张笃建 王宗华 李晓

摘  要：目的  探究對结核性胸膜炎患者实施泼尼松与标准四联抗结联合治疗的效果评价，为临床提供必要指导。方法  随机将2018年7月至2020年7月山东省枣庄市肿瘤医院收治的74例结核性胸膜炎患者分为实验组（37例，应用泼尼松与标准四联抗结联合治疗）、对照组（37例，应用标准四联抗结治疗）。对比两组患者临床治疗效果、治疗指标、并发症状况、胸膜肥厚粘连发生率。结果  实验组患者总有效率高于对照组，差异有统计学意义（P<0.05）;实验组胸膜厚度小于对照组，差异有统计学意义（P<0.05）;实验组患者胸水吸收时间、临床症状缓解时间、住院时间均短于对照组，差异有统计学意义（P<0.05）;实验组患者骨质疏松、乏力多汗、向心性肥胖发生率明显低于对照组，差异有统计学意义（P<0.05）;实验组患者胸膜肥厚粘连发生率明显低于对照组，差异有统计学意义（P<0.05）。结论  结核性胸膜炎患者在临床治疗中，将泼尼松与标准四联抗结有效联用，可使疗效显著提高，在短时间内缓解患者临床症状、缩短胸水吸收时间与住院治疗时间，且并发症和胸膜肥厚粘连发生率偏低。

关键词：泼尼松;标准四联抗结疗法;结核性胸膜炎;应用价值

中图分类号：R764.04    文献标识码：A    文章编号：1009-8011（2021）-4-0001-03

Abstract： Objective  To explore the effect evaluation of prednisone and standard quadruple anti-junction therapy for patients with tuberculous pleurisy， and provide necessary guidance for the clinic. Methods  RandomLy divide 74 patients with tuberculous pleurisy who were admitted to Zaozhuang Cancer Hospital in Shandong Province from July 2018 to July 2020 into an experimental group（37 cases， using prednisone and standard quadruple anti-knot combination therapy） and a control group（37 cases were treated with standard quadruple anti-knot therapy）. The clinical treatment effects， treatment indicators， complications， and incidence of pleural hypertrophy and adhesions were compared between the two groups. Results  The total effective rate  of the experimental group was higher than that of the control group ， and the difference was statistically significant（P<0.05）; the thickness of the pleura of the experimental group was smaller than that of the control Group， the difference was statistically significant（P<0.05）; in the experimental group， the pleural fluid absorption time， clinical symptom relief， hospitalization time  is shorter than the control group， the difference is statistically significant（P<0.05）; the experimental group patients with osteoporosis， fatigue and sweating， central obesity was significantly lower than the control group， the difference was statistically significant（P<0.05）; the incidence of pleural hypertrophy adhesion in the experimental group was significantly lower than the control group ， the difference was statistically significant（P<0.05）. Conclusion  In the clinical treatment of patients with tuberculous pleurisy， the effective combination of prednisone and standard quadruple anti-binding can significantly improve the curative effect， relieve the patient's clinical symptoms in a short time， shorten the time of pleural fluid absorption and hospitalization， and have complications The incidence of adhesions with pleural hypertrophy is low.

Keywords： prednisone; standard quadruple anti-knot therapy; tuberculous pleurisy; application value

结核性胸膜炎是渗出性炎症的一种，主要是结核菌经过淋巴管后向胸膜血播散，或者与胸膜较近的原发病灶直接侵入胸膜引发，主要症状表现为发热、病侧胸痛以及咳嗽并发胸水等等[1]。若治疗不及时，很容易引起骨质疏松、乏力多汗以及向心性肥胖等多种并发症。在临床治疗期间，糖皮质激素的应用可使炎症早期渗出以及毛细血管扩张等一系列反应得以减轻，同时也可有效抑制炎症晚期形成结缔组织与肉芽组织，进而减少胸膜肥厚与粘连情况的发生[2]。为更好地针对结核性胸膜炎患者实施临床治疗，使其预后效果得到改善，优化患者的生活质量，在此次研究中，将重点阐述泼尼松与标准四联抗结联合治疗的临床应用价值与作用，以供参考。

1  资料与方法

1.1  一般资料

选取2018年7月～2020年7月间山东省枣庄市肿瘤医院接受治疗的结核性胸膜炎患者74例为研究对象，按照随机数字表法划分两组。……