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目的观察心包腔内注入尿激酶治疗结核性包裹性心包积液的疗效。方法 36例中至大量结核性包裹性心包积液患者,在充分抗结核药物及肾上腺糖皮质激素治疗基础上经心包穿刺留置中心静脉导管引流,并给予注射尿激酶,观察其临床情况。结果 36例患者均能充分引流出心包积液,引流量为380~1470 ml,平均引流量为860 ml,引流时间5~9 d,未发生严重不良反应及并发症。随访1~4年36例患者均治愈,无一例患者发展至缩窄性心包炎。结论经心包置入导管引流并心包腔注射尿激酶治疗结核性包裹性心包积液能防治缩窄性心包炎的发生,疗效确切。值得临床推广应用。
Objective To observe the efficacy of pericardial injection of urokinase in the treatment of tuberculous paroxysmal pericardial effusion. Methods Thirty-six patients with moderate to severe tuberculous paroxysmal pericardial effusion underwent drainage of central venous catheter by pericardiocentesis and percutaneous injection of urokinase on the basis of adequate antitubercular drugs and glucocorticoid therapy. The clinical situation was observed. Results All the 36 patients were able to drain the pericardial effusion completely. The drainage volume was 380 ~ 1470 ml, the average drainage volume was 860 ml and the drainage time was 5 ~ 9 days. No serious adverse reactions and complications occurred. Thirty-six patients were followed up for 1 to 4 years, none of whom developed to constrictive pericarditis. Conclusion Transcatheter percutaneous catheter drainage and peritoneal injection of urokinase in the treatment of tuberculous pericardial effusion can prevent the occurrence of constrictive pericarditis, the exact effect. Worthy of clinical application.