Method for sanitation of tracheobronchial tree at pulmonary diseases

FIELD: medicine, thoracic surgery, phthisiology, pulmonology.

SUBSTANCE: the present innovation deals with carrying out urgent and planned curative aid. For this purpose, one should pre-conduct puncturing of anterior tracheal wall along its median line being caudally against thyroid isthmus; then one should introduce a catheter with, at least, one lateral foramen at its working end into tracheal lumen to apply it into the main bronchus of affected lung to be installed so that its working end to be at the level of the upper-lobar bronchus mouth and its lateral foramen facing towards its side. Then comes the occlusion of the main bronchus of affected lung due to applying an obturator into corresponding bronchus followed by sanitation of tracheobronchial tree through the catheter - evacuation, washing and introduction of medicinal preparations. The innovation enables to decrease traumatism, provide reliable protection of healthy department of tracheobronchial tree.

EFFECT: higher efficiency of sanitation in case of different pulmonary diseases.

1 ex

 

The invention relates to medicine, namely to thoracic surgery, Phthisiology and pulmonology.

In the daily practice of thoracic branches, TB and pulmonology hospitals often arises the need to provide urgent and routine medical care, including surgical operations in patients with tuberculosis, suppurative diseases of the lung and pleura, which is characteristic and typical of the following:

continuing or relapsing, including life-threatening, pulmonary hemorrhage, tolerant to standard hemostatic therapy;

the highlighting significant (up to 0.3-0.5 l per day or more) amount of purulent sputum in patients with gangrene, caseous pneumonia, acute and chronic abscesses of the lungs with progressive forms of fibrous-cavernous tuberculosis, bacterial destruction of the lungs, primarily complicated pyopneumothorax (acute empyema), and chronic empyema pulmonary-pleural hiss (fistula), accompanied by acute and chronic inflammation in the trachea, bronchi, lungs and pleura. Difficulties due to various objective reasons in the implementation of comprehensive and effective expectoration of pus and/or blood from the tracheobronchial tree, lung, and blew the individual cavities themselves as sick, and stimulate expectoration of sputum and pathological content of purulent cavities with the help of medicines, as well as involving instrumental, including invasive techniques (therapeutic tracheobronchoscopy, microrheology, puncture and drainage plavalaguna cavities, abscissae and cavernosae etc.);

naturally the risk of infection healthy departments of the tracheobronchial tree and lung tissue, including the contralateral lung content of purulent cavities and propagation of the inflammatory process, until its generalization. In addition, when the pulmonary bleeding in 10% or more of patients developing blood asphyxia due hemisphericity lung tissue and geboorteli of the tracheobronchial tree.

Significant challenges to the full evacuation of the pathological content of the tracheobronchial tree, lungs and the pleural cavity was observed in the cases of development of spontaneous, traumatic and iatrogenic pyopneumothorax (acute empyema) in acute and chronic lung abscesses, destructive forms of tuberculosis, injuries of the chest. Special difficulties arise in children and adults in the presence of multiple pulmonary-pleural fistula (fistula), and bronchopleural fistula significant (0,2-0,4 cm) diameter, preventing as rehabilitation cavities, and b the stroma and the full unfolding of the affected lung.

The need for multiple rehabilitation tracheobronchoscopy, drainage (transbronchial and transthoracic) with lavage of purulent cavities, which in some cases is accompanied by the development of chronic (pleurotaenia and others) fistula.

Patients with this pathology are one of the major hospital groups - sources of nosocomial (hospital) infections, dangerous for both medical staff and cross-contamination of patients.

Thus, these categories of patients with respiratory diseases who do not have at the present time the tendency to reduce the frequency of its development and is characterized by the separation of a significant number of pathological content (pus, blood, exudates) in the tracheobronchial tree, lung tissue and/or pleural cavity, at the same time are twofold clinical problem to be solved as therapeutic, including pre-operative and surgical treatment.

Known method of aspiration in the treatment of pathological cavities in the lungs (abscess, cavity, cyst, etc.) (Donaldi. Endovenosa aspiration in the treatment of pathological cavities in the lungs. In the book: Cavernosae. Edited by Nagaishi Cuso, M, Medicine, 1972, s-263).

The method includes transthoracic drainage absce the sa, cavities, cysts, pleural cavity, which in some cases is combined with pleuro-, abscess and cavernoma, intraoral endoscopic operations and other manipulations with the full evacuation of pathological content by active or passive aspiration(removal), including fractional introduction through drainage (irrigator) and other antibacterial drugs.

