ABSTRACT
The results of surgical treatment of 37 patients, suffering relatively advanced pulmonary tuberculosis (PT), were analyzed. Chemoresistant PT was revealed in 35 (94.6%) observed patients, and multiresistant one--in 30 (81.1%). Preoperative preparation during 2-3 mo was conducted in two main directions: administration of a line II antibacterial preparations and a pneumoperitoneum (PP) establishment. A main operative procedure was resection. Intrapleural thoracoplasty in our own modification have constituted a seconf direction of treatment, it consisted obligatory of the 5 ribs resection. Initially a rib V was partially resected 8-10 cm in length, and a rib I was excised completely. Complications were absent. The patients were discharged from the hospital in 2-3 mo postoperatively. PP in 34 (91.9%) patients was completed in a same terms. In a remote postoperative period (1-4 yrs) a tuberculosis reactivation was absent. All operated patients were bacilli free.
Subject(s)
Pneumonectomy/methods , Pneumoperitoneum/surgery , Thoracoplasty/methods , Tuberculosis, Multidrug-Resistant/surgery , Tuberculosis, Pulmonary/surgery , Adult , Antitubercular Agents/therapeutic use , Drug Resistance, Multiple, Bacterial , Female , Humans , Male , Middle Aged , Mycobacterium tuberculosis/drug effects , Pneumoperitoneum/microbiology , Pneumoperitoneum/pathology , Postoperative Period , Ribs/surgery , Treatment Outcome , Tuberculosis, Multidrug-Resistant/drug therapy , Tuberculosis, Multidrug-Resistant/microbiology , Tuberculosis, Multidrug-Resistant/pathology , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/microbiology , Tuberculosis, Pulmonary/pathologyABSTRACT
Analysis of thrombohemorrhagic complications was conducted in 98 patients, operated on for various forms of chemoresistant pulmonary tuberculosis. To prevent such complications it is necessary to prescribe heparin in minimal doses or fraxiparine preoperatively and intraoperatively. It permits to lower the prethrombotic background significantly, to prevent thrombohemorrhagic complications, and in their incidence--to eliminate thrombotic and hemorrhagic clinical features with minimal losses.
Subject(s)
Hemorrhage/prevention & control , Intraoperative Complications/prevention & control , Thromboembolism/prevention & control , Thrombosis/prevention & control , Tuberculosis, Multidrug-Resistant/surgery , Tuberculosis, Pulmonary/surgery , Adult , Anticoagulants/therapeutic use , Antitubercular Agents/therapeutic use , Female , Humans , Hydroxyethylrutoside/analogs & derivatives , Hydroxyethylrutoside/therapeutic use , Indomethacin/therapeutic use , Male , Middle Aged , Mycobacterium tuberculosis/drug effects , Mycobacterium tuberculosis/growth & development , Nadroparin/therapeutic use , Tuberculosis, Multidrug-Resistant/drug therapy , Tuberculosis, Multidrug-Resistant/microbiology , Tuberculosis, Multidrug-Resistant/pathology , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/microbiology , Tuberculosis, Pulmonary/pathologyABSTRACT
Basing on the literature and the observations of their own data analysis, the authors suggest, that pleurectomy constitutes a reconstructive-restoration operation. Nevertheless, this procedure, due to its complexity and traumatism, not infrequently is complicated by various intraoperative complications, in particular, the life threatening--in 1.1% observations and dangerous for health--in 13.8%. The methods of prevention and overcoming of possible complications are determined.
Subject(s)
Intraoperative Complications/prevention & control , Pleura/surgery , Pleurisy/surgery , Thoracic Surgical Procedures , Adult , Humans , Intraoperative Complications/etiology , Pleura/blood supply , Thoracic Surgical Procedures/adverse effects , Thoracic Surgical Procedures/methods , Treatment OutcomeABSTRACT
Basing on the literature data and own experience, grounded on results of follow-up on 2000 patients, suffering an acute pleuritis and performance of more than 200 operative interventions--pleurectomy, the clinic-radiological classification of chronic pleuritis, mostly answering the practical health care necessities, was proposed by the authors.
Subject(s)
Pleurisy/surgery , Thoracic Surgical Procedures/methods , Chronic Disease , Humans , Pleurisy/classification , Pleurisy/diagnosis , Pleurisy/diagnostic imaging , Radiography , Treatment OutcomeABSTRACT
Authors present the frequency, pathological disorders and consequences of fat microembolia of the lung. Peculiarities of fat embolia in patients with blunt traumas of the foot and shin were shown in the article. Rare cases (2) of SPE manifestation in patients with fat embolia of the lung, experience of pathogenetic therapy of complications and recommendations regarding diagnostics of complications in patients with this disease are given in the article.
