| Authors |
Romanov Mikhail Dmitrievich, Doctor of medical sciences, professor, sub-department of hospital surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Penza, Russia), MDRomanov@yandex.ru
Kireeva Ekaterina Mikhaylovna, Candidate of medical sciences, associate professor, sub-department of hospital surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Penza, Russia), emkireeva@yandex.ru
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| Abstract |
Background. The effectiveness of intracavitary combined quantum therapy in patients with acute pleural empyema, which is a complication of lung abscess, was examined.
Materials and methods. The results of treatment of 44 patients with acute pleural empyema were analyzed. All patients were divided into 2 groups. The first group (I) – 22 patients who underwent comprehensive treatment, including sanitation of the pleural cavity with 0.01% chlorhexidine solution. The second (main) group included 22 patients, who additionally received a course of quantum intracavitary therapy. On medical grounds, both groups underwent sanative bronchoscopy, vacuum aspiration of the contents of the empyema cavity. If the effectiveness was insufficient, valvular bronches blocking was used. Treatment effectiveness was assessed using fibrobronchoscopy (FBS), x-ray, ultrasound and laboratory methods.
Results. The duration of drainage of empyema cavities in group II was 4.4±0.6 days shorter, and the duration of treatment of patients with bronchopleural communication was less than 6.7±2.2 days compared to the I group. 10 patients with “simple” empyema from group II recovered, 1 patient recovered clinically and another patient's disease passed into chronic form. 7 patients with empyema with bronchopleural communication recovered, 1 patient recovered clinically, and another 2 patients' diseases passed into chronic form. 7 patients with “simple” empyema from group I recovered, 3 patients' diseases passed into chronic form, and 3 patients recovered clinically. 7 patients with empyema with bronchopleural communication recovered, 4 patients' diseases passed into chronic form, 1 patient recovered clinically, and 1 patient died because of multiple organ failure.
Conclusions. The use of quantum intracavitary therapy with sanation of cavities and bronchological method leads to reduction of drainage duration of pleural cavity and treatment duration. It is accompanied by reduction of frequency of passing into chronic form and formation of residual cavities in pleura and lungs. Under the influence of quantum therapy the substrate volume for microorganism growth in pathological focus reduces and the resorptive effect of antibacterial drugs, as a result of bloodstream enhancement in the zone of perifocal inflammation, increases.
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