膿胸時Streptokinase-Streptodornase之使用

Use of Streptokinase and Streptodornase in the Treatment of Pyothorax

錢光新(Kouang-Sing Tsien) ； 陳武雄(Wu-Shoung Chen)

《Acta Paediatrica Sinica》 9卷4期 (1968/12) Pp. 203-211

摘要

著者報告曾因各種原因使用SK-SD胸膜腔內注入法治療26例膿胸，共使用66次，其中男17例，女9例，年齡自2½月至12歲11月。使用藥量SK大部分為50,000至100,000u.SD大部分為12,500至25,000u.所有病孩，除1例外皆有胸腔管。SK-SD在胸膜腔內停留時間大部分為3～4小時至18小時，使用次數大多數病例為4次以下，但亦有多達7次者。
使用結果在X光檢查可見之效果很好者有6例(23%)，中度者有8例(31%)，輕微者有6例(23%)，無可見效果者有6例(23%)。對胸膜腔膿液效用良好者有22例(84.6%)，不佳者3例(11.5%)，不明者1例(3.9%)。對發熱效用很好者有9例(35%)，效用中度者8例(31%)，無可見效用者5例(19%)，4例(15%)則效用不明。最後一般結果良好，並無死亡者。
使用SK-SD 66次後之副作用發熱者有44次，用後有出血現象者26例中有5例，但並不嚴重，能訴痛者14例中訴胸痛者有8例。
一般而言，如需用SK-SD，胸膜腔內停留時間較久，使用次數較多時有較佳效果。

並列摘要

The authors report 26 cases of pyothorax treated, for various reasons, with all together 66 intrapleural administrations of streptokinase-streptodornase (SK-SD). 17 patients were male and 9 were female. Their ages ranged from 2½ months to 12 years and 11 months. The dosages for single administration were mostly 50000-100000 u. of SK and 12500-25000 u. of SD. All but one patient had chest tube drainage when SK-SD was used. In most cases, SK-SD was administered for 1 to 4 times and kept in pleural cavity for 3 to 18 hours each time,
The effects visible on roentgenologic examination were excellent in 6 cases (23%), good in 8 cases (31%), slight in 6 cases (23%), nil in 6 cases (23%). The results concerning the pleural fluid were good in 22 cases (84.6%), not good in 3 cases (11.5%), not clear in 1 case (3.9%). Fever subsided within 3 days after the treatment in 9 cases (35%), within 3-5 days in 8 cases (31%), beyond 5 days in 5 cases (19%) and not clear in 4 cases (15%). The end results were favorable iii all cases
As to the sile effects of SKSD, fever occurred following 44 of the 66 intrapleural administrations. The pleural fluids in 5 cases became sanguineous after the use of SKSD, without serious consequences. Among 14 cases who were able to communicate their feelings, 8 complained of chest pain after the use of SK-SD.
Generally speaking, it seemed that intrapleural administrations of SK-SD for the treatment of pyothorax, showed better results when SK-SD was more often administered and kept longer in the pleural cavity.