乔瑞君

[摘要] 目的 探討丹红注射液配合胸腔闭式引流加四联抗结核药物治疗结核性胸腔积液的效果。 方法 选择沈阳市第十人民医院2017年1～6月80例诊断明确初治结核性胸腔积液患者临床资料，依据治疗方式不同分为对照组（四联抗结核药物治疗，40例）和联合治疗组（丹红注射液配合胸腔闭式引流加四联抗结核药物治疗，40例）。观察两组胸腔积液引流时间、引流总量、住院时间，观察两组患者治疗前后胸膜厚度、肺功能、胸液白介素-12（IL-12）、肿瘤坏死因子-α（TNF-α）、腺苷脱氨酶（ADA）含量情况及两组临床疗效。 结果 联合治疗组患者胸腔积液引流时间、住院时间均短于对照组（P < 0.05）。治疗后对照组和联合治疗组胸膜厚度、IL-12、TNF-α、ADA低于治疗前，TLC、FVC、FEV1/FVC%均高于治疗前，且联合治疗组胸膜厚度、IL-12、TNF-α、ADA低于对照组，TLC、FVC、FEV1/FVC%均高于对照组，差异均有统计学意义（P < 0.05）。联合治疗组临床治疗总有效率高于对照组（P < 0.05）。 结论 采用丹红注射液配合胸腔闭式引流加四联抗结核药物治疗结核性胸腔积液，可以缩短引流时间，提高引流量，改善胸膜厚度、肺功能和胸液积液生化指标，提高临床疗效，值得临床推广应用。

[关键词] 丹红注射液；胸腔闭式引流；四联抗结核药物；结核性胸腔积液

[中图分类号] R521.7 [文献标识码] A [文章编号] 1673-7210（2018）07（b）-0116-04

[Abstract] Objective To explore the effect of Danhong Injection combined with closed thoracic drainage plus four anti-tuberculous drugs in treating tuberculous pleural effusion. Methods The 80 cases clinical data of early diagnose clearly tuberculous pleural effusion in the Tenth People′s Hospital of Shenyang from January to June in 2017 were selected and divided into control group （four anti-tuberculosis drugs， 40 cases） and combined treatment group （Danhong Injection cooperate thoracic close drainage and four anti-tuberculosis drugs， 40 cases） by different treatment method. The pleural effusion drainage time， pleural effusion drainage volume and hospital stays in the two groups were detected， the pleural thickness， lung function and the levels of IL-12， TNF-α， ADA in the two groups before and after treatment were compared and the clinical effects of two groups were detected. Results The pleural effusion drainage time， hospital stays in the combined treatment group were shorter than those of the control group （P < 0.05）. After treatment， the pleural thickness and the levels of IL-12， TNF-α， ADA in the two groups were lower than those before treatment， and the levels of TLC， FVC， FEV1/FVC% were higher than before treatment， besides the pleural thickness and the levels of IL-12， TNF-α， ADA in the combined treatment group after treatment were lower than those in the control group， and the levels of TLC， FVC， FEV1/FVC% were higher than those of the control group， with statistically significant difference （P < 0.05）. The clinical treatment total effective rate of combined treatment group was higher than that of the control group （P < 0.05）. Conclusion Danhong Injection with closed thoracic drainage plus four anti-tuberculosis drugs in the treatment of tuberculous pleural effusion can shorten the time， increase the flow， and improve pleural thickness， lung function and pleural effusion， biochemical indicators and the clinical curative effect， which is worthy of clinical application.

[Key words] Danhong injection； Thoracic close drainage； Four anti-tuberculosis drugs； Tuberculous pleural effusion

结核性胸腔积液属于常见的结核类疾病，其发生和结核分枝杆菌感染密切相关，胸膜浸润后易诱发高度变态反应，临床上以渗出性胸膜炎比较多见，在病情早期，主要是充血和水肿，然后胸膜内皮细胞发生脱落，胸膜纤维化和增生[1-2]。有资料显示，结核性胸腔积液患者渗出液中含有大量的纤维蛋白，如果不能给予及时治疗，很容易造成纤维蛋白在胸膜聚集，诱发胸膜肥厚、粘连和多层性包裹，严重者造成胸廓畸形，对患者的肺功能和日常生活造成严重的影响[3-4]。本研究通过分析沈阳市第十人民医院（以下简称“我院”）诊断明确初治结核性胸腔积液患者的临床资料，拟探讨丹红注射液……