OBJECTIVETo observe the clinical effect of central venous catheter in the treatment of refractory pleural effusion and pneumothorax.

METHODSPatients with coal workers' pneumoconiosis-tuberculosis complicated by pleural effusion or pneumothorax were randomly divided into central venous catheter group (48 cases, treated by chest drainage using a peripherally inserted central catheter) and conventional puncture group (56 cases, treated by conventional pleural puncture). Chemotherapy (DOTS strategy) was fully supervised, and both groups used 3HRZE/6HR (H, isoniazid; R, rifampicin; Z, pyrazinamide; E, ethambutol).

RESULTSIn the central venous catheter group, catheterization in the thoracic cavity was performed once in all cases, without fall-off; the mean total volume of pumped effusion was 3932±4430 ml; the time to disappearance of pleural effusion and pneumatosis was 10±2 d; 40 (83.33%) of the 48 cases were cured. In the conventional puncture group, the volume of pumped effusion was 2753±315 ml; the time to disappearance of pleural effusion and pneumatosis was 18±6 d; pleural puncture was performed twice in 4 cases, 3-4 times in 38 cases, and over 5 times in 10 cases, with an average of 3.8 times; 26 (46.43%) of the 56 cases were cured. The cure rate was significantly higher in the central venous catheter group than in the conventional puncture group (χ(2) = 7.59, P < 0.01).

CONCLUSIONFor pleural effusion and pneumothorax, PICC can be used instead of closed thoracic drainage and pleural puncture, and it has good clinical effect, causes little pain, and is easy to operate.