Treatment of multilocular encircled pleural effusion with ultrasound-guided drainage and urokinase injection

Objective To study the efficacy of ultrasound-guided drainage and urokinase injection to the pleural cavity in treatment of multilocular encircled pleural effusion. Methods Seventy-six patients with multilocular encircled pleural effusion were randomly divided into treatment (n=40) and control (n=36) groups, and then divided into A and B in treatment group, C and D in control group. Patients in treatment group were treated with ultrasound-guided drainage, followed by intrapleural injection of 125, 000 IU urokinase (diluted by 50 ml normal saline), including 14 patients with pleural thickness5 mm (group B). The 36 patients in control group were treated with chest drainage only, including 13 patients with pleural thickness5 mm (group D). After 24 hours, the chest drainage was repeated, and the volume of the chest drainage and the thickness of pleura were measured, and cellulose was separated. The differences of their values before and after treatment were tested by univariate ANOVA. Results The efficacy in group A was better than that in B, C and D groups, such as increase of the volume of chest drainage, thiness of pleural and decrease cellulose separate after cure. The value before urokinase injection was significantly different from that after the first injection (P0.05). The result in group B was the same as that in group C and group D. Conclusion The therapy with chest drainage and injection of urokinase into the chest is a good measure for draining the pleural effusion and reducing the pleural thickness, but it is ineffective in the patients with pleural thickness5 mm.