ЭФФЕКТИВНОСТЬ ИСКУССТВЕННОГО ПНЕВМОТОРАКСА У БОЛЬНЫХ КАВЕРНОЗНЫМ ТУБЕРКУЛЁЗОМ ЛЁГКИХ МОЛОДОГО ВОЗРАСТА С МНОЖЕСТВЕННОЙ И ШИРОКОЙ ЛЕКАРСТВЕННОЙ УСТОЙЧИВОСТЬЮ ВОЗБУДИТЕЛЯ

Abstract

The article presents the results of clinical studies of the effectiveness of artificial pneumothorax in the treatment of 124patients with cavernous pulmonary tuberculosis patients and extensively drug resistance. Clinical trials of the use of artificial pneumothorax in young patients with cavernous pulmonary tuberculosis MDR and XDR MBT have proved its high efficiency and that it can be recommended for widespread clinical use. The indications for the use of artificial pneumothorax is a cavernous pulmonary tuberculosis with the release of MDR and XDR MBT with unformed or formed thin-walled cavity not larger than 4 cm in diameter. Pleuropulmonary adhesions revealed at primary application of artificial pneumothorax are the direct indications fpr surgical burn of adhesions. With the diameter of cavities up to 2cm the artificial pneumothorax treatment is applied for 6months and with cavities of 2–4cm in diameter – for 12months. Contraindications to the use of artificial pneumothorax are cavities in the lungs more than 4cm in diam-eter, massive pleural commissures, with the impossibility of their surgical burnout; specific lesion bronchial tubes and severe comorbidities (mental illness, organic lesions of the central nervous system, chronic obstructive lung disease, chronic cardiovascular diseases in the stage of decompensation, congenital malformations of the heart and lungs, chest wall deformity). Treatment of patients with artificial pneumothorax cavernous pulmonary tuberculosis MDR and XDR pathogen can be recommended for use in stationary phase in TB facilities with thoracic surgery, where the implementation of operational burnout pleural commissures is possible.