RU2456935C1 - Method of treating chest trauma, complicated by serous-hemorrhagic pleuritis, with application of intra-organ electrophoresis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to thoracic surgery, and can be used in treatment of patients with chest trauma, complicated with serous-hemorrhagic pleuritis. For this purpose in early post-trauma period carried out are pleural punctures with removal of blood and exudate from pleural cavity with further drainage of pleural cavity by Bulau. After removal of serous-hemorrhagic exudate from pleural cavity, physiological solution is introduced into pleural cavity through pleural drainage with further removal of washing water through drainage tube, procedure being performed not fewer than two times. After that, novocaine solution with added into it broad-spectrum antibiotic is introduced into pleural cavity. Pleural drainage is compressed for not less than 10 minutes and intra-organ electrophoresis is performed. Simultaneously introduction of hemostatic and antiplatelet medications, immunocorrecting and symptomatic preparations, application of anti-inflammatory drugs, antibiotics, expectorants, as well as inhalation are realised.

EFFECT: method makes it possible to stop manifestations of post-trauma pneumonia, developing as a result of serous-hemorrhagic pleuritis due to complex impact on pleuritis pathogenesis immediately in acute period.

Description

A method of treating a chest injury complicated by serous-hemorrhagic pleurisy using intraorgan electrophoresis relates to medicine, namely to surgery, traumatology, military field surgery, allows the sanation of the pleural cavity in the early post-traumatic period, leads to subsidence of post-traumatic pneumonia, preventing the formation of adhesions, coagulated hemothorax, acute pleural empyema, can be used in surgery, thoracic surgery, traumatology, neurosurgery, military field surgery, pu Lemonology, Oncology.

A known method of conservative treatment of pleurisy of various etiologies with the introduction of hydrocortisone and streptomycin into the pleural cavity, intravenous and intrapleural administration of antibiotics in the treatment of patients with pleurisy and pneumonia (1).

Its disadvantage is the indefinite time sequence of the introduction of antibiotics in the treatment of patients, the non-use of physiotherapeutic methods of treatment in patients in the acute period of inflammation.

A known method of treating a chest injury complicated by hemothorax by drainage of the pleural cavity (2).

Its disadvantage is the lack of effectiveness in the treatment of post-traumatic pneumonia and pleurisy, the possibility of the formation of lumped areas in the pleural cavity with the development of acute pleural empyema.

A known method of drainage of the pleural cavity in patients with a chest injury with three drains (3).

Its disadvantage is excessive trauma, inconvenience to use, insufficient treatment of post-traumatic pneumonia and pleurisy.

A known method of treating patients with various pulmonary pathologies, including the combined use of direct current and various pharmacological drugs that come in different ways (4).

The method is not used for the treatment of post-traumatic pleurisy in the acute period.

It is known that in the treatment of pleurisy, electrophoresis with potassium iodide begins after acute processes subside during the formation of massive pleural layers (5).

This method is not used for the treatment of post-traumatic pleurisy in the acute period.

It is known to use in the treatment of residual pneumonia during a period of subsidence of the inflammatory process of intrapulmonary electrophoresis with antibiotics (6).

This method is not used for the treatment of post-traumatic pleurisy in the acute period.

The aim of the method of the invention is to improve ease of use, adequate sanitation of the pleural cavity and relief of post-traumatic pneumonia.

This goal is achieved by the fact that in the early post-traumatic period immediately after removal of the serous-hemorrhagic exudate from the pleural cavity, physiological solution is injected into the pleural cavity through the pleural drainage, followed by the removal of washings through the drainage tube, the procedure is performed at least two times, after which the pleural cavity a solution of novocaine is introduced with the addition of a broad-spectrum antibiotic, the pleural drainage is squeezed for at least 10 minutes and intraorgan electrophoresis is performed.

Comparison of the proposed method of the invention with other known methods showed its compliance with the criteria of the method of the invention, which allows to obtain additional beneficial advantages in the treatment of patients with chest injury complicated by hemothorax with stopped bleeding.

The method of the invention is used as follows.

After removal of the serous-hemorrhagic exudate from the pleural cavity, at least 50 ml of physiological saline is injected into the pleural cavity through the lower drainage according to Bülau, followed by the removal of washings through the drainage tube, the procedure is performed at least two times, after which no less than 20 ml of novocaine solution, the concentration of the solution and its amount should be selected individually depending on the nature of the pathology. Instead of novocaine, you can use any other anesthetic in solution. Any antibiotic is added to the solution, which is selected according to the results of bacteriological research and sensitivity to antibiotics, or a broad-spectrum antibiotic is administered, the amount of which is individually selected. The pleural drainage is squeezed for at least 10 minutes and intraorgan electrophoresis (galvanization) is performed. It is most preferable to use the Potok-1 apparatus with 10 by 10 cm electrodes. It is advisable to perform the procedure in such a way that the anode is located between the scapular and middle axillary lines from 4 to 8 intercostal space, and the cathode is between the midclavicular line and the anterior axillary line at the level from 4 ribs to the lower edge of the costal arch, however, you can use a different arrangement of plates. The most effective current is 10-15 mA. The procedure is performed for at least 8 minutes, at least 1 time per day for at least 3 days, it is preferable to perform the procedure daily for 7 days.

The method of the invention is used in clinical practice in the treatment of 18 patients with a chest injury complicated by hemothorax and / or serous-hemorrhagic pleurisy, showed high efficiency and ease of use. There were no complications associated with the use of the method. Using the method of the invention allowed to improve the results of treatment of patients with a chest injury complicated by hemothorax or serous-hemorrhagic pleurisy, and to reduce the development of complications.

INFORMATION SOURCES

1. Putov VV, Fedoseev G.B. Guide to pulmonology. L., "Medicine", 1978. S. 483-484.

2. Bisenkov L.N., Zubarev P.N. et al. Emergency Breast and Abdomen Surgery: A Guide for Physicians. / Ed. L.N. Bