临床误诊误治2019，Vol.32Issue(3)：25-31,7.DOI:10.3969/j.issn.1002-3429.2019.03.007
胸腔内尿激酶注射治疗结核性胸膜炎的疗效评价
Efficacy Evaluation of Intrapleural Injection of Urokinase in the Treatment of Tuberculous Pleurisy
摘要
Abstract
Objective To evaluate the clinical effect of intrapleural injection of urokinase in the treatment of tuberculous pleurisy (TP). Methods The clinical data of intrapleural injection of urokinase in the treatment of TP were searched from CBM, CNKI, CQVIP, WAN-FANGDATA from the time of database etablishment to December 2017. The observation group was given conventional anti-tuberculosis treatment + thoracentesis drainage + intrapleural injection of urokinase. The control group was given conventional anti-tuberculosis treatment and (or) thoracentesis drainage and (or) intrapleural injection of the same amount of 0.9％ sodium chloride. Bias risk was assessed using the Cochrane assessment tool. The Jadad scoring scale was used to score the quality of the literature. Rev Man 5.3 software was used to process the data. Inspection RR and 95％ confidence interval (CI) were used as the indicator of effect. In addition, I2 and P were selected to be heterogeneity test indicators. Meta analysis, subgroup analysis, sensitivity analysis and publication bias assessment were also performed in the meantime. Results A total of 19 articles were included in this study. Meta analysis results showed that as compared with the control group, the incidence of pleural adhesion was significantly reduced in the observation group [OR=4.93, 95％CI (3.66, 6.65), P＜0.00001]. The absorption time of pleural effusion was obviously shortened [WMD=-0.80, 95％CI (-0.95, -0.66), P＜0.00001]. The thickness of the pleura was decreased obviously [WMD=-1.61, 95％CI (-1.86, -1.36), P＜0.00001]. Sensitivity analysis of the literature showed that the results were robust, but the heterogeneity of included studies was relatively large, and the reliability of Meta analysis results was uncertain. Conclusion Intrapleural injection of urokinase for the treatment of TP can reduce the incidence of pleural adhesion, shorten the absorption time of pleural effusion, and alleviate the thickening of the pleura.关键词
结核,胸膜/尿激酶/Meta分析Key words
Tuberculosis, pleural/Urokinase/Meta-analysis分类
医药卫生引用本文复制引用
夏欣田,张伟,李丽娜,陈文嘉..胸腔内尿激酶注射治疗结核性胸膜炎的疗效评价[J].临床误诊误治,2019,32(3):25-31,7.基金项目
广东省中医药强省中医临床重点专科建设项目(201508) （201508）
