Effect of an intrathoracic injection of sodium hyaluronic acid on the prevention of pleural thickening in excess fluid of tuberculous thoracic cavity.

1. The aim of the present study was to evaluate the effect of a hyaluronate-based gel (HAbg) on the prevention of pleural thickening and adhesion in tuberculous pleural effusions (TPE). 2. Fifty-two patients who had accumulated a medium or large volume of tuberculous thoracic fluid, fluid being bound by fibre tissues and a pleura thickened more than 2 mm were divided randomly into two groups. All patients were all given standard treatments with antituberculous drugs. The HAbg was injected into the thoracic cavity in the treatment group (n = 27 patients), whereas normal saline was introduced into the thoracic cavity in the control group (n = 25 patients). Before and after HAbg injection, routine thoracic fluid examinations (including qualitative protein analysis, cell counts and classification of cell types) and protein quantification were performed. A chest radiograph and B-ultrasound were performed and pulmonary function was tested after 2 weeks and 3 months of thoracic fluid absorption. 3. The results show that patients who were treated with the HAbg had a significantly thinner pleura, a lower protein concentration and white blood cell count in the thoracic fluid and a higher forced expiratory volume in 1 s and forced vital capacity compared with patients in the control group. 4. Intrathoracic HAbg can prevent pleural thickening and improve lung function in patients who have a large amount of TPE.