Evolutionary Process Of Pleural Thickening And Pulmonary Function Changes Among Exudative Pleural Effusion Patients:an Observational Study

Objective To investigate the regular pattern of formation and dissipation of pleural thickening andpulmonary function changes among exudative pleural effusion?EPE?patients.MethodsThe enrolled participants were 17 tuberculous pleural effusion patients receiving inpatient treatment and regular post-discharge follow-ups from Anhui Chest Hospital from February 2016 to June 2017.Results of thoracic ultrasound examinations and pulmonary function tests performed at 8 time points?timing of discharge,at 1,2,3,4,5,6,9 months after discharge?were collected.ResultsAt T3?2 months after discharge?,both the average number of intercostal spaces involved by pleural effusion and average pleural effusion depth were significantly reduced compared with at T2?1 month after discharge??P<0.05?,but showed little changes compared with at T4?3 months after discharge??P>0.05?,suggesting that T3 was a turning point for the improvement in the involved number of intercostal spaces and pleural effusion depth.At T5?4 months after discharge?,both the average number of intercostal spaces with thickened pleura,and average area of pleural thickening were obviously decreased compared with at T4?P<0.05?,but presented little differences compared with at T6?5 months after discharge??P>0.05?,indicating that T5 was a turning point for the improvement in the number of intercostal spaces with thickened pleura and area of pleural thickening.At T6,the measured average FVC,FEV₁ and MVV values were all greater compared with at T5?P<0.05?,but all of them varied little compared with at T7?6 months after discharge??P>0.05?,demonstrating that T6 was a turning point for the improvement in FVC,FEV₁ and MVV.At T5,the measured average DLCO value was greater compared to at T4?P<0.05?,but did not differ significantly from that at T6?P>0.05?,showing that T5 was a turning point for the improvement in DLCO.ConclusionFor EPE patients,the small amount of pleural effusion that can not be drained completely can be absorbed generally at 2 months after discharge.The extent of pleural thickening is the most severe at the time that the patient with incompletely drained small amount of pleural effusion,after that the pleural thickening gradually decreases,and is relatively stable 4 months later.The impaired pulmonary function recovers to a relatively stable state at 4-5 months after the pleural effusion is controlled basically,and it almost reaches the lower limit of the normal range,then the speed of recovery slows down significantly.