METHOD OF SURGICAL TREATMENT OF DISSEMINATED DESTRUCTIVE PULMONARY TUBERCULOSIS

摘要

FIELD: medicine.;SUBSTANCE: invention relates to field of medicine, namely to thoracic surgery and can be used in carrying out lung resection caused by dissiminated tuberculosis, main forms of which are fibrous-cavernous tuberculosis and caseous pneumonia. Method consists in carrying out thoracotomy, isolation of lung from fusions and carrying out revision of lung parenchyma by isolation of lung tissue with main tuberculosis process and lung tissue with tuberculosis foci of dissemination, ablation of lung tissue with main tuberculosis process, performing hemostasis, drainage of pleural cavity and suturing thoracotomic wound. Puncture of parenchyma is performed in lung tissue with tuberculosis foci of dissemination. After that, light guide is introduced through it to supply irradiation directly into focus of tuberculosis changes. Impact with high-energy laser with irradiation wavelength 970 nm is performed with power of irradiation flow 10-15 W and temporary exposure 0.2-0.5 sec. Application of claimed invention makes it possible to perform destruction of tuberculosis foci in lung tissue with preservation of parenchyma which surrounds them, ensure smaller over-stretching of lung parenchyma in postoperative period and thus preserve vital capacity of lungs, to minimise risk of intra-operation complications, including damage to elements of lung root in the process of processing. Parameters of laser irradiation and exposure time ensure destruction of tuberculosis foci of lung tissue, which remain in parenchyma after cavern ablation.;EFFECT: aseptic productive character of inflammation in the process of lung parenchyma reparation in post-operative period contributes to reduction of inflammatory changes in operated lung.;1 ex