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A method of treatment of tuberculosis of peripheral lymph nodes

IPC classes for russian patent A method of treatment of tuberculosis of peripheral lymph nodes (RU 2190970):
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< / BR>
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(57) Abstract:

The invention relates to medicine, to tuberculosis, to methods of treatment of tuberculosis of peripheral lymph nodes. First remove the affected peripheral lymph nodes, and then carry out anti-TB chemotherapy. This method allows you to avoid multi-step operations, reduce treatment time and eliminate possible complications of the disease.

The invention relates to medicine, namely tuberculosis, and can be used for the treatment of tuberculosis of peripheral lymph nodes /TPLA/.

The relevance of the chosen subject of research is that there has been a steady tendency to increase the number of patients TPLO. Diagnosis and treatment of the disease remains a difficult problem /Bellendir E. P., Savin I. A. Tuberculous lymphadenitis as the actual problem of Phthisiology //Probl. tuberc. - 1997. - 4. - S. 43-44/.

The basis of the proposed medical complexes is tuberculostatic therapy conducted after the biopsy and histological verification of diagnosis, and then shown in the cases of operations /szczerba B. C., Bellinger E. N., Nadezhnikov A. T. Pathogenesis, early diagnosis, and l is conservative therapy and the place of surgical treatment of tuberculosis of peripheral lymph nodes// proceedings of the 2nd scientific. are the practice. proc. - Saint-Petersburg. - 1996. - 104-106 C./.

It is known that a long and often unsuccessful treatment tuberculostatic due to impaired microcirculation, caseous necrosis, fibrosis in the area of lymph nodes. These pathological changes hinder the achievement of adequate drug concentrations at the site of destruction /Bellendir E. N. , Harashina C. I., Vinogradov centuries Modeling and some questions of the pathogenesis of tuberculosis of lymph nodes// TB and ecology. - 1995. - 4 - C. 19-20/. These data are a prerequisite for the implementation of early operations with suspected or presence of TPLO.

The closest analogue is the work Makarova c.u Terms of treatment and follow-up of patients operated on for tuberculosis of peripheral lymph nodes// Probl. tuberc. - 1997. - 2. - S. 14-17/. The author traced the benefits of a comprehensive treatment of TPLO compared with conservative therapy.

During examination of the patient was performed by puncture or operating lymph node biopsy to confirm the diagnosis. Then within 2 months spent tuberculostatic therapy against this background made the surgery to remove affected limfaticheskikh indicators in patients undergoing surgery and took tuberculostatic drugs amounted to 1 year. Patients who received only conservative therapy, was treated two years.

The disadvantages of the method. As in all known methods of treatment, previously conducted a biopsy of a lymphonodus, pending confirmation of diagnosis histological examination 2 weeks, and bacteriological up to 3 months. Then assign within 2 months of chemotherapy, and only then perform surgery to remove the affected lymph nodes. Thus the center of destruction evacuate no earlier than 2.5 months from receipt of the patient. In this way Pets multistage operation, there are relapses of the disease, surgical allowance is only in case of failure of conservative therapy.

The purpose of this proposal is to increase the efficiency of treatment of patients, TPLO by early removal of infected tuberculous process of lymph nodes with subsequent chemotherapy.

The task is achieved by the fact that a patient with localized and uncomplicated, TPLO without prior surgical biopsy and chemotherapy produce operation - the lad with the purpose of removal of lymph nodes, and ZAT is logical and bacteriological study.

The method allows to avoid multi-step operations and complications, to accelerate the onset of treatment and to reduce the period of time, and also helps to achieve not only therapeutic, diagnostic effect /histological and bacteriological examination preparation distant lymph nodes gives the opportunity to verify the diagnosis.

The method is as follows.

Patient tuberculous lymphadenitis in the first week of the standard examination to determine the activity of adenozindezaminazy serum - ADA /Titarenko O. T. and other problems. tuberc. - 1998. - 2. - S. 25-27/. High diagnostic efficacy of the test ADA - 88% avoids operating the biopsy and reduce the duration of pre-operative examination. Remove the affected lymph nodes and assign standard TB therapy.

The proposed method was treated 22 patients with TPLO. In the nearest and distant /over 3 years/ the results of treatment of complications and exacerbations were observed in patients was not enlarged peripheral lymph nodes, clinical and laboratory data has remained normal the whole time of observation. Differences in clinical and supported by pathological diagnosis was not recorded.

Example 2. Patient P., aged 27, was admitted 06.02.98, with tuberculous lymphadenitis of the neck, locally determined conglomeration of lymph nodes 4x5 cm, painless. Made a standard examination, the activity level of HELL serum confirmed the presence of specific lesions of the lymph nodes. 18.02.98, made an operation to remove a conglomerate of neck lymph nodes assigned to three anti-TB drugs, postoperative course without complications. Histological examination verified tuberculous lymphadenitis. Discharged 10.06.98, peripheral lymph nodes are not enlarged, clinical and laboratory data consistently normal.

 

 

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