Objective To explore the clinical efficacy of intrathoracic injection of thrombin combined with drainage tube suspension in the treatment of refractory pneumothorax, and to observe the effect of this treatment scheme on the closure time of leakage and the incidence of fever. Methods From June 2020 to June 2022, 106 patients with refractory pneumothorax were prospectively selected and divided into a control group (53 cases) and a study group (53 cases) according to random number table. The control group was treated with intrathoracic injection of thrombin+conventional closed thoracic drainage, while the study group was treated with intrathoracic injection of thrombin+drainage tube suspension. The clinical efficacy, retention time, leakage closure time, hospitalization time, complications (fever, pleural adhesion, mediastinal emphysema) of the 6MWT groups were observed, and the lung function indexes [vital capacity (VC), residual volume (RV), pulmonary carbon monoxide diffusion (DLCO), total lung volume (TLC)] and blood gas analysis indexes [arterial oxygen partial pressure (PCO2) before and after the treatment were compared. Results After the treatment, the total effective rate of the study group was higher than that of the control group (P < 0.05). The retention time, leakage closure time and hospitalization time of the study group were shorter than those of the control group (P < 0.05). The complications in the study group were less than those in the control group (P < 0.05). After the treatment, the levels of VC, RV, DLCO and TLC in the two groups were higher than those before the treatment, and higher in the study group than in the control group (P < 0.05). After the treatment, PaO2, PaO2/FiO2, and SaO2 in the two groups were higher than those before the treatment, PaCO2 and Borg dyspnea index were lower than those before the treatment, and 6MWT was longer than that before the treatment, and compared with the control group, the change range in the study group was greater (P < 0.05). Conclusion Thoracic injection of thrombin combined with drainage tube suspension is effective in the treatment of refractory pneumothorax, which can improve the pulmonary function index and blood gas index, relieve dyspnea symptoms, improve exercise tolerance, shorten the recovery time, and will not increase complications. [ABSTRACT FROM AUTHOR]