Intrapleural urokinase versus normal saline in the treatment of complicated parapneumonic effusions and empyema. A randomized, double-blind study.

摘要: Intrapleural administration of fibrinolytic agents has been shown to be effective and safe in the treatment loculated parapneumonic pleural effusions. However, controlled studies possible role activity urokinase (UK) through volume effect are lacking. We therefore investigated hypothesis that UK is lysis adhesions not effect. Thirty-one consecutive patients with multiloculated effusions were randomly assigned receive either intrapleural (15 patients) or normal saline (NS) (16 for 3 d, a double-blind manner. All had inadequate drainage chest tube (< 70 ml/24 h). was given daily dose 100.000 IU diluted 100 ml NS. Controls same NS intrapleurally. Response assessed by clinical outcome, fluid drainage, radiography, ultrasonography (US) and/or computed tomography (CT). Clinical radiographic improvement noted all but two group only four control group. The net mean drained during 3-d period significantly greater (970 +/- 75 versus 280 55 ml, p < 0.001). Pleural complete 13 (86.5%) (two treated video-assisted thoracoscopy) (25%) Twelve subsequently six them drainage; remaining after thoracoscopy. Our results suggest