Tuberculous pleural effusion has a high fibrin content, which tends to form hypertrophy and adhesions. Fibrin in the pleural cavity for too long can easily lead to pleural hypertrophy and adhesions, forming encapsulated effusions, and in some cases, forming abscess chests, requiring surgical treatment. Early standardized treatment, timely placement of a central venous catheter in the chest cavity to remove pleural fluid, and timely injection of fibrinogen activator, anti-tuberculosis drugs and hormones into the chest cavity can reduce the occurrence of pleural hypertrophy and adhesions. Tuberculous pleurisy is an inflammation of the pleura caused by Mycobacterium tuberculosis and its metabolites entering the pleural cavity in a sensitive state or directly infecting the pleura. The clinical manifestation is a large accumulation of fluid in the pleural cavity. The pathogenesis is closely related to the type of Mycobacterium tuberculosis infection and the immune function of the patient. Clinically, tuberculous pleurisy is divided into three types: dry, exudative, and tuberculous pustular pleura, because tuberculous pleural effusion is exudative fluid with more inflammatory components in the pleural fluid, which tends to form wrapping and adhesions, resulting in pleural hypertrophy and pleural adhesions. Therefore, the treatment of tuberculous pleurisy should be based on regular anti-tuberculosis treatment to reduce the retention time of pleural fluid in the pleural cavity as soon as possible, which is the main method to reduce pleural hypertrophy and pleural adhesions. Once the best time for treatment is missed and the disease is delayed, the course of the disease will be prolonged and most patients will develop pleural adhesions and pleural hypertrophy, and some patients will need surgical treatment. Due to the lack of awareness of tuberculous pleurisy in primary hospitals, only anti-tuberculosis treatment is given, and no attention is paid to removing pleural fluid as soon as possible, resulting in many patients coming to our hospital with chest adhesions and pleural hypertrophy, and individual patients forming bronchopleural fistula and tuberculous abscess chest. In 2003, our hospital started to apply central venous catheter placement to drain pleural fluid for the treatment of patients with tuberculous pleurisy with moderate or above pleural effusion, which is simple to operate, has short puncture time, causes fewer complications such as pneumothorax and pleural reaction, is well tolerated by patients, can avoid multiple thoracentesis and aspiration, and speeds up the absorption of pleural fluid. It is reported as follows. 1.Data and methods 1.1 …. General data From May 2003 to May 2010, 198 patients with tuberculous pleurisy were admitted to our hospital, 112 males and 86 females. Pleural effusion: 106 cases on the left side, 92 cases on the right side; 55 cases with massive pleural fluid, 120 cases with moderate pleural fluid, and 23 cases with small amount of pleural fluid. The above 198 patients were randomly divided into 2 groups: 99 patients in the central venous catheter placement group, 59 males and 40 females, with an average age of (30.2±8.4) years; 99 patients in the conventional thoracentesis group, 53 males and 46 females, with an average age of (39.8±7.5) years. 1.2 …. Treatment All patients in the two groups were treated with chemotherapy using the 2HRZV/9HRE anti-tuberculosis regimen, with the addition of prednisone orally at a starting dose of 30.mg per day, taken in the morning, and then the dose was reduced by 5.mg per week after 2 weeks of application, and prednisone was generally discontinued within 6 weeks. Some patients with more severe thoracic adhesions require a longer course of hormone therapy. In the conventional thoracentesis group, thoracentesis was performed 2 to 3 times a week, and the total amount of fluid withdrawn did not exceed 800.mL. The chest drainage tube could be removed and the chest ultrasound could be reviewed if there was no significant increase in chest fluid. no chest irrigation and drug injection were performed in both groups. 1.3 …. The chest ultrasound was performed weekly in both groups to determine the absorption of pleural fluid, and the chest X-ray and chest ultrasound were repeated at the end of the first month to observe the degree of pleural hypertrophy and chest adhesions. 1.4 …. The efficacy was judged as effective: the pleural fluid basically disappeared, chest X-ray and B ultrasound showed no obvious pleural hypertrophy and pleural adhesions; effective: the pleural fluid basically disappeared, but there were some pleural hypertrophy and pleural adhesions; ineffective: the pleural fluid partially remained, and the pleural hypertrophy was greater than 3.mm as shown by B ultrasound. 