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目的:探究尿激酶联合地塞米松治疗结核性胸膜炎的临床效果。方法:选取本院2012年2月-2014年2月收治的80例结核性胸膜炎患者作为研究对象,按照随机数字表法将其分为对照组和研究组各40例。两组均利用中心静脉导管胸腔置入术进行治疗,对照组向胸腔注入地塞米松,研究组在此基础上加注尿激酶。观察比较两组患者的临床疗效、引流量、胸膜厚度及并发症的差异。结果:研究组治疗总有效率85.0%(34/40)明显高于对照组的62.5%(25/40),差异有统计学意义(字2=5.23,P=0.001)。研究组的引流量(1790±78)mL明显多于对照组的(1273±46)mL,胸膜厚度(1.10±0.20)mm明显小于对照组的(1.42±0.28)mm,差异均有统计学意义(t=36.04,P=0.000;t=5.88,P=0.001)。而研究组出现3例胸痛、2例胸膜反应;对照组出现3例胸痛,1例胸膜反应,两组的并发症发生率比较差异无统计学意义(P>0.05)。结论:尿激酶联合地塞米松治疗结核性胸膜炎临床效果显著,能够有效提高治疗总有效率,增加引流量,值得在临床上推广应用。
Objective: To investigate the clinical effect of urokinase combined with dexamethasone in the treatment of tuberculous pleurisy. Methods: Eighty patients with tuberculous pleurisy admitted from February 2012 to February 2014 in our hospital were selected as the study subjects. They were divided into control group and study group according to random number table method. Both groups were treated with central venous catheterization and thoracic surgery. The control group was injected dexamethasone into the thoracic cavity, and the study group was given urokinase on this basis. The clinical efficacy, drainage, pleural thickness and complications of the two groups were observed and compared. Results: The total effective rate of the study group was 85.0% (34/40), which was significantly higher than that of the control group (62.5%, 25/40). The difference was statistically significant (word 2 = 5.23, P = 0.001). The drainage volume of the study group (1790 ± 78 mL) was significantly higher than that of the control group (1273 ± 46 mL) and the pleural thickness (1.10 ± 0.20 mm) was significantly less than that of the control group (1.42 ± 0.28) mm, with significant differences (t = 36.04, P = 0.000; t = 5.88, P = 0.001). There were 3 cases of chest pain and 2 cases of pleural reaction in the study group. There were 3 cases of chest pain and 1 case of pleural reaction in the control group. There was no significant difference in the complication rates between the two groups (P> 0.05). Conclusion: The clinical effect of urokinase combined with dexamethasone in the treatment of tuberculous pleurisy is significant, which can effectively improve the total effective rate of treatment and increase the drainage volume, which is worth popularizing and applying in clinic.