【Abstract】Objective: to observe the efficacy of microwave-assisted treatment of encapsulated tuberculous pleurisy. Methods: 45 cases of encapsulated tuberculous pleurisy patients hospitalized in our hospital were treated with microwave physiotherapy in the comprehensive treatment of routine anti-TB, pleural fluid extraction and hormone. RESULTS: The disappearance of encapsulated pleural effusion was fast, and the adhesion hypertrophy was obviously reduced, and good clinical results were achieved. CONCLUSION: The efficacy of microwave-assisted treatment of encapsulated tuberculous pleurisy is remarkable. [Keywords] Encapsulated tuberculous pleurisy Tuberculous pleurisy is the pleural inflammatory reaction caused by Mycobacterium tuberculosis and its metabolites entering into the pleural cavity of the organism which is in the state of supersensitivity, and it leads to pleural effusion which is mostly exudate, and therapeutic measures are given to the main treatment of pleural puncture and pumping of night and anti-TB treatment, and at the same time, oral prednisone tablets are taken. If the treatment is not timely and unreasonable, pleural fluid is easy to form parcels, pleural thickening, adhesion, coupled with small and limited fluid volume, thoracocentesis is difficult to bring certain difficulties in clinical treatment. 2008 May ~ 2011 May our hospital auxiliary local microwave physiotherapy 45 cases of parcels of tuberculous pleurisy, achieved better results are reported as follows. 1, data and methods 1.1 Objects: 85 cases of patients diagnosed as tuberculous parcel pleural effusion, manifested by ultrasound or CT examination as different degrees of pleural adhesion, parcels, multiple small room formation, effusion with floating material. Among them, 58 cases were male and 27 cases were female, aged 14-65 years old, with a mean of 35.2 years old, and the course of treatment ranged from 2 to 8 weeks. There was no obvious active tuberculosis foci in the affected lung lobe, except for those with special pleural thickening or pyothorax. The patients were randomly divided into 45 cases in the treatment group and 40 cases in the control group. There was no significant difference between the two groups in terms of gender, age and condition. 1.2 Methods Both the treatment group and the control group were treated with the same anti-TB 2HRZS / 4HR chemotherapy regimen, oral prednisone tablets, pleural fluid extraction and other comprehensive treatments, while the treatment group added microwave physiotherapy. Both groups underwent chest CT scanning and B ultrasound sound wave examination, and the microwave treatment was carried out with the microwave therapy instrument of Shanghai Viscon. The microwave probe was placed on the front and back of the chest at the site of effusion (the side of the chest wall was placed on the side and back of the chest), with a gap of 5-10 cm, a wavelength of 16 cm, and a power of 20-50 W. The microwave treatment was carried out for 30 min each time, once a day, and for 15 days as a course of treatment. Until the pleural fluid is basically absorbed. Ultrasonography was performed every 2 weeks to determine the absorption of pleural fluid. Routine and biochemical examination of pleural fluid was performed in both groups. 2.Results Efficacy evaluation standard: obvious effect: pleural wrapping adhesion completely absorbed, blood sedimentation returned to normal; effective: pleural fluid obviously absorbed, liquid dark area reduced by more than 80%, pleural wrapping adhesion partially absorbed, blood sedimentation significantly reduced; ineffective: pleural water volume and blood sedimentation before and after the treatment did not change. Comparison of the efficacy of the two groups, X2=8.917, P<0.01, the difference is highly significant, the treatment group is better than the control group (Table 1). Table 1 Comparison of the efficacy between the treatment group and the control group (cases, %) Groups Cases Apparent Effective Effective Ineffective Treatment group 45 32(71.11) 12(26.67) 1(2.22) Control group 40 16(40.) 7(17.50) 17(42.5) 3. Discussion The results of this study show that microwave adjuvant treatment of tuberculous pleurisy has significant efficacy in the absorption of tuberculous pleural effusions, reduction of pleural adhesion and encapsulation. There is a significant efficacy. Tuberculous pleural effusion contains fibrin, which is easy to be deposited in the pleura, forming "fibrin moss", acting as a convergent of inflammatory cells, affecting vascular permeability, promoting fibroblast adhesion and proliferation, and generating collagen and mucopolysaccharides, so that the pleura is hypertrophied, adherent, wrapped, and prone to the formation of a small room. In the course of treatment, it is easy to form encapsulated pleural effusion. The fluid is difficult to be absorbed due to the thick wall, plus the small volume of fluid and limited segregation, thoracic puncture is difficult, which brings certain difficulties to the clinical treatment. Slow absorption of effusion is easy to form pleural adhesion and hypertrophy, affecting lung function, microwave has good anti-inflammatory and dehydration effect on local inflammation and edema. Microwave therapy instrument mechanism is: (1) through the improvement of blood circulation, resulting in the organization of the capillary expansion, blood flow greatly strengthened, so that the focal tissues get adequate nutritional supply, promote the cell metabolism and regeneration function, and then produce a series of clinical efficacy; (2) through the improvement of blood circulation, so that a large number of immune function of the material, such as white blood cells and macrophages, immune proteins to reach the inflamed tissues, play a good role in the inflammation and edema, and have good effect on the inflammation. (2) By improving blood circulation, a large number of immune function substances, such as white blood cells and macrophages, immune proteins, etc., can reach the inflamed tissues, and play the roles of antibacterial, sterilizing and removing free radicals. All these effects are conducive to the absorption of effusion, accelerate the recovery of local pathology, shorten the course of the disease, avoid pleural adhesion and excessive hypertrophy, and prevent the lung function from being damaged. It is worth noting that in both clinical and animal experiments, it is observed that the therapeutic effect is more significant for the thin fibrin adhesions, while for the late stage of the disease, a thicker fibrin layer can be formed on the wall layer and the dirty layer, such as CT shows that the pleural thickness is more than 6mm, the therapeutic effect of the microwave may be unsatisfactory, so it is advocated to use it in the early stage. As for the starting time of microwave, there is no clear conclusion, mainly according to the degree of fluid viscosity and adhesion and encapsulation. In conclusion, microwave treatment of tuberculous pleural effusion has the advantages of low price, simplicity, safety, non-invasive, and exact efficacy, which is an effective method for treating encapsulated tuberculous pleural effusion, and it is worthwhile to popularize the application in clinic.