1.5 …. Statistical methods used χ2 test, P<0.05 as the difference is statistically significant. 2, Results 2.1... .2 Comparison of the total efficiency of the groups The total efficiency of the central venous catheter placement group was 91.9%, and the total efficiency of the conventional thoracentesis group was 72.7%, and the central venous catheter placement group was better than the conventional thoracentesis group (P<0.01). See Table 1. 2.2... The incidence of pleural hypertrophy and adhesions at the end of 1 month was 20.2% in the group with central venous catheter placement and 35.4% in the group with conventional thoracentesis. The central venous catheter placement group was significantly lower than the conventional thoracentesis group (P<0.05). The clinical manifestation of tuberculous pleurisy is a large amount of fluid in the pleural cavity, and a large amount of pleural fluid can cause local lymphatic and blood circulation disorders in the pleura, leading to pleural fluid exudation and aggravating the inflammatory anti Table 111112 Comparison of the total effective rate of the group Group Number of cases Significantly effective and ineffective Total effective rate (%) Central venous catheter placement group 99 66 25 8 91.9 Conventional thoracentesis group 99 45 27 27 72.7 χ2 12.53P < 0.01 Table 211112 Comparison of the incidence of pleural hypertrophic adhesions at the end of 1 month of group treatment Group Number of cases Number of cases of pleural hypertrophic adhesions at the end of 1 month Incidence of pleural hypertrophic adhesions (%) Central venous catheter placement group 99 20 20.2 Conventional thoracentesis group 99 35 35.4 χ2 5.66P < 0.05 should, forming a vicious circle. Failure to extract pleural fluid in time after the onset of disease is a key factor leading to pleural hypertrophy and pleural adhesions. The benefits to patients of reducing the retention time of pleural fluid in the chest cavity as soon as possible include: it can reduce the symptoms of fever, chest suffocation and tightness of air, and improve the hypoxic state of patients; it can reduce the more inflammatory components in the pleural fluid and avoid the formation of extensive adhesions. At present, the clinical treatment of tuberculous pleurisy mostly adopts systemic anti-tuberculosis chemotherapy with short-term application of hormones. When available, thoracentesis is used to extract pleural fluid, but for small amounts of pleural fluid, thoracentesis is not available. In recent years, closed drainage of the chest cavity has also been used to treat tuberculous pleurisy, which has achieved good results but generally requires surgical treatment. In our hospital, on the basis of systemic antituberculosis nuclear chemotherapy with short-term hormone application, we applied central venous catheter placement for chest drainage and performed a control analysis with the conventional thoracentesis method for the treatment of tuberculous pleurisy. The long-term and short-term efficacy of the two methods was observed, and it was concluded that central venous catheter placement for chest drainage could promote the absorption of pleural fluid and reduce pleural hypertrophy and chest adhesions more quickly than conventional thoracentesis. The central venous catheter placed into the chest cavity for drainage can minimize the fluid accumulation, and the pleural fluid disappeared around 101 d after the central venous catheter placed into the chest cavity for drainage, an average of 51 d earlier than the conventional puncture and aspiration method; the conventional thoracentesis caused more pleural hypertrophy and pleural adhesions due to repeated aspiration and slower absorption of pleural fluid. Patients with pleural adhesions and pleural hypertrophy can be treated with thoracic irrigation through central venous catheter and thoracic injection of fibrinogen activator, anti-tuberculosis drugs, hormones and other drugs as adjunctive therapy. In contrast, conventional thoracentesis is difficult to puncture in patients with thoracic adhesions and pleural hypertrophy, resulting in thoracic irrigation and thoracic injection not being possible. It can be seen that the effect of central venous catheter placement for chest drainage is better than that of conventional thoracentesis in the treatment of tuberculous pleurisy above the equivalent amount in pleural water, and can be widely promoted in clinical practice.