However, this method is ineffective, unenforceable, and in some cases even dangerous in a number of clinical variants of flow suppurative processes in the lungs and pleura, as frequently accompanied by the development of different, including life-threatening complications.

The disadvantages of the known and widely used in practice of the method due to the following reasons:

Regardless of the methods and techniques of drainage, duration of drainage in plavalaguna cavity, the method of evacuation of pathological content of the specified group of patients is one of the most frequent sources of the spread of hospital-acquired (nosocomial) infections in thoracic, TB, pulmonary and other, mainly branches of surgery.

Finding a drainage simultaneously in plavalaguna cavity intercostal space and soft tissues of the chest wall after 3-5 days, despite the e known precautions, may lead to the development of local or widespread subcutaneous emphysema with the inevitable imbabala through the intercostal space endocavitary infected content of soft tissues, contributes to the development of cellulitis chest wall, as well as the formation of pleurotaenia or bronchopleural fistula, including chronic.

In the presence of a fistula (fistula) significant (0,2-0,4 cm) diameter and/or multiple bronchopleural fistulas ("grating light"), which provides internal-lung cavity with the tracheobronchial tree and at the same time the pleural cavity, the method of drainage in most cases, by itself, is ineffective for rapid purification and rehabilitation purulent cavity or cavities in the lung, especially in large and giant (5-6 cm and more) their size, and also in the presence of pyopneumothorax (acute or chronic empyema) with a significant (at 1/3 or more of the volume) affected by the collapse of easy.

The main cause of failures in the treatment of these patients is that in practice cannot be created even for a short period of time strictly necessary tightness internal-lung cavity and thereby to prevent the receipt of pathological contents into the tracheobronchial tree and/or the pleural cavity and, consequently, to create the necessary conditions on the I full evacuation pathological endocavitary content and sanitize the cavity(ti) via previously placed drainage with quick and long lasting smoothing lung.

In addition, patients with no pyopneumothorax and bronchopleural fistula drainage of intra-lungs cavity of any Genesis is not always possible and safe.

Drainage of intra-lungs cavity is almost impossible or dangerous in small (1-3 cm), as well as numerous cavities in different segments of the lung, the location of the cavity in the Central (core) parts of the segment. Any way drainage internal-lung cavity, including the use of drainage from an inflated cuff, application method pre-adhesion (physical, chemical and others) parietal and visceral pleura in the area of future installation of drainage does not preclude the development of traumatic pneumothorax (at the time of installation of drainage), as well as its development in the education of bedsore while standing, including arrozivnym bleeding.

As the closest analogue of the adopted method of rehabilitation of the tracheobronchial tree in the treatment of common complications of destructive pulmonary tuberculosis (Bdivision, Vourakis. Endoscopic occlusion of the bronchi in the treatment of common complications of destructive pulmonary tuberculosis. The Ministry of health of the RSFSR guidelines. Moscow, 1991, Typography RSFSR Ministry of health page 13), including installation of the obturator (occluder) in the form of a sterile foam is howling sponge in the bronchus, the corresponding source localization of pulmonary hemorrhage, bronchopleural fistula with spontaneous pneumo(PIO)thoraxe to stop the receipt of pathological content ( blood, pus, exudate, and the like) in the tracheobronchial tree and healthy lungs from the pleural and/or internal-lung cavity, as well as reliable and complete sealing of the entire lung tissue in the presence of bronchopleural fistula (fistula), create the necessary conditions for more rapid and complete unfolding of the lung, the evacuation of pleural content, lavage of the pleural cavity in the presence of air(PIO, hemo)taraxa.

Methods endoscopic transbronchial bronchology (occlusion) in patients with pathology of respiratory organs, as shown by numerous observations on the practice and analysis of materials of domestic and foreign literature, found the main and wide application mainly in cases of complications of the disease development life-threatening pulmonary hemorrhage and/or spontaneous and post-traumatic pneumatic(PIO, hemo)taraxa with significant collapse of the affected lung and the presence of bronchopleural fistula (fistula, "grating light").

