MINIMALLY INVASIVE TRANSTHORACIC COMBINED TECHNOLOGIES IN TREATMENT                                OF PATIENTS WITH ACUTE LUNG ABSCESSES

Romanov Mikhail Dmitrievich, Doctor of medical sciences, professor, sub-department of hospital surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, the Republic of Mordovia, Russia), MDRomanov@yandex.ru
Kireeva Ekaterina Mikhaylovna, Candidate of medical sciences, associate professor, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, the Republic of Mordovia, Russia), emkireeva@yandex.ru

616.724–002.3

Background. The purpose of the article is to develop and investigate the effectivenes of combined transthoracic technologies of rehabilitation of patients with lung abscesses with peripheral localization.
Materials and methods. The work is based on the data on 132 patients with acute lung abscesses with peripheral localization. To conduct combined transthoracic methods the authors used 0,06 % solution of sodium hypochlorite in 26 patients, combined with intracavitary laser in 27 patients, and combined with intracavitary UV-irradiation in 25 patients. Transthoracic intervention and treatment effectiveness monitoring were carried out using a digital x-ray apparatus and ULTRASONIC scanners.
Results. In the first comparison group (peripheral location, without transthoracic readjustments) 14 (56 %) of 25 patients were cured, 2 (8 %) had clinical recovery, 5 (20 %) underwent transition into the chronic form, and 4 (16 %) had progression of sepsis (2 (8 %) died). In the comparison group II (transthoracic sanitation by 0.01 % solution of chlorhexidine) cavities of 21 (72,4 %) patients out of 29 healed, in 1 (3,4 %) patient there was formed a dry residual cavity, in 3 (10,3 %) patients the process passed into the chronic form, 3 (10,3 %) patients were operated on the emergency basis and 1 (3,4 %) patient died. Combined transthoracic technologies of rehabilitation of lung abscesses in 78 patients 67 (85,9 %) cases resulted in full recovery in 6 (7.7 per cent) patients had clinical improvement with formation of residual cavities of small size, 3 (3,8 %) cases featured transition into the chronic form, progression of the process was obderved in 2 (2,6 %) patients.
Conclusions. The combined transthoracic technology rehabilitation is recommended for patients with abscesses of lungs with peripheral localization in combination with sanative bronchoscopy for large and giant sizes of cavities, ineffective drainage through the bronchus, progression of the process in lungs, in cases of gangrenous and blocked abscesses. The quantum intracavitary technologies enhance the resorptive effect of sodium hypochlorite and improve outcomes.

lung abscess, transthoracic drainage and sanation, sodium hypochlorite, quantum intracavitary technology.

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