目的 觀察胸腔閉式引流并注入尿激酶治療結(jié)核性胸膜炎的療效。方法 將100例滲出性結(jié)核性胸膜炎患者隨機(jī)分為2組，胸腔閉式引流加尿激酶治療55例為治療組，經(jīng)皮胸腔穿刺治療45例為對(duì)照組，兩組均應(yīng)用9HREZ抗結(jié)核治療方案。治療組胸腔閉式引流同時(shí)注入尿激酶1×105 U，保留24 h，每3天1次，2次為1個(gè)療程，治療2～3個(gè)療程；對(duì)照組經(jīng)皮胸腔穿刺抽出胸水，治療約28 d，治療4周后檢測兩組胸膜厚度及胸水蛋白水平。結(jié)果 治療組總有效率100%，對(duì)照組總有效率86.7%，治療組明顯高于對(duì)照組（P＜0.01），2組治療4周后胸膜厚度及胸水蛋白水平差異均有統(tǒng)計(jì)學(xué)意義（P＜0.05）。結(jié)論 結(jié)核性胸膜炎并發(fā)胸膜腔積液患者行胸腔閉式引流術(shù)并按療程注入尿激酶，可減少并發(fā)癥的發(fā)生，該方法安全、簡單、療效良好，可推廣使用。

Objective To observe the effect of closed drainage with injecting the urokinase to the chest on tuberculous pleurisy. Methods One hundred patients with exudative tuberculosis pleuritis were randomly divided into two groups, among which 55 patients were treated by closed drainage with injecting the urokinase to the chest (treatment group), and 45 patients were treated by percutaneous thoracentesis (control group). The 9HREZ treatment program was applied in the two groups of patients. The treatment group should be injected 1×105 U of urokinase into the chest once every 3 d, and be reserved among 24 h (twice for a course while usually two to three couses). The control group was received pleural effusion puncture for 28 d. the pleural thickness and the effusion protein levelt after four weeks’ treatment between treatment and control groups were observed. Results The total effective rate was 100% in the treatment group and 86.7% in the control group, the difference between the two groups was significant (P＜0.01). The pleural thickness and the effusion protein level after four weeks’ treatment in treatment group were significantly lower than those in the control group (P＜0.05). Conclusion The therapy of closed drainage with injecting urokinase to patients suffered from tuberculous pleurisy and pleural effusion, is effective and could reduce the incidence of complications. This method is safe and simple, and can be widely promoted with the good efficacy.