摘要
近年来结核病发病率未见下降趋势.虽然目前研究显示早期积极抗结核治疗、开放引流可有效避免胸膜肥厚、粘连,然而结核病起病隐匿,由于患者发现迟、就诊时间晚或疗程不足,胸腔积液处理不及时,容易产生胸水包裹、分房等,即使在影像学辅助下也难以抽液、充分引流,引起患者治疗难度增加,住院时间增加,最终引起肺功能下降、限制性通气功能障碍等不可逆改变,造成生活质量下降.临床上有用胸腔注入激素、抗结核药的方法 ,但仅仅是减轻炎症渗出而未处理已渗出的积液.近年来临床发现胸腔注入尿激酶可以防治胸膜肥厚、粘连.本文结合近年来研究进展,对结核性胸腔积液病理及尿激酶治疗结核性胸腔积液、预防胸膜肥厚的作用机理做一综述.
The incidence of tuberculosis （TB） has not declined in recent years.Although recent studies have shown that early,aggressive anti-TB treatment combined with tube thoracostomy can effectively prevent pleural thickening and adhesion,pleural effusion is easy to be enveloped and separated because of late medical diagnosis,inadequate treatment,or prolonged pleural effusion.The fluid is difficult to be fully removed even with the assistance of radiology,resulting in the increases in the difficulties of treatment and length of hospital stay,and in eventually the decrease in lung function and in the development of restrictive ventilation dysfunction and other irreversible changes; quality of life in patients declines.Available therapies with pleural injections of hormones or anti-tuberculosis agents only reduce inflammatory infiltration but not completely control the existing effusion.Recent research shows pleural effusion of urokinase can prevent and treat pleural thickening and adhesion.This literature narrates the pathology of tubercular pleural effusion and the mechanism of action of urokinase for effusion to prevent pleural thickening.
出处
《国际医药卫生导报》
2010年第14期1790-1792,F0003,共4页
International Medicine and Health Guidance News
关键词
尿激酶
结核
胸腔积液
胸膜炎
Urokinase
Tuberculosis
Pleural effusion
Pleurisy
