Clinical study on central venous catheter drainage and intrapleural injection of urokinase in the treatment of tuberculous pleurisy

Abstract

Objective To observe the therapeutic effect of central venous catheter drainage and intrapleural injection of urokinase on tuberculous pleurisy patients. Methods 60 hospitalized patients with tuberculous pleurisy were selected, and they were divided into two groupsby simple random grouping method.Both two groups received 3HRZE/6HR anti-tuberculosis treatment.30 patients in the observation group were treated with central venous catheter drainage and intrapleural injection of urokinase.30 patients in the control group were treated with conventional pleurocentesis.The duration of pleural effussion drainage, incidence of pleural thickening, hospitalization time and expense, and the adverse reaction rate were observed during treatment. Results In the observation group, the curative effect at 1 week was 46.7%, the duration of pleural effussion drainage was (20.5±6.7)days, the incidence rate of pleural thickening was 26.7%, the hospitalization time was (9.4±2.7)days, the hospitalization expense was (6 675.4±1 818.4)RMB, the incidence rate of adverse reaction was 3.3%.In the control group, the curative effect at 1 week was 20.0%, the duration of pleural effussion drainage was (25.1±7.7)days, the incidence rate of pleural thickening was 46.7%, the hospitalization time was (10.3±2.8)days, the hospitalization expense was (7 508.9±1 692.1)RMB, the incidence rate of adverse reaction was 20.0%.There were statistically significant differences between the two groups in the curative effect at 1 week(χ2=4.800, P=0.028), duration of pleural effussion drainage (t=2.484, P=0.016), incidence of pleural thickening (t=4.444, P=0.035) and incidence rate of adverse reaction (χ2=4.043, P=0.044). No statistically significant differences were observed between the two groups in hospitalization time(t=1.270, P=0.209) and expense(t=1.838, P=0.071). Conclusion In comparison to conventional pleurocentesis, the treatment of central venous catheter drainage and intrapleural injection of urokinase for tuberculous pleurisy is markedly efective, it is safe and worthy of popularizing in clinical application. Key words: Pleurisy; Tuberculosis, pleural; Central venous catheter drainage; Urokinase