The Effects of Urokinase Instillation Therapy via Percutaneous Transthoracic Catheter in Loculated Tuberculous Pleural Effusion: A Randomized Prospective Study
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Abstract
The purpose of this study was to propose that intrapleural urokinase (UK) instillation could reduce pleural thickening in the treatment of loculated tuberculous pleural effusion. Forty- three patients who were initially diagnosed as having loculated tuberculous pleural effusion were assigned at random to receive either the combined treatment of UK instillation including anti-tuberculosis agents (UK group, 21 patients) or strictly the unaccompanied anti-tuberculous agents (control group, 22 patients). The UK group received 100,000 IU of UK dissolved in 150ml of normal saline daily, introduced into the pleural cavity via a pig-tail catheter. The control group was treated with anti-tuberculous agents, excepting diagnostic thoracentesis. After the cessation of treatment, residual pleural thickening (RPT) was compared between the two groups. Clinical characteristics and pleural fluid biochemistry were also evaluated. The RPT (4.59±5.93mm) of the UK group was significantly lower than that (18.6±26.37mm) of the control group (p<0.05). The interval of symptoms observed prior to treatment of patients with RPT ≥10mm (6.0±3.4 wks) was detected to be significantly longer than in those with RPT<10mm (2.1±1.2wks) in the control group (p< 0.05). However, there were no discernible differences were seen in the pleural fluid parameter in patients with RPT≥10 mm, as compared to patients with RPT<10mm in the UK group. These results indicate that the treatment of loculated tuberculous pleural effusion with UK instillation via percutaneous transthoracic catheter can cause a successful reduction in pleural thickening.
참고문헌 (25)
- "The relationship between pleural fluid findings and the development of pleural thickening in patients with pleural tuberculosis", 100, pp.1264~1267 (1991)
- "Clinical and pathological features of tuberculous pleural effusion and its long-term consequences", 58, pp.171~175 (1991)
- "Reactivation disease: the commonest form of tuberculous pleural effusion in Edinburgh, 1980-1991", 88, pp.301~304 (1994)
- "Are pleural fluid parameters related to the development of residual pleural thickening in tuberculosis?", 112, pp.1293~1297 (1997)
- "Factors associated with pleural thickening in pleural tuberculosis. Review of 99 cases", 13, pp.364~368 (1996)
- "Corticosteroids in the treatment of tuberculous pleurisy: a double-blind, placebo-controlled, randomized study", 94, pp.1256~1259 (1988)
- "Randomised trial of corticosteroids in the treatment of tuberculous pleurisy", 50, pp.1305~1307 (1995)
- "Corticosteroids in the treatment of tuberculous pleurisy. A double-blind, placebo-controlled, randomized study", 110, pp.333~338 (1996)
- "Prevention of pleural thickening through pleural aspiration in patients with tuberculous effusion", 15, pp.180~184 (1989)
- "Treatment of loculated pleural effusions with transcatheter intracavitary urokinase", 153, pp.941~945 (1989)
- "Treatment of thoracic multiloculated empyemas with intracavitary urokinase: a prospective study", 179, pp.771~775 (1991)
- "Intrapleural urokinase for loculated effusion", 101, pp.1467~1469 (1992)
- "Intrapleural urokinase in the treatment of loculated pleural effusions", 105, pp.868~873 (1994)
- "Treatment of complicated pleural fluid collections with image-guided drainage and intracavitary urokinase", 108, pp.1252~1259 (1995)
- "Intrapleural urokinase in the treatment of complicated parapneumonic pleural effusions and empyema", 9, pp.1656~1659 (1996)
- "Transcatheter instillation of urokinase into loculated pleural effusion: analysis of treatment effect", 167, pp.649~652 (1996)
- "Treatment of loculated pleural effusion with intrapleural urokinase in children", 32, pp.1473~1475 (1997)
- "Intrapleural urokinase versus normal saline in the treatment of complicated parapneumonic effusions and empyema: a randomized, double-blind study", 159, pp.37~42 (1999)
- "Intrapleural fibrinolytic treatment of multiloculated thoracic empyemas", 57, pp.803~814 (1994)
- "Intrapleural fibrinolytics in management of empyema thoracis", 110, pp.102~106 (1996)
- "Utility of fibrinolytic agents for draining intrapleural infections", 14, pp.39~47 (1999)
- "Use of purified streptokinase in empyema and hemothorax", 161, pp.560~562 (1991)
- "Early administration of intrapleural streptokinase in the treatment of multiloculated pleural effusions and pleural empyemas", 44, pp.252~256 (1996)
- "Randomised controlled trial of intrapleural streptokinase in community acquired pleural infection", 52, pp.416~421 (1997)
- "Intrapleural streptokinase versus urokinase in the treatment of complicated parapneumonic effusions: a prospective, double-blind study", 155, pp.291~295 (1997)