摘要
目的评估胸腔内注入尿激酶对结核性包裹性胸腔积液的疗效。方法通过网络检索收集1989-2015年关于尿激酶治疗结核性包裹性胸腔积液的临床研究文献,并査阅所有纳入文献中的参考文献加以补充。制定严格的纳入及排除标准,采用Rev man 5.1软件对符合条件的所有研究结果进行meta分析:评估纳入研究偏倚风险;对研究结果进行异质性检验,使用固定效应模型或随机效应模型进行合并研究,合并加权均数差及其95%可信区间,绘制森林图分析疗效。结果 12篇文献符合纳入标准;meta分析结果显示,常规抗结核、引流(抽液)等治疗的基础上应用尿激酶胸腔内注射治疗的试验组与仅予常规抗结核、引流(抽液)等治疗的对照组比较,治疗有效率、引流(抽液)总量、残留胸膜厚度、胸腔积液吸收时间差异均有统计学意义(P<0.01)。结论在常规抗结核、引流(抽液)等治疗的基础上联合尿激酶胸腔内注射治疗结核性包裹性胸腔积液安全、有效。
Objective To investigate the efficacy of intrapleural urokinase infusion in treatment of loculated tu- berculous pleural effusion. Methods Clinical literatures published from 1989 to 2015 about urokinase in treatment of loculated tuberculous pleural effusion were searched via internet, and the studies as references of eligible articles were al- so collected. The admitting and eliminant criteria were established strictly, and a meta analysis was performed using Rev- man 5.1 software for the involved literatures. Articles were evaluated with bias risk assessment tool. Alloplastic analysis was performed for study results, and combined study was performed using fixed effect or random effect models. The weighted mean difference （WMD） and 95% confidence interval （CI） were calculated, and the urokinase efficacy was analyzed using drawing forest map in the combined values. Results A total of 12 literatures met all eligible criteria. The control group was treated with conventional therapies such as anti-tuberculosis drugs and drainage （pumping liquid） , while the experimental group was treated with intrapleural urokinase infusion based on control group therapy. The meta a- nalysis showed that the differences in therapic effective rate, total drainage （pumping liquid） volume, reliquus pleural thickness and absorption time of pleural effusion were statistically significant between the two groups （ P 〈 0. 01 ）. Con- clusion The conventional therapies such as anti-tuberculosis and pumping liquid combined with intrapleural urokinase infusion in treatment of loculated tuberculous pleural effusion is safe and effective.
出处
《解放军医药杂志》
CAS
2015年第11期94-98,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
关键词
胸腔积液
结核
尿激酶
META分析
Pleura1 effusion
Tuberculosis
Urokinase
meta analysis
