• 论著 •

### 经胸壁超声导入三联药品辅助治疗结核性胸膜炎的临床价值

1. 570311 海口,海南省人民医院呼吸与危重症医学科(郑亚妹、谢甜、陈永倖),超声科(伍卓乐)
• 收稿日期:2020-03-13 出版日期:2020-07-10 发布日期:2020-07-09
• 通信作者: 陈永倖 E-mail:chenyongxing1969@163.com
• 基金资助:
海南省自然科学基金青年基金项目(819QN354)

### Clinical value of triple-drug adjuvant therapy for tuberculous pleurisy via chest wall ultrasound

ZHENG Ya-mei, XIE Tian, WU Zhuo-le, CHEN Yong-xing()

1. Department of Respiratory and Critical Care Medicine, Hainan General Hospital, Haikou 570311,China
• Received:2020-03-13 Online:2020-07-10 Published:2020-07-09
• Contact: CHEN Yong-xing E-mail:chenyongxing1969@163.com

Abstract:

Objective To explore the clinical value of triple-drug adjuvant therapy for tuberculous pleurisy (TBP) via chest wall ultrasound. Methods A total of 76 eligible TBP patients admitted to Hainan General Hospital from January 2016 to December 2018 were collected and randomly divided into the observation group and the control group according to the order of admission, with 38 cases in each group. Both groups were treated with 2H-R-Z-E/10H-R systemic chemotherapy+thoracentesis and drainage. On this basis, the observation group was supplemented with a triple-drug treatment of isoniazid+rifampicin+urokinase via transthoracic ultrasound, and the control group was given the same triple-drug treatment applied to the skin of the chest wall. The therapeutic efficacy of patients was compared between the two groups. The count data were represented by $\bar{x}$±s and analyzed using t test; and the measurement data were represented by rate (%) and analyzed using χ2 test. P<0.05 was considered statistically significant. Results The total effective rates of the observation and the control groups were 94.74% (36/38) and 78.95% (30/38), respectively, with the statistically significant difference (χ 2=4.146, P=0.042). The thickness of the parietal pleura in the observation and the control groups was (5.29±0.21) mm and (5.98±0.25) mm at 2 months of treatment, respectively; (3.25±0.39) mm and (3.75±0.41) mm at 6 months of treatment, respectively; and (2.15±0.25) mm and (2.62±0.34) mm at 6 months after treatment, respectively; with the statistically significant differences (t=13.028, 29.669 and 47.132, P=0.000, 0.000, and 0.000, respectively). The ratios of the complete absorption of pleural effusion in the observation and the control groups were 65.79% (25/38) and 42.11% (16/38) at 6 months of treatment, respectively; and 94.74%(36/38) and 78.95% (30/38) at the end of 6 months, with the statistically significant differences (χ 2=4.290 and 4.146, P=0.038 and 0.042, respectively). The forced vital capacity (FVC) of the observation group and the control group was (3.86±0.68) L and (3.51±0.61) L at 2 months of treatment; (4.28±0.90) L and (3.74±0.84) L at 6 months of treatment; and (4.68±0.75) L and (3.98±0.79) L at the end of 6 months of treatment, respectively; with the statistically significant difference between the two groups (t=5.578, 4.894, and 35.307, P=0.021, 0.000, and 0.000, respectively). The 1s forced expiratory volumes (FEV1) of the observation group and the control group were (3.54±0.67) L and (3.38±0.69) L at 2 months of treatment, respectively; (3.89±0.72) L and (3.38±0.69) L at 6 months of treatment, respectively; (4.23±0.75) L and (3.54±0.71) L at the end of 6 months of treatment, respectively, with the statistically significant difference (t=4.541, 3.153, 16.962, P=0.036, 0.000, 0.000, respectively). The inspiratory capacity (IC) of the observation group and the control group was (2.76±0.42) L and (2.30±0.38) L at 6 months of treatment, respectively; (2.98±0.45) L and (2.49±0.43) L at the end of 6 months of treatment, respectively; with the statistically significant difference (t=5.007 and 23.551, P=0.000 and 0.000, respectively). Conclusion The triple-drug treatment of isoniazid+rifampicin+urokinase via chest wall ultrasound can further improve the clinical efficacy of tuberculous pleurisy, significantly reduce the thickness of the pleura, accelerate the absorption of pleural effusion and improve lung function.