A method of treating acute lung abscess complicated by pyopneumothorax

 

(57) Abstract:

The invention relates to medicine, namely to surgery, and can be used for the treatment of acute lung abscess complicated by pyopneumothorax. Additionally produce daily intra-arterial infusion of ozonized physiological solution of sodium chloride 0.9% in the pulmonary artery on the side of the affected lung in a dose of 450 ml once daily for 10 - 14 days of the acute period of the disease. For this kateteriziruyut pulmonary artery by the Seldinger technique through the subclavian vein on the side of the localization of a purulent process. The method can improve the microcirculation of the lungs and reduce bronchial exudation. This improves patient outcomes. 1 C.p. f-crystals.

The invention relates to medicine, namely to methods of treatment of acute lung abscess.

There is a method of treatment of acute lung abscess by endoscopic rehabilitation of the tracheobronchial tree and abscess cavity, optionally with drainage of purulent cavity of the pleura on Below followed by washing it through a drainage solutions of antiseptics and antibiotics [1].

However, this traditional way of anti-inflammatory is in the pulmonary structures and large duration of stay of the patient in the hospital.

The purpose of the invention is to reduce mortality in patients of chronic inflammation in the lungs and pleura, reducing treatment time and patient stay in the hospital.

This goal is achieved by the fact that in the traditional method of treatment of acute purulent pleuropneumonia complicated by lung abscess and pyopneumothorax by endoscopic rehabilitation of the tracheobronchial tree and the cavity of the abscess, drainage of lesion on Below, followed by chemotherapy, the patient additionally produce daily single infusion into the pulmonary artery ozonated physiological saline in a dose of 450,0 ml with a concentration of 500 g/l within 10-14 days ostogo period of illness. Catheterization of the pulmonary artery for intraarterial administration of ozonized solution of 0.9% NaCl produced by the Seldinger technique, through the subclavian vein on the side of the localization of a purulent process.

The proposed method of treatment of a patient with acute lung abscess and pyopneumothorax is as follows.

Traditional, there is a method of treatment of acute suppurative destructive pneumonia, complicated by lung abscess and pyopneumothorax ozone 500 g/l in the pulmonary artery of the affected lung. Catheterization of the pulmonary artery is on the side of the localization of a purulent process in the lung and is on the Seldinger technique (subclavian vein - superior Vena cava - right atrium - right ventricle - common pulmonary trunk - pulmonary artery diseased lung) under control of the x-ray machine. Silicone catheter is fixed to the skin piercing ligature. Is control review chest x-ray for diagnostic localization of the distal catheter. After catheterization of the arterial bed in the fixed and fixed silicone catheter 50 cm long is introduced a solution of heparin in a dose of 2 ml (5 thousand UNITS) in 5 ml of saline for the prevention of inflammation of the vascular bed and prevention of thrombosis cavity of the catheter. In the following days, the heparin solution is introduced to the patient daily at the same dose after each infusion of ozonized solution with the same objective. Proximal division of the catheter permanently sealed closed by a screw plug, preserving the integrity of the vascular bed. The duration of ozonated daily infusions in the arterial bed of patients with acute lung abscess and pyopneumothorax ozonated fiziologicheskogo is through L. 44 years old, diagnosis: right purulent abstemiously pneumonia and abscess in the right lower lobe, empyema right. Under local anesthesia Sol. Novocaini of 0.25%, the patient produced thoracocentesis right, the drainage of pleural cavity for Below. Medication: Cefazolin 1,h times a day/m calcium chloride 10% - 10,0/, 1 times a day, potassium chloro - 5% - 30,0/1 time a day, vitamins: B1, B6 and B12, expectorant syrup 1 tbsp. spoon 3 times, physiotherapy, physiotherapy. Advanced medical complex was included infusion therapy, which in the right pulmonary artery, every day one has been the introduction of ozonized physiological solution of sodium chloride 0.9% dose 450,0 with ozone concentration of 500 g/l, after each infusion into the cavity of the catheter was introduced a solution of heparin in a dose of 2 ml (5 thousand UNITS) in 5 ml of saline. After 5 days of intensive care, including intra-arterial injection of ozonized physiological solution of sodium chloride at 0.9%, the condition of the patient with pronounced positive dynamics. The patient's dyspnea disappeared, reduced to subfebrile figures fever, drainage from the pleural cavity is. is so In the whole course of treatment the patient received 10 infusions of ozonized physiological solution of sodium chloride 0.9% in the number 450,0 once daily in the right pulmonary artery. Pathological adverse reactions in patients with intraarterial the introduction of ozonized solution of 0.9% sodium chloride was not observed. In General, the patient's condition progressively improved and by the end of the first week of treatment, his condition was regarded as satisfactory. In the study of the protein composition of the blood in a patient with marked content in the serum total protein level 65 g/l with normalization of liver tests: AST, ALT, bilirubin. Positive dynamics and restoration of the indicators of immunological indexes of the patient. Subsequently, to control the x-ray image of the chest of the patient and at discharge remain moderate pleural overlay in the lower right lobe, there was a slight deformation, convergence and increased pulmonary pattern, left rentgenostructural easy - without features. Patient after 28 days of treatment has been discharged from hospital and transferred to the outpatient stage of rehabilitation rehabilitation by a pulmonologist.

The proposed method is laciniata treatment of patients, including a significant reduction in their mortality to 2% of the total number of chronic inflammation in the lungs and pleura to 6%, reducing the duration of intensive care patients in the hospital to 28 Cicogna.

Sources of information

1. Bogatov, A. I., Mustafin D., Complicated staphylococcal pneumonia in adults. M., 1984, S. 99 and 100.

1. A method of treating a patient with acute lung abscess complicated by pyopneumothorax by endoscopic rescue bronchial tree and purulent abscess cavity, drainage of the pleural cavity on Below and subsequent intensive medical therapy, wherein the patient is additionally produce daily intra-arterial infusion of ozonized physiological solution of sodium chloride 0.9% in the pulmonary artery on the side of the affected lung, a single dose of 450 ml within 10 - 14 days of the acute period of the disease.

2. The method according to p. 1, characterized in that the catheterization of the pulmonary artery is carried out by the Seldinger technique through the subclavian vein on the side of the localization of a purulent process.

 

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