Central venous catheter inserted into thoracic cavity combining with sodium hyaluronic acid reduces residual pleural thickening of tuberculous pleurisy

Objective To investigate the effect of intrathoraeic injection sodium hyaluronie acid on prevention of residual pleural thickening(RPT)of pleural effusions of tuberculous pleurisy after central venous catheter were inserted into thoracic cavity and pleural fluid were completely drained and to discuss its mechanisms.Methods Sixty-four patients with tuberculous pleurisy,defined as middle to large plerural effusions,were randomized into two groups.Patients in treat group were inserted into central venous catheter and after complete drainage,sodium hyaluronic acid 2.5 ml was put into pleural cavity.Patients in control group rcecived routine thoracentesis and 2.5 ml normal saline was introduced into pleural cavity as the second thoracentesis.The patients of two groups all received identical standard antituberculosis drug treatment including 2HRZE/4HR.Before HA use and after 72 hours of HA use and after three months of HA use,residual pleural thickening of patients in both groups were measured respectively.Results Fifty-nine patients were finally introduced into analysis.The beginning relieving time of dyspnoea,fever time,pleural fluid complete drainage time and the days of hospital stay in treat group were lower than those in control group(P＜0.01 or P＜0.05).Drainage amount of pleural fluid in treat group was higher than that in control group(P＜0.05).Compared with control group,therapeutic regimen of treat group can significantly reduce the level of LDH,TP and WBC of pleural effusion.RPT after 72 hours and three months of HA use in treat group were lower than those in control group[(5.75±2.10)mm vs(8.29±2.62)mm,(3.81±2.42)mm vs(7.47±2.85)mm](all P＜0.01).Conclusions Central venous catheter inserted into thoracic cavity combining with sodium hyaluronie acid can release dyspnoea due to pleural effusion,shorten the days of hospital stay,reduce the degree of RPT of tuberculous pleurisy. Key words: Tuberculosis/Pleural; Hyaluronic acid; Central venous catheter; Pleural thickening