内科胸腔镜联合不同方案治疗结核性包裹性胸腔积液的效果

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摘要目的探讨内科胸腔镜、内科胸腔镜联合微卡菌苗、内科胸腔镜联合冷冻三组不同治疗方案对结核性包裹性胸腔积液的效果及安全性，寻找出临床最佳治疗方案。方法选取2019年1月至2020年12月宜春市人民医院收治的60 例结核性包裹性胸腔积液患者作为研究对象，按照随机数字表法分为X 组（20 例）、W 组（20 例）、L 组（20 例）。 X 组采用内科胸腔镜方法，W 组采用内科胸腔镜联合微卡菌苗方法，L 组采用内科胸腔镜联合冷冻方法。比较三组的临床症状消失时间、体温正常时间、置管天数、胸腔积液总量、胸膜腔包裹评分、白介素-27（IL-27）值、CD3+值、CD8+值。结果 L 组的临床症状消失时间、体温正常时间、置管天数均短于X 组和W 组，胸腔积液总量少于X 组和W 组，胸膜腔包裹范围评分低于X 组和W 组，IL-27 水平低于X 组和W 组，CD3+、CD8+水平高于X组和W 组，差异有统计学意义（P＜0.05）；X 组的临床症状消失时间、体温正常时间、置管天数均短于W 组，胸腔积液总量少于W 组，胸膜腔包裹范围评分低于W 组，IL-27 水平低于W 组，CD3+、CD8+水平高于W 组，差异有统计学意义（P＜0.05）。结论内科胸腔镜联合冷冻组在结核性包裹性胸腔积液中的治疗效果较佳，值得临床进一步推广。

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关键词 ：内科胸腔镜, 微卡菌苗, 冷冻, 结核性包裹性胸腔积液

Abstract：Objective To evaluate the therapeutic effect and safety of three different treatment schemes of medical thoracoscopy, medical thoracoscopy combined with microcapsule vaccine and medical thoracoscopy combined with cryotherapy in the treatment of tuberculous encapsulated pleural and peritoneal effusion, so as to find out the best clinical treatment scheme. Methods A total of 60 patients with tuberculous encapsulated pleural and peritoneal effusion treated in Yichun People′s Hospital from January 2019 to December 2020 were selected as the research objects. They were divided into group X (20 cases), group W (20 cases) and group L (20 cases) according to random number table method. Group X used the medical thoracoscopy, group W used medical thoracoscopy combined with microcapsule vaccine, and group L used medical thoracoscopy combined with cryotherapy. The disappearance time of clinical symptoms,normal temperature, days of catheterization, the total amount of pleural fluid, the score of pleural encapsulation range,interleukine-2 (IL-27) value, CD3+ value and CD8+ value among the three groups were compared. Results The disappearance time of clinical symptoms, the normal time of normal temperature and the days of catheterization in group L were shorter than those in group X, group W, the total amount of pleural fluid in group L were less than those in group X and group W, the score of pleural encapsulation range in group L were lower than those in group X and group W, the level of IL-27 in group L were lower than those in group X and group W, and the levels of CD3+ and CD8+ in group L were higher than those in group X and group W, the differences were statistically significant (P＜0.05). The disappearance time of clinical symptoms, the normal time of body temperature and the days of catheterization in group X were shorter than those in group W, the total amount of pleural effusion in group X was less than that in group W, the score of pleural encapsulation range in group X was lower than that in group W, the level of IL-27 in group X was lower than that in group W, and the levels of CD3+ and CD8+ in group X were higher than those in group W, the differences were statistically significant (P＜0.05). Conclusion The effect of medical thoracoscopy combined with cryotherapy in the treatment of tuberculous encapsulated pleural and peritoneal effusion is better, which is worthy of further clinical promotion.

Key words： Medical thoracoscope Microcapsule vaccine Cryotherapy Tuberculous encapsulated pleural and peritoneal effusion

基金资助:江西省宜春市科技局科技计划指导性项目（JXY C2019KSC014）。

通讯作者: 钱小军（1983-），男，江西宜春人，硕士，副主任医师，科室主任，研究方向：内科学呼吸。

作者简介: 刘露（1989-），女，江西高安人，硕士，研究方向：中西医结合呼吸。

引用本文:

刘露；钱小军；揭云云. 内科胸腔镜联合不同方案治疗结核性包裹性胸腔积液的效果[J]. 中国当代医药, 2022, 29(8): 51-54.
LIU Lu QIAN Xiaojun▲ JIE Yunyun. Effect of medical thoracoscopy combined with different schemes in the treatment of tuberculous encapsulated pleural and peritoneal effusion. 中国当代医药, 2022, 29(8): 51-54.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2022/V29/I8/51

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