How to treat tuberculous pleurisy in children

The treatment of tuberculous pleurisy in children should be carried out as soon as possible. The common treatment method is the application of corticosteroids, and thoracentesis can be used according to the condition of the patient. The use of any method should be selected according to the patient's condition.

1. Application of adrenal cortex hormone

It can alleviate the symptoms of poisoning, promote the absorption of pleural effusion, and prevent or reduce pleural adhesion and hypertrophy. Prednisone can be used until the clinical symptoms improve, the body temperature drops, and the pleural effusion is reduced or absorbed. Generally, the dosage will be gradually reduced after 2 to 3 weeks, and the course of treatment should be 4 to 6 weeks. If during the dose reduction process or after stopping hormones, the pleural effusion increases and is accompanied by symptoms such as fever, the hormones can be added back to the dose before the rebound and then gradually reduced after 1 to 2 weeks.

2. Thoracentesis

At the beginning of the disease, a diagnostic thoracentesis should be performed, and routine and bacteriological examinations of the pleural effusion should be performed. After the application of anti-tuberculosis drugs plus hormones, repeated thoracentesis and fluid extraction are generally not required. However, when the amount of pleural effusion is large and breathing difficulties occur, thoracentesis can be performed for decompression treatment. If pleurisy turns into tuberculous empyema, it is advisable to repeatedly drain the pus and flush with 1% sodium bicarbonate solution, followed by injection of 0.1g of isoniazid.

3. Surgical treatment

After medical treatment, the clinical symptoms disappear, but the pleura is obviously thickened, which affects the child's development and respiratory function, so pleural decortication is appropriate. In addition, the medical treatment of encapsulated tuberculous empyema is not effective, so surgical treatment is required as soon as possible.