摘要
目的评价肝素及不同剂量尿激酶对结核包裹性胸腔积液的疗效。方法 80例结核包裹性胸腔积液患者随机分成4组,每组20例,分别向胸腔内注入肝素1.25万IU/次,3次/周(A组);尿激酶10万IU/次,3次/周(B组);尿激酶25万IU/次,3次/周(C组);尿激酶50万IU/次,3次/周(D组),4组1台疗方案均为2HRZ/4HR,治疗周期为15d,治疗前及24h后分别测定胸腔积液的纤维蛋白原和D-二聚体含量。记录胸腔积液引流量和吸收时间,观察不良反应的发生率。结果 A组治疗后纤维蛋白原的含量较治疗前明显升高(P<0.005),B、C、D组明显降低,(P<0.05)。胸腔内注入肝素或尿激酶后胸腔积液中D-二聚体含量均显著升高[A组P<0.05;B组P<0.05;C组P<0.05;D组P<0.05]。胸腔积液吸收时间4组间无显著差异(P>0.05)。A及D组的胸腔积液引流量较B、C组显著增多(P<0.05),其中C组的胸腔积液引流量较B组显著增多,P<0.05。但A、D组的血性胸水及胸痛等不良反应的发生率达50%。结论胸腔内注入肝素或尿激酶对结核包裹性胸腔积液有明显疗效,是减少胸膜增厚及粘连的有效方法,但胸腔内反复多次的注入肝素或大剂量的尿激酶容易出现血性胸水及胸痛等不良反应,应慎用。
Objective To evaluate different doses of heparin or urokinase in the treatment of tuberculosis encysted pleural effusion. Methods Eighty patients with tuberculosis encysted pleural effusion were allocated into four groups randomly. 20 patients in each group. Heparin 12 500U/time,3 times/week （A group）; urokinase 100 000 IU/time,3 times/week （B）; urokinase 250 000 IU/time,3 times/week （C group）; urokinase 500 000 IU/time,3 times/week （D）,chemotherapy regimens in four groups were 2HRZ/4HR,treatment period was 15 days,before treatment and after 24 hours,the fibrinogen and D-dimer in pleural effusion were measured. Volume of pleural effusion drainage and absorption time were recorded,the incidence of adverse reactions was observed. Results Fibrinogen levels after treatment was significantly higher than that before treatment in A group （P0.005）,B,C,D group was significantly lower,（P0.05）. Using heparin or urokinase the D-dimer levels in the pleural effusion were significantly higher ／[A group P0.05; B group P0.05; C group P0.05; D group P0.05／]. There was no significant difference between absorption time of pleural effusion in 4 groups （P0.05）. Volume of pleural effusion drainage of A and D group was significantly increased than B,C group （P0.05）,where volume of pleural effusion drainage of C group was significantly increased than group B,P0.05. but the incidence of adverse reactions of bloody pleural effusion and chest pain in A,D group were 50%. Conclusion There is significant effects of heparin or urokinase on tuberculosis encysted pleural effusion,it is an effective method to reduce the pleural thickening and adhesion,but repeat heparin injection or large doses of urokinase which cause bloody pleural effusion and chest pain and other adverse reactions.
出处
《中华肺部疾病杂志（电子版）》
CAS
2012年第1期33-36,共4页
Chinese Journal of Lung Diseases(Electronic Edition)
