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目的:研究和探讨难治性结核性胸膜炎的临床特点和防治措施。方法:收集难治性结核性胸膜炎患者共35例,对他们的临床资料进行分析和总结。结果:所有患者在入院后均进行了抗结核治疗,有29例患者患侧的胸腔积液达到了2.8cm以上并能够抽出积液,进行胸腔内注射尿激酶和胸腔置管的持续引流治疗,其中17例患者的积液完全吸收,6例患者出现轻度的胸膜肥厚粘连,6例行外科胸腔镜手术治疗;其余6例无法抽液者进行中药治疗并痊愈。结论:在难治性结核性胸膜炎患者的治疗过程中应进行抗结核的治疗,同时综合应用胸腔置管引流、外科手术、中医等治疗手段,能够有效提高治疗的效果。
Objective: To study and explore the clinical features and prevention and treatment of refractory tuberculous pleurisy. Methods: A total of 35 patients with refractory tuberculous pleurisy were collected, their clinical data were analyzed and summarized. Results: All patients were treated with anti-TB drugs after admission. Twenty-nine patients had pleural effusion more than 2.8cm on the ipsilateral side and were able to withdraw effusion. Continuous thoracic drainage was achieved by intrapleural injection of urokinase and pleural catheter. Among them, effusion was completely absorbed in 17 patients, mild pleural thickening in 6 patients and surgical thoracoscopic surgery in 6 patients. The remaining 6 patients who were unable to take liquid medicine were treated with traditional Chinese medicine and recovered. Conclusion: The treatment of tuberculous pleurisy in patients with refractory tuberculosis should be treated, and combined application of thoracic tube drainage, surgery, Chinese medicine and other treatment can effectively improve the treatment effect.