本文選題：結(jié)核性胸膜炎 + 胸腔積液��； 參考：《河北醫(yī)科大學》2017年碩士論文

【摘要】：目的:觀察微波治療、深部熱療輔助治療結(jié)核性胸膜炎的臨床療效,探討微波治療、深部熱療在治療結(jié)核性胸膜炎中的應(yīng)用價值。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醫(yī)院就診的結(jié)核性胸膜炎患者120例,隨機分為三組。對照組:給予常規(guī)治療(包括規(guī)律抗結(jié)核治療、應(yīng)用糖皮質(zhì)激素及積極抽取胸腔積液等)。微波組:在常規(guī)治療基礎(chǔ)上聯(lián)合微波治療。熱療組:在常規(guī)治療基礎(chǔ)上聯(lián)合深部熱療。治療4周后對比三組的治愈率、有效率及胸膜厚度、胸水量、胸水吸收時間臨床療效的差異。結(jié)果:1熱療組及微波組與對照組治療4周后臨床療效比較;對照組治愈率40%(16/40),總有效率65%(26/40);微波治療組治愈率45%(18/40),總有效率75%(30/40);微波組治愈率較對照組無差異(P=0.651),總有效率較對照組無差異(P=0.884);熱療組治愈率65%(26/40),總有效率90%(36/40),熱療組在治愈率(P=0.025)及總有效率(P=0.029)方面均明顯優(yōu)于對照組。深部熱療較微波治療在治愈率(P=0.072)及總有效率(P=0.077)無差異。2對照組胸水吸收時間為22.45±5.17天,微波組胸水吸收時間20.45±4.22天,微波組較對照組胸水吸收時間略有縮短(P=0.062);熱療組胸水吸收時間為18.18±3.86天,與對照組、微波組胸水吸收時間相比明顯縮短(P分別為0.000,0.014)。3四周后對照組胸膜肥厚程度為10.53±7.81mm,微波組胸膜肥厚程度為7.95±9.99mm,微波組較對照組胸膜肥厚程度略減輕(P=0.131)。熱療組胸膜肥厚程度為4.80±4.91mm,較微波組胸膜肥厚程度減輕(P=0.025),較對照組胸膜肥厚程度明顯減輕(P=0.000)。結(jié)論1深部熱療及微波治療均能夠減輕胸膜增厚,縮短胸水吸收時間,提高臨床有效率及治愈率;2深部熱療較微波治療更易促進結(jié)核性胸膜炎胸水吸收,減輕胸膜肥厚,而在治愈率及有效率方面無明顯優(yōu)勢。
[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 鹵5.17 days, and in the microwave group was 20.45 鹵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 鹵3.86 days, and that in the control group was 18.18 鹵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 鹵7.81 mm, and that in microwave group was 7.95 鹵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 鹵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.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R521.7

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