Extensive experience of clinical use known endoscopic occlusion of the bronchi has convincingly shown that in most of these R what her cases there is an objective need for long-term (3-5 days and more) retention of the obturator in taking part in the bronchus, that, in turn, determines a number of unwanted, often trudnovospituemyh and even dangerous consequences. The most difficult to solve problems can occur when the most easy and affordable occlusion of the right and left main bronchus, especially if it is involuntary, because it is urgent repair about increasing life-threatening pulmonary hemorrhage, as well as in cases of acute progressive valvular pneumothorax with the threat of embarrassment and a sharp displacement of the mediastinum, the development of widespread subcutaneous emphysema caused by them and the main disease, progressive respiratory failure on a background of suction air and/or fluid from the pleural cavity through the previously installed it drain.

Thus the conventional methods transbronchial endoscopic occlusion of the bronchi, used for the protection and rehabilitation of the tracheobronchial tree, lung tissue and pleural cavity, a natural characteristic of and peculiar to a considerable disadvantages, especially when the occlusion of the main bronchus, the main ones are:

1. In cases of installation of bronchomotor in the main bronchus distal to it in the tracheobronchial tree and internal-lung cavity inevitably accumulates pathological content (blood,pus, exudate, bronchial secret), the amount of which naturally increases with each day of the finding of the obturator. The above pattern is especially pronounced in the absence of adequate drainage, i.e. the presence of bronchopleural fistula of large diameter, indicating an abscess, cavity or cyst with the pleural cavity. Therefore, in these cases, drainage of the pleural cavity is strictly compulsory treatment method.

2. Delayed and inadequate expectorate with the inevitable increase in the number of pathological contents into the tracheobronchial tree, lung tissue and pleural cavity, usually accompanied by the increase of the fever, intoxication, an infected healthy departments of the tracheobronchial tree and lung tissue and further spread of the inflammatory process.

3. Set forth in items 1 and 2 leads to earlier endoscopic transbronchial removal of the obturator from the main bronchus, the full evacuation of the pathological content of the tracheobronchial tree and lung tissue, which is not always attainable, and then re-bronchology in the absence of Hermeticism lung tissue and preservation of the previously described variants of the spread and progression of the disease.

4. In cases of ominous levothyrocine install bronchomalacia in the first place is a way to protect healthy departments of the tracheobronchial tree and lung tissue from flowing blood, and not a means definitive hemostasis and prevention of the inflammatory process in the lung tissue distal to the obturator in the bronchus.

5. In the presence of bronchopleural fistula of large diameter, and in the presence of multiple fistulas and pneumatic(PIO)taraxa to achieve reliable and stable leakage of light from the full unfolding of the lung with the reorganization of the pleural cavity in most cases, you need more than 5-6 days, especially tuberculosis, re podrecznik hard tracheobronchoscopy with the change of obturators, evacuation pathological content that does not exclude the negative effects of prolonged bronchology.

6. In cases of life-threatening pulmonary hemorrhage with a high likelihood of asphyxia blood bronchomalacia as a means of protection from flowing blood is not able yet to solve the whole problem, i.e. to stop the bleeding, protect healthy lungs from streamed blood and effective sanitation, especially with the time limit in preparation for an emergency or delayed surgery for health reasons.

Object of the invention is the creation of a more universal way of rehabilitation of the tracheobronchial tree, lung disease, providing reliable protection and effective reorganization of the tracheobronchial tree, LEGO is Noah tissue and pleura in various diseases of the lungs, including in the presence of a destructive process in the lungs complicated by bleeding and/or spontaneous (post) pneumatic(PIO, hemo)teracom.

The invention consists in that in the method of rehabilitation of the tracheobronchial tree, lung diseases, including performing occlusion of the main bronchus of the affected lung by installing the appropriate bronchus of the obturator previously by puncture of the anterior wall of the trachea at its midline Caudalie isthmus of the thyroid gland in the lumen of the tracheal catheter having a working end of the at least one side opening, hold it in the main bronchus struck a light and set so that the working end was located at the level of the mouth of the upper lobe bronchus and the side hole was facing in his direction, after installation in the main bronchus of the obturator carry out reorganization the tracheobronchial tree through a catheter - evacuation content, irrigation and introduction of medicinal substances.

Achieved full and persistent Hermeticism throughout the lung tissue of the affected lung without performing a search bronchology by setting occluder immediately in the main bronchus. It is well known that endoscopic occlusion of the main bronchus is technically the most simple, easily accessible, requires significantly less time for SV is its performance compared with the occlusion of the lobar and segmental bronchi, the right and left lung.

