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WAYS TO IMPROVE THE EFFECTIVENESS OF TREATMENT NEWLY IDENTIFIED PATIENTS DESTRUCTIVE PULMONARY TUBERCULOSIS

DOI: https://doi.org/10.29296/25877305-2022-02-01
Issue: 
2
Year: 
2022

A. Zakharov, MD; Professor V. Romanov, MD; Professor A. Ergeshov, MD Central Tuberculosis
Research Institute, Moscow

Against the background of the improvement of the main epidemiological indicators in Russia over the past decade, there has been no significant dynamics in the effectiveness of treatment of newly diagnosed patients. According to the results of 2019, the healing of destructions was noted in 61,6%, and the cessation of bacterial excretion – in 68,9% of patients. Along with an increase in the proportion of resistant tuberculosis, issues of patients ‘ adherence to treatment, morphofunctional changes in the lung tissue that reduce the flow of chemotherapy drugs to the lesion play a significant role in the low efficiency of treatment of pulmonary tuberculosis. The pathogenetically based therapeutic technology presented by the authors of the combined use of retrosternal lymphotropic chemotherapy and pneumoperitoneum is aimed at creating effective inhibitory concentrations of chemotherapy drugs that suppress the pathogen in conditions of altered lung tissue and increase the effectiveness of treatment. With the use of radionuclide research methods, the strengthening of regional microcirculation of lung tissue against the background of pneumoperitoneum, including with low-volume procedures, was proved. The obtained results of the application of the proposed technology demonstrate an increase in the effectiveness of treatment of patients with newly diagnosed destructive pulmonary tuberculosis according to the criterion of stopping bacterial excretion by 45,3%, healing of destructions – by 49,7%. The method can be used in the complicated course of infectious pulmonary diseases of non-tuberculous etiology.

Keywords: 
phthisiology
pulmonary tuberculosis
lung destruction in tuberculosis
retrosternal lymphotropic administration of drugs
therapeutic pneumoperitoneum
regional pulmonary perfusion
effectiveness of treatment of pulmonary tuberculosis



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