Tuberculosis encapsulated pustule is a regression limited lesion that cannot be completely absorbed after active anti-tuberculosis treatment, repeated chest puncture or tube drainage of tuberculosis pleurisy, mostly formed after six months of treatment, and can be clearly diagnosed by chest CT examination. The best treatment option is to perform surgical intervention for TB lesion removal and fibrous plate debridement in a timely manner after active medical treatment for TB that cannot be completely absorbed or calcified, and the timing of surgery is more than half a year after effective anti-TB treatment, and the chronic abscess chest has been basically controlled, with the daily pus volume within 50 ml, but the pus cavity still exists and the pus continues to flow; the thorax is collapsed, and there is no extensive lesion in the lung and no large bronchopleural fistula. Pleural fibrous plate stripping is feasible for chronic abscess chest without extensive lesions in the lung and without large bronchopleural fistulas. We can perform the fibrous plate debridement and lesion removal under general anesthesia with intubation, which can not only make the postoperative anti-tuberculosis treatment more effective and shorten the course of treatment, but also improve the function of the affected lung and correct the collapsed deformity of the thorax to a certain extent. Pre-operative preparation: assessment of general condition such as liver, kidney, heart and other important organ function, blood routine, coagulation four and infectious five, etc., in-depth examination if necessary, assessment of surgical organs and the disease such as tuberculosis poisoning symptoms, blood sedimentation changes, anti-tuberculosis treatment, lung function, etc., to understand the timing of surgery, according to the patient’s imaging, symptoms and signs and preoperative tracheoscopy and melanography to determine the presence of pneumothorax and bronchopleural fistula If the lung is inflamed and the bronchus is inflamed, the fistula is easily caused after resection, prophylactic antibiotics are applied, anti-tuberculosis treatment is continued, the size and scope of the abscess cavity is determined by chest CT examination and the lung situation is understood. The plasma was replaced by Hershey’s plasma, and the instruments used for surgery were selected one day before surgery. Anesthesia: General anesthesia by endotracheal intubation, single-lung isolation by double-lumen bronchial intubation if necessary. Surgical procedure: 1. Lateral position: After anesthesia, the body was positioned with a small square pillow under the axilla to avoid pressure on the axillary vein, a small square pillow at the hip, a long garden pillow on each side and fixed with a bed sheet, the abdomen and the hip were fixed with a fixed frame, and the posterior lateral incision was made, and the ribbed bed and the mural pleural fiberboard were cut with an electric knife in the corresponding area. 2.Separate the wall fiber plate above and below, use rib retractor to open the rib bed and wall pleural fiber plate incision, and enter the pus cavity after puncture. 3, quickly aspirate the pus, use electric knife or blade to carefully make a small “+” incision in the center of the dirty layer of the fiber plate until the dark brown lung tissue can be seen. 4, with tissue forceps clamped fiber plate incision edge, carefully peeled with stripper close to the fiber plate, stripper force direction should be toward the fiber plate, not to the lung force, so as not to puncture the lung tissue. After peeling away part of the lung tissue, the index finger can also be used for blunt separation. The dirty fibrous plate is cut while peeling. Describe the site and size of the pus cavity in different patients. 5.If the fiber plate is too tightly adhered to the lung and cannot be peeled off, it can be cut at its edge and peeled off by bypassing the adherent area so that the adherent area is left on the lung surface in isolation. 6, pus cavity edge reflex migration at the fiber plate is often thick, the lung mediastinal surface and the adhesions between the lung fissures, should also be stripped, so that the lung can maximize the expansion. If there is a bronchopleural fistula on the lung surface, the edge of the fistula should be excised and sutured. 7. The fibrous plates covering the diaphragmatic surface, the cardiodiaphragmatic angle and the rib diaphragm angle should also be peeled off to facilitate recovery of diaphragmatic function. If there is more bleeding on the surface of the diaphragm, sutures should be made to stop the bleeding. The small tidal volume of ventilation not only has space, and in the lung expansion peel off a certain amount of confrontation easy to peel off than the single lung ventilation is good, will be gradually anesthetized expansion of the lung with air leakage or tear given to repair sutures, rinsing, warm saline hemostasis, incision above and below each placed drainage tube, placed in the direction of the opening tunnel, above up against the anterior chest wall, below the diaphragm above. The incision was tightly sutured, and the intercostal muscles above and below the broken ends of the ribs were first sutured to avoid postoperative bleeding from punctured intercostal vessels. Postoperative treatment: 1. Take the slope position after surgery. 2.Keep the closed drainage of the chest cavity unobstructed after surgery, closely observe the flow of drainage and fluctuation of fluid injection, and generally withdraw the tube in 5-7 days after surgery when the drainage is less than 50ml. 3.After extubation, if there is still fluid and gas in the chest cavity, it should be removed by puncture in time. 4.Encourage deep breathing, coughing and ballooning for the injured and sick, and get out of bed early to promote lung expansion. 5.Apply antimicrobial agents systemically to prevent and control infection.