Abstract
Objective:To explore the clinical effect of central venous catheter closed thoracic drainage in the treatment of tuberculous pleurisy.Methods:One hundred and four patients with tuberculous pleurisy who were admitted to Binzhou People’s Hospital from August 2016 to August 2017 were divided into a control group and a treatment group according to random number table method, 52 each. The control group was treated with conventional pleural puncture and drainage, while the treatment group was treated with closed central venous catheter based thoracic drainage. The clinical efficacy, improvement time of clinical symptoms, total volume of drainage, pleural thickness, and improvement of quality of life and occurrence of adverse reactions were compared between the two groups.Results:Pleural effusion, fever and chest tightness of the treatment group disappeared earlier (P<0.05); the hospitalization time in the treatment group was less than that in the control group (P<0.05); the total amount of drainage in the treatment group was lower than that in the control group (P<0.05); the pleural thickness of the treatment group was higher than that in the control group (P<0.05); the quality of life score in the treatment group was significantly higher than that in the control group (P<0.05). The total effective rates of the treatment group and the control group were 93.5% and 85%, respectively, with a significant difference (P<0.05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group, with a significant difference (P<0.05).Conclusion:Central venous catheter based closed thoracic drainage is more effective than conventional thoracic puncture and drainage in the treatment of tuberculous pleurisy. It can accelerate the improvement of clinical symptoms, improve the quality of life of patients, and reduce the incidence of complications. It is worth popularizing and applying.
Highlights
Tuberculous pleurisy is a pleural specific inflammatory reaction caused by the entry of tuberculosis bacillus and its metabolites into highly allergic pleural cavity
Patients with tuberculous pleurisy have high fibrin content in pleural effusion, Pak J Med Sci July - August 2019 Vol 35 No 4 www.pjms.org.pk 1024 which is easy to separate and form multilocular effusion deposited in pleura to aggravate pleural inflammation, inhibit the permeability of pleural vessels, induce pleural thickening, encapsulation and adhesion, and lead to dyspnea and pulmonary dysfunction.[2,3]
To further understand the clinical effect of central venous catheter based closed thoracic drainage in the treatment of tuberculous pleurisy, this study studied tuberculous pleurisy patients who underwent central venous catheter based closed thoracic drainage and analyzed the clinical efficacy
Summary
Tuberculous pleurisy is a pleural specific inflammatory reaction caused by the entry of tuberculosis bacillus and its metabolites into highly allergic pleural cavity. The treatment principle of tuberculous pleurisy is thoracic drainage, emptying inflammatory factors and fibrin, and giving necessary anti-tuberculosis drugs.[4] The active pleural effusion emptying can reduce the toxic symptoms of tuberculosis virus, relieve the pressure of pleural effusion on the heart and lung lobes, thereby improving the function of the heart and lung.[5] In the conventional thoracic puncture and drainage, 2-3 times of puncture per week was needed This kind of repeated puncture is very harmful to patients, and due to the limitation of puncture means, drainage cannot be completely emptied, which may slow treatment progress and aggravate clinical symptoms.[6,7] In recent years, a study has shown that central venous catheter drainage on the basis of standardized antituberculosis treatment can reduce inflammation by eliminating pleural effusion quickly and early.[8] Central venous catheter based closed thoracic drainage successfully overcomes the shortcomings of traditional drainage, such as time-consuming, laborious, small volume of drainage and large trauma. The drainage is continuous and the fluid flow can be controlled; the drainage is more complete.[9,10]
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