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Thrombin, fibrinogen, traffic speed only treatment of recurrent pneumothorax combined efficacy

: The treatment group was significantly less than the disappearance time of pleural effusion control group, but adverse effects was also significantly higher. Conclusion: The treatment of tuberculous exudative pleurisy should be balance, regulate, reasonable, appropriate and individualized use of prednisone. Keywords prednisone tuberculous exudative pleurisy Key words: R521.7 Document code: A Article ID :1001-7585 (20o5) 12-1431-021993 in January March 2005 of 120 patients in our department tuberculous exudative pleurisy treatment. All cases were based on clinical performance, tuberculin test, chest x ray, pleural effusion routine pathological examination and epidemiological history, proved to be tuberculous exudative pleurisy, and the exclusion of other diseases caused by pleural effusion, 120 patients cases were divided into two groups, 65 patients (treatment group) the use of prednisone combined with anti-TB drugs and treatment of pleural fluid drainage. 55 patients (control group) with anti-TB drugs and treatment pleural fluid drainage. 1 1.1 General information clinical data of 65 cases in treatment group 42 males and 23 female, aged 18-72 years, mean age 38.7 years; one simple tuberculous exudative pleurisy in 21 cases, combined with tuberculous pleurisy 4-4 cases of tuberculosis. Male control group, 37 cases in 55 patients, 18 females, aged 16-68 years, mean age 36.5 years, in which tuberculous exudative pleurisy simple 18 cases of tuberculous exudative pleurisy 37 cases of pulmonary tuberculosis. 1.2 Methods regular use of anti-tuberculosis treatment group therapy,[link widoczny dla zalogowanych], program 2HRSZ (E) / (4-6) HR, Prednisone, and early 30mg Dayton clothing, time 2 weeks later changed to prednisone 20mg Dayton clothing, time of 2 weeks, and finally prednisone lOmg Dayton clothing, time 2 weeks, serving a total of 6 weeks of prednisone, pleural effusion with drainage, 2-3 times per week until the pleural effusion disappeared. Chemotherapy in the control group and treatment group the same as pleural effusion with drainage, 2-3 times per week, until the pleural effusion disappeared. Pleural effusion treatment group lost 1.3 hours of 7-15d, the average time for 12d, 12 patients had pleural thickening, adhesion, formation of 3 cases of pleural effusion package. Tuberculous exudative pleurisy simple new TB patients in 8 cases. Pleural effusion time for the control group lost 8-22d, the average time for 15.5d, 3 patients had pleural adhesions, the formation of pleural effusion in 1 case package, simple tuberculous exudative pleurisy Add tuberculosis in 3 cases. 1.4 Adverse reactions in the treatment group, 9 cases of abnormal liver function, nausea, abdominal distension in 16 patients; according to the group 7 cases of abnormal liver function, nausea, abdominal distension, 12 cases were treated by symptomatic relief of symptoms and Liver , not stopping treatment. 2 discussion tuberculous exudative pleurisy and its metabolites by Mycobacterium tuberculosis highly allergic to the organism into the pleural cavity and pleural disease caused by the body is allergic enhanced onset of tuberculous exudative pleurisy one of the reasons. Treatment must first formal anti-TB,[link widoczny dla zalogowanych], combined with pleural drainage, symptomatic treatment and the use of prednisone treatment can relieve symptoms rapidly absorbed pleural effusion, the paper based on the regular anti-TB pleural fluid drainage and the use of prednisone combined with oral treatment , pleural effusion disappeared time was significantly less than the control group. Prednisone in the treatment of tuberculous exudative pleurisy play a role because the prednisone has anti-inflammatory anti-allergy, reduce the sensitivity of the body, reducing pleural fluid leakage, and promote absorption of pleural effusion, pleural adhesions prevent or mitigate the effects. However, the treatment group were found in the treatment of pleural thickening and pleural adhesion was significantly higher package, considering tuberculous exudative pleurisy in the early, middle, often dominated by inflammatory exudate, pleural effusion early use of hormones to speed up absorption, post- calm with plenty of fibrin fibers in the pleura or the formation of sclerosis,[link widoczny dla zalogowanych], the local blood circulation and lymphatic circulation, so that the pleural thickening and adhesion. Corticosteroids to giant cell phagocytosis and decreased collagen degradation,[link widoczny dla zalogowanych], so that fibrinogen,[link widoczny dla zalogowanych], fibrinolytic activity and reduced collagenase activity, promote collagen formation, accelerated adhesion induced pleural fat. In therapy, hormone therapy group was significantly higher than new pulmonary tuberculosis, and the role of hormones on the immune system suppression, resulting in spread of tuberculosis. 3 Conclusion The treatment of tuberculous exudative pleurisy in the regular use of anti-tuberculosis drugs, combined with pleural drainage and symptomatic treatment of the premise, should assess the situation, regular and rational, individual use of corticosteroids to achieve optimal efficacy and reduce adverse reaction.

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