Completely eliminates the flow of blood, purulent sputum, exudates in the contralateral lung, prevents the likelihood of blood asphyxia, aspiration pneumonia, are more secure conditions for the conduct of the forthcoming IVL, including through a single channel of an endotracheal tube during urgent thoracic surgery.

Provided the necessary time for preoperative preparation in urgent situations, a heavy contingent of patients with high surgical and anesthetic risk in life-threatening pulmonary hemorrhage and astroprocessor total pneumothorax pulmonary-cardiac insufficiency II-III century

The method allows for almost complete evacuation of pathological content of the affected lung by aspiration through an installed catheter into the tracheobronchial tree, use or fractional hour (drip) introduction through the catheter into the affected lung antibacterial drugs, hemostatic and other medicines for the purpose of rehabilitation and/or stop of pulmonary hemorrhage.

Thus, the method allows for simultaneous protection and rehabilitation of the lungs and the pleural cavity in the presence of bronchopleural fistula.

Technically, the DOS is ikaetsya by sequential introduction of the catheter and bronchomalacia in the tracheobronchial tree with achievement in it Hermeticism, i.e. disconnection with the external environment. This creates objective conditions for the effective prevention of further infection, and hence the distribution of the pathological process in the bronchi, lungs and pleura, as well as asphyxia blood, pleural exudate, purulent contents pulmonary-pleural cavities, as well as to ensure reliable and effective interventions for the most complete evacuation of pus and blood from the tracheobronchial tree, lung (cavities) and the pleural cavity in order to more rapid detoxification and the elimination of life-threatening condition of patients.

The method is as follows.

In patients with life-threatening pulmonary or lung-pleural bleeding, as well as in individuals with pneumo(hemo)teracom, due to the presence of bronchopleural fistula or multiple fistulas ("grating light"), the inefficiency of the known methods aimed at stopping and termination of pulmonary hemorrhage and/or pneumothorax, including bronchology and drainage of pleural cavity, carry out poddarkennel hard tracheobronchoscopy with artificial lung ventilation (ALV). In cases of pneumothorax tracheobronchoscopy produce on the background of previously drained pleural cavity with active aspiration of air and exudate.

P is d control bronchoscope dotted line in the anterior wall of the cervical trachea in its middle line Caudalie isthmus of the thyroid gland and the Seldinger technique into the lumen of the tracheal catheter with an internal diameter of 0.2-0.3 cm and 1-2 lateral holes. The catheter is introduced into the main bronchus of the affected lung and is positioned so that its end lies in the mouth of the upper lobe bronchus and the side hole was facing in his direction and was on his level. Then in the main bronchus introduce sterile foam obturator, which is firmly fixed due to its pronounced elasticity and adhesion in the lumen of the main bronchus with measures to offset catheter from a predetermined level. Optionally, the catheter is fixed to the obturator, which is firmly fixed due to its pronounced elasticity and adhesion in the lumen of the main bronchus with measures to offset catheter from a predetermined level. Optionally, the catheter is fixed on the skin of the lateral parts of the neck with adhesive tape. When establishing the date of termination of air flow drainage from the pleural cavity proceed to the final aspiration of the contents of the tracheobronchial tree, irrigation and the introduction of antibacterial drugs fractional or continuous drip through the catheter. During the day regularly carry out the evacuation of the contents and lavage bronchial tree, in the pleural cavity also introduce antibacterial medicines and facilitate the development of adhesion of the visceral and parietal pleura. Branchiostoma is the PR of the main bronchus removed 2-3 days after the onset of Hermeticism lung tissue and lung straightening. Endobronchial catheter is removed either simultaneously with the obturator or leave to continue administering drugs, on the basis of appropriate evidence of compliance with prevention education persistent tracheopharyngeal fistula at the site of its installation.

Patient P in V.L., case history No. 471, enrolled in Tambov oblast TB dispensary 12.02.2003 was diagnosed with disseminated pulmonary tuberculosis in the phase of disintegration, the office +. Spontaneous pneumothorax on the left. Previously 04.02.2003, Michurinsky CRH was diagnosed with spontaneous pneumothorax, in connection with what was left drained pleural cavity on Below, and the patient was sent to the regional TB dispensary.

