微波及深部热疗辅助治疗结核性胸膜炎的疗效观察

发布时间：2018-05-16 17:05

本文选题：结核性胸膜炎 + 胸腔积液　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:观察微波治疗、深部热疗辅助治疗结核性胸膜炎的临床疗效,探讨微波治疗、深部热疗在治疗结核性胸膜炎中的应用价值。方法:收集2016年1月1日至2016年12月31日于保定市第二中心医院就诊的结核性胸膜炎患者120例,随机分为三组。对照组:给予常规治疗(包括规律抗结核治疗、应用糖皮质激素及积极抽取胸腔积液等)。微波组:在常规治疗基础上联合微波治疗。热疗组:在常规治疗基础上联合深部热疗。治疗4周后对比三组的治愈率、有效率及胸膜厚度、胸水量、胸水吸收时间临床疗效的差异。结果:1热疗组及微波组与对照组治疗4周后临床疗效比较;对照组治愈率40%(16/40),总有效率65%(26/40);微波治疗组治愈率45%(18/40),总有效率75%(30/40);微波组治愈率较对照组无差异(P=0.651),总有效率较对照组无差异(P=0.884);热疗组治愈率65%(26/40),总有效率90%(36/40),热疗组在治愈率(P=0.025)及总有效率(P=0.029)方面均明显优于对照组。深部热疗较微波治疗在治愈率(P=0.072)及总有效率(P=0.077)无差异。2对照组胸水吸收时间为22.45±5.17天,微波组胸水吸收时间20.45±4.22天,微波组较对照组胸水吸收时间略有缩短(P=0.062);热疗组胸水吸收时间为18.18±3.86天,与对照组、微波组胸水吸收时间相比明显缩短(P分别为0.000,0.014)。3四周后对照组胸膜肥厚程度为10.53±7.81mm,微波组胸膜肥厚程度为7.95±9.99mm,微波组较对照组胸膜肥厚程度略减轻(P=0.131)。热疗组胸膜肥厚程度为4.80±4.91mm,较微波组胸膜肥厚程度减轻(P=0.025),较对照组胸膜肥厚程度明显减轻(P=0.000)。结论1深部热疗及微波治疗均能够减轻胸膜增厚,缩短胸水吸收时间,提高临床有效率及治愈率;2深部热疗较微波治疗更易促进结核性胸膜炎胸水吸收,减轻胸膜肥厚,而在治愈率及有效率方面无明显优势。
[Abstract]:Objective: to observe the clinical effect of microwave therapy and deep hyperthermia therapy in the treatment of tuberculous pleurisy and to explore the application value of microwave therapy and deep hyperthermia in the treatment of tuberculous pleurisy. Methods: from January 1, 2016 to December 31, 2016, 120 patients with tuberculous pleurisy were randomly divided into three groups. Control group: routine treatment (including regular antituberculous therapy, glucocorticoid and active pleural effusion, etc. Microwave group: combined with microwave therapy on the basis of routine therapy. Hyperthermia group: combined with deep hyperthermia on the basis of routine therapy. The curative rate, effective rate, pleural thickness, hydrothorax volume and the time of hydrothorax absorption were compared between the three groups after 4 weeks of treatment. Results the clinical efficacy of the control group and the microwave group were compared after 4 weeks of treatment. The cure rate of the control group was 40%: 16 / 40%, the total effective rate was 65% / 40%; in the microwave treatment group, the cure rate was 45 / 18 / 40%, and the total effective rate was 7530 / 40%; the cure rate in the microwave group was not different from that in the control group (P < 0. 651), but the total effective rate was no different from that in the control group (P 0. 884); in the hyperthermia group, the cure rate was 6526 / 40%, the total effective rate was 9036 / 40%, and the cure rate in the hyperthermia group was 90 36 / 40%. The rate of P0. 025) and the total effective rate of P0. 029) were significantly better than those of the control group. There was no difference in the cure rate and the total effective rate between deep hyperthermia and microwave therapy. 2 the time of hydrothorax absorption in the control group was 22.45 卤5.17 days, and in the microwave group was 20.45 卤4.22 days. The time of hydrothorax absorption in the microwave group was slightly shorter than that in the control group, and that in the hyperthermia group was 18.18 卤3.86 days, and that in the control group was 18.18 卤3.86 days. The absorption time of pleural effusion in microwave group was significantly shorter than that in microwave group (P = 0.000) 0.014.3 weeks later, the degree of pleural hypertrophy in control group was 10.53 卤7.81 mm, and that in microwave group was 7.95 卤9.99 mm. The degree of pleural hypertrophy in microwave group was slightly less than that in control group. The degree of pleural hypertrophy in the hyperthermia group was 4.80 卤4.91 mm, which was less than that in the microwave group (0.025 mm) and the degree of pleural hypertrophy in the control group (0.000mm). Conclusion (1) Deep hyperthermia and microwave therapy can reduce pleural thickening, shorten the time of pleural effusion absorption, improve the clinical effective rate and cure rate. Compared with microwave treatment, deep hyperthermia can promote pleural effusion absorption and reduce pleural hypertrophy. There was no obvious advantage in cure rate and effective rate.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R521.7

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