Abstract
Lung tuberculosis (TB) can be complicated by cavity forming. Patients with destructions in the Russian Federation in 2010 have made 49,0% from first time revealed lung TB, closing of lung cavities was achieved in 63,0% of cases. The lethality of this patients reaches 14,0% and frequency of early relapses – 30,0%. 60-70% of cases caused by drug resistant strains of Myc.Tuberculosis.
Objective: To increase the efficiency of treatment of a destructive lung tuberculosis by valvular lung volume reduction on early terms of therapy.
Material and Methods: The work is the result of supervision over 40 patients with lung TB. 47,5% of patients were smear-positive, drug resistant MBT - in 25,0%. Destructions defined in the top shares of lungs in 72,3% of patients, in 27,7% - in the bottom share (the sixth lung segment). Visualized cavities from 1,0 cm. To 21 patient during a chemotherapy was installed a non-return endobronchial valve (I gr.). The comparison group - 19 persons (II gr.) received only chemotherapy. Valve installation was made with flexible bronchoscope. In all patients with lower lobe cavity localization therapy was supplemented with artificial pneumoperitoneum.
Results: 70,0% of patients became smear-negative in a month, by 3 months - 100,0% of patients (33,3% and 77,8% in II gr). Destructions closed in 3 and 6 months in 38,0% and 90,5% in I gr., 15,8% and 57,9% in II gr.(p<0,05). Duration of lung volume reduction has made 128,9±10,9 day.
Conclusions: Valvular lung volume reduction is an effective non-drug technique in complex treatment of lung tuberculosis, raising efficiency of treatment in 1,7 times on closing of destruction cavities by 6 month.
- © 2012 ERS