Application of collapsotherapeutic methods in complex treatment of patients with disorder chemoresistant pulmonary tuberculosis

Objective — to determine the effectiveness of using collapsotherapeutic methods in the complex treatment of patients with destructive tuberculosis of the lungs.Materials and methods. The analysis of the results of treatment of 28 patients with common destructive chemoresistant pulmonary tuberculosis, in which were used colapse-therapy methods in a complex of therapeutic measures. Results and discussion. Artificial pneumoperitoneum was used in 17 (60.7 %), artificial pneumo-thorax — in 11 (39.3 %) patients, including those with video-assisted thoracoscopic pneumolysis — in 5 (17.9 %). Collapse of the lung was maintained for 8 to 12 months. Clinical and radiological positive dynamics (improvement of state of health, normalization of body temperature, reduction of sputum excretion to < 10 mL/day, resorption of infiltration and closure of cavities of destruction) was observed in 84 % of patients, the negative result of sputum microscopy was observed in more than half of the subjects 6 months after beginning treatment. Closure of cavities of destruction by scarification was achieved in 7 patients, in 4 cases cavities of decay were formed in tuberculomas. In 5 patients, the outcome of the tuberculous process was observed in cirrhosis.Conclussions. The use of collapsotherapy in the complex treatment of patients with destructive chemoresistant tuberculosis allowed achieving satisfactory results in 24 (85.7 %) cases. The cure was achieved in 19 (67.9 %) patients, of whom 3 (10.7 %) did not need surgical treatment. Complications of collapse therapy were observed in 8 (28.6 %) patients, however, additional measures (drainage of the pleural cavity with constant aspiration) required only 2 patients.