On admission, the patient's condition is severe, fever 38°S, severe intoxication, cough, dyspnea at rest, odalevaut to 150 ml of Muco-purulent sputum per day. Radiographically left was determined spontaneous pneumothorax with total collapse of the lung, which come pre-loaded to the mediastinum, lung tissue is not rendered, above the diaphragm, the liquid level. Drainage steady inflow of air and separate portions turbid exudate. When connecting it to the system active aspiration clinical-radiological trends unfolding light is not marked.

Given the threat of development of acute Thoth who enoy empyema with lung-pleural fistula, patient 14.02.2003 were podnagotnaya hard tracheobronchoscopy with search bronchosoothe. During endoscopic examination, it was found that the air in the pleural cavity mainly comes through the segments of the lower lobe. Installed bronchoconstrictor of sterile foam in the proximal bronchus on the left. However, upon further observation of patients established that the preservation of receipt of air in the pleural cavity, but in smaller amounts. Showed some tendency of the lung to the smoothing. So 15.02.2003 were repeated hard podnagotnaya tracheobronchoscopy, the obturator from the proximal bronchus removed, made the readjustment of the tracheobronchial tree with lavage of the segments of the lower lobe. Against the background of continuing high-frequency ventilation through the bronchoscope and under his control by puncture of the anterior wall of the cervical trachea in the Seldinger technique in the last entered catheter, the end of which is held in the left main bronchus and installed several Caudalie upper lobe bronchus, and then implemented the blockade foam left main bronchus with a strong fixation of the catheter foam in the bronchus or adhesive tape on the skin-side surface of the neck.

The flow of air through the drainage stopped. For two days through the installed catheter was maintained by evacuat what I exudation and individual portions of air from the pleural cavity, the introduction of its anti-TB drugs and antiseptics in the pleural cavity. Light expanded and 17.02.2003 was removed bronchoconstrictor from the main bronchus, then removed the drainage from the pleural cavity. Patient 29.02.2003, written (translated) for further treatment of tuberculosis of the lungs to the medical Department.

The method of rehabilitation of the tracheobronchial tree, lung diseases, including performing occlusion of the main bronchus of the affected lung by installing the appropriate bronchus of the obturator, wherein the pre by puncture of the anterior wall of the trachea at its midline Caudalie isthmus of the thyroid gland in the lumen of the tracheal catheter having a working end of the at least one side opening, hold it in the main bronchus struck a light and set so that the working end was located at the level of the mouth of the upper lobe bronchus and the side hole was facing in his direction, after installation in the main bronchus of the obturator carry out reorganization of the tracheobronchial tree through the catheter - evacuation of the contents, rinse and introduction of medicinal substances.



 

Same patents:

FIELD: medicine.

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1 ex

FIELD: medicine.

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1 ex

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EFFECT: higher efficiency.

1 ex

FIELD: medicine, anesthesiology, resuscitation.

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2 dwg, 3 ex

FIELD: medicine.

SUBSTANCE: method involves making cut along mucogingival boundary of the maxilla down to periosteum. The mucous membrane is detached in transition fold area. It is moved towards deeper oral cavity atrium fornix and sutured to periosteum. Wound surface is covered with bound flap taken from buccal area behind lip commissure. To form the flap, the first incision is made on the maxillary transition fold area behind lip commissure. The incision is continued downwards over the cheek 2-3 mm far from the commissure towards mandibular transition fold. The second incision is done in maxillary transition fold area 1 cm distal from the previous one. The incision is continued downwards over the cheek and connected to the first incision end. Mucosubmucous flap is detached beginning from the lower end. The formed flap width in the central region is to be equal to 1 cm. The flap is turned on the feeding pedicle at an angle of 90°, laid over the wound surface on vestibular side of maxillary alveolar process and fixed with sutures on mucous membrane edge. Another version of the method involves making incision along mucogingival boundary of the mandible down to periosteum. The mucous membrane is detached in transition fold area. It is moved towards deeper oral cavity atrium fornix and sutured to periosteum. Wound surface is covered with bound flap taken from buccal area behind lip commissure. To form the flap, the first incision is made on the maxillary transition fold area along projection immediately behind lip commissure. The incision is continued downwards over the cheek towards mandibular transition fold. The second incision is done in maxillary transition fold area from the beginning of the first incision. The incision is continued downwards over the cheek towards mandibular transition fold. Mucosubmucous flap is detached beginning from the upper end. The formed flap width in the central region is to be equal to 1 cm. The flap is turned on the feeding pedicle at an angle of 90°, laid over the wound surface on vestibular side of mandibular alveolar process and fixed with sutures on mucous membrane edge.

