糖皮质激素治疗结核性胸膜炎的临床研究.docVIP

糖皮质激素治疗结核性胸膜炎的临床研究 梁燕蓉 庞红燕 （茂名石化医院 广东 茂名525011） 摘要: 目的 探讨地塞米松在治疗结核性胸膜炎的影响。方法 66例结核性胸膜炎患者随机分为两组，非给药组(29例)为2HRZE/4HR方案抗结核及胸腔穿刺抽液治疗，给药组(33例)在非给药组治疗基础上，胸腔抽液后注入地塞米松10mg。观察两组患者治疗后胸水吸收、胸膜肥厚粘连情况和血清腺苷脱氨酶的变化。结果 给药组总有效率为97.0％，非给药组总有效率为79.3％( P 0.05)；给药组 6个月末胸膜粘连的发生率为11.7％，明显低于非给药组23.8 ％( P 0.05)。治疗后两组血清腺苷脱氨酶水平均明显下降，治疗前、后比较差异具有统计学意义( P0.05 )。结论 地塞米松胸腔内注射联合2HRZE/4HR方案治疗结核性胸膜炎疗效可有效消除胸水及减轻胸膜的肥厚粘连情况，血清ADA变化在一定程度上可反映肺结核的疗效。 【关键词】地塞米松；腺苷脱氨酶；结核性胸膜炎 Clinical study of dexamethasone in the treatment of tuberculous pleurisy by chest injection Liang Yan-rong Pang Hong-yan Maoming Petrochemical Industry Hospital, GuangDong Maoming，525011 【Abstract】0bjective To investigate the clinical eficacy of dexamethasone in the treatment of tuberculous pleurisy by chest injection.Methods 62 cases of tuberculous pleurisy were randomly divided into two groups．The patients in controlgroup(29 cases)was treated by 2HRZE/4HR solutions and pleural puncture fluid therapy，while those in the treatment group(33 cases)were treated by pumping the Chest after the injection of dexamethasone 10mg based on control group．The situation of pleural efusion，pleural thickening and adhesions absorption were observed after treatment．Results The total effective rate of treatment group(97.0％ )was significantly better than the total efective rate of the control group(79.3％)(P0．05)；the incidence of pleural thickening and adhesion of treatment group(11.7％)Was significantly lower than the control group(23.8％)(P0．05). In the two groups after treatment serum adenosine deaminase levels was significantly decreased, the statistically significant differences comparing before and after therapy (P 0.05).Conclusion Dexamethasone in the treatment of tuberculous pleurisy by chest could effectively eliminate pleural effusion and reduce the thickening pleural adhesions．The level of sADA could reflect the therapy effect of pulmonary tuberculosis to a certain degree. 【Key words】dexamethasone；adenosine deaminase；tuberculous pleur 结核性胸膜炎是肺