were randomly divided into treatment group (27 cases) and control group (25 cases), and the two groups were treated by 2HRZS 4HR chemotherapy , The treatment group after injection of sodium hyaluronate gel 2. 5ml, control group injected normal saline 2. 5ml, respectively, 72h before and after injection of test pleural fluid routine and protein quantification. Pleural effusion absorption 2wk and 3mon for lung function test. Results: Compared with the control group, the number of thoracentesis decreased and the time of complete absorption of pleural effusion was significantly shorter (P <0.05). The FEV1% and FVC% of pulmonary function indexes were significantly better than those of the control group (P <0.05) ). The thickness of pleural thickness varied significantly from 0 .92 ± 0.11 cm before injection and 0.57 ± 0.13 cm after injection, which was significantly different from the control group (P <0.05). 72h after injection of pleural fluid protein and pleural effusion white blood cell count was significantly lower than before injection (P <0. 05). No adverse reactions in treatment. Conclusion: Intrapleural injection of sodium hyaluronate gel has the effect of preventing and treating pleural thickening of tuberculous pleural effusion without any adverse reaction