EFFECT: improved esthetic and functional results.

2 cl

FIELD: medicine.

SUBSTANCE: method involves making two incisions on atrophied region of alveolar process or alveolar portion on the same side with mouth vestibule directed from one tooth to the other one in parallel to each other 2-4 mm far from each other. Each incision has beginning and end 1-1.5 mm far from dental cervix. Trapezoid incision is done on alveolar process or alveolar portion on the side close to oral cavity and a flap is built with its base turned towards the alveolar edge. Periosteum and mucous membrane are separated from bone via the produced incisions from the vestibular side and oral cavity side, forming tunnel in this way. Cortical plate of alveolar process or alveolar portion is perforated with spherical bore form vestibular side, from alveolar edge side and from oral cavity side. Resorbable membrane strip containing hydroxyapatite is introduced into the built tunnel from the oral cavity side. Some quantity of paste, containing hydroxyapatite grains, required for filling defect, is introduced into space between bone and membrane by means of syringe.

EFFECT: improved cosmetic results.

1 dwg

FIELD: medicine.

SUBSTANCE: method involves carrying out dental prosthetics in lateral maxillary region when bone tissue height from alveolar process to the maxillary sinus is equal to 0.5-0.7 cm by increasing bone tissue height. Incision is made along alveolar process crest, mucoperiosteal flap is separated, rectangular fragment is formed in the lateral region and mucous membrane is lifted in the vicinity of maxillary sinus fundus. The newly created space is filled with osteoplastic material, intraosseous dental implants are set, the mucoperiosteal flap is laid, the wound is sutured and prosthetic repair follows. A rectangular bone fragment is formed separable. Its lower boundary is an area located at the level of maxillary sinus fundus or 1 mm higher and its upper boundary is an area planned for building new maxillary sinus fundus. When formed, the boundaries are joined with vertical saw cuts. The fragment is placed into physiologic saline. 2-3 mm thick fragment is cut out with a saw from the maxillary sinus fundus exposing a part of compact plate. After having filled the newly created space with osteoplastic material, the lateral rectangular opening is covered with the fragment taken out from the physiologic saline and fixed.

EFFECT: enhanced effectiveness of treatment; reduced risk of traumatic complications; enforced osteogenesis process.

18 dwg

FIELD: medicine.

SUBSTANCE: method involves cutting mucous membrane and periosteum in the area of lateral hard palate portions. Cuts are done in anterior and middle hard palate part. Mucoperiosteal flaps are produced. The flaps are separated from nasal mucosa and bone part of the hard palate. Mucous and submucous layer are cut in retromolar zones beginning from Langenbeck incision back edge and finishing in glossal surface projection of mandibular alveolar process with pterygoid processes hamulus of the main bone being exposed. Soft tissues are detached from the processes in interfacial space layer located between musculus levator veli palatini and the hamulus to the pharyngopalatine muscle insertion site. Upper pole of musculus levator veli palatini tendons is cut in the cases of lacking mobility. Reticular implant manufactured from 40-60 mm thick titanium nickelide thread and cell size of 3x3-4x4 mm is sutured to mucoperiosteal flaps surfaces turned towards nasal cavity or to each other after moving them. The implants are attached to each other. The mucoperiosteal flaps are fixed by means of removable protection plate.

EFFECT: enhanced effectiveness of treatment; prevented flap divergence; forming solid connective tissue regenerate.

FIELD: medical engineering.

SUBSTANCE: device has casing formed by head and handle parts. External part of the casing has facial part, back part, transition parts, scraper part having sharp edge for cleaning tongue and bristle toothbrush. Bristle fibers are fixed on facial head part surface. Device casing is manufactured as a whole with the scraper part. Sharp scraper edge is formed by line of intersection of one of transition parts and back part of the external part of the casing and is directed mainly along the casing.

EFFECT: enhanced effectiveness of hygienic treatment; simplified design; low material consumption.

13 cl, 8 dwg

FIELD: medicine, phthisiology.

SUBSTANCE: one should create pulmonary atelectasis from inside due to applying bronchial valve in tuberculosis-affected lung in case of bronchoscopy depending upon localization of tubercular process. The method enables to avoid course anatomical alterations and functional disorders, avoid the development of reactive exudative pleuritis and rigid pneumothorax.

EFFECT: higher efficiency of therapy.

3 dwg, 1 ex

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