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过渡性儿科 empyema 管理: tPA 和 DNase 与手术干预相比,对tPA和DNase的比较疗效分析

Henri Haapanen¹, Antti Huuskonen¹, Tea Nieminen²

¹New Children's Hospital, Surgery and Anaesthesia Unit, Cardiothoracic Surgery, Helsinki, Finland.

Journal of pediatric surgery

|November 13, 2025

概括

组织等离子素激活剂 (tPA) 和多尔纳斯α (DNase) 组合疗法为治疗儿科瘤提供了安全有效的替代方案. 与手术相比,这种方法导致重症监护室的入院和治疗费用较低.

科学领域:

儿科肺病学儿科肺病学
胸部外科手术胸部外科手术
药理干预药理干预

背景情况:

儿科医生 empyema 是儿童发病的一个重要原因.
也给医疗保健系统带来了相当大的财务负担.
评估新型治疗策略对于改善患者的治疗结果和降低医疗保健成本至关重要.

研究的目的:

为了比较结合组织等离子体激活剂 (tPA) 和多尔纳斯α (DNase) 治疗与手术干预 (VATS/胸切除术) 的疗效,用于儿科肺炎.
评估纤维溶解药物治疗对住院时间,ICU入院率,再干预率,治疗费用和瘤复发的影响.
在儿科队列中研究与tPA + DNase疗法相关的学习曲线.

主要方法:

87名儿科患者的回顾性队列研究 (2018年1月至2024年12月).
患者被分为手术治疗 (n=43) 和tPA + DNase治疗 (n=44) 组.
纤维溶解组进一步分析了初始 (n=22) 和最新 (n=22) 时期,以评估学习曲线.

主要成果:

住院时间在两组之间是相似的 (10天对11天,p=0.086).
tPA + DNase 组显示了显著较低的ICU入院率 (13.6%对34.8%,p=0.019) 和治疗成本 (27,523欧元对32,628欧元,p=0.011).
虽然纤维解毒剂组最初的再干预率较高 (36.0%),但在最近一段时间内显著下降 (9.1%,p=0.034),这表明学习曲线.

结论:

结合tPA和DNase治疗是一种安全有效的治疗选择,用于儿科.
纤维溶解疗法在降低ICU入院和医疗保健成本方面具有优势.
对于tPA + DNase疗法存在学习曲线,随着时间的推移观察到改善的结果.

关键词:

达尔纳酶α是一种多纳酶.肺炎是一种肺炎.进行胸腔切除术 (thoracotomy).组织等离子素激活剂增值税增值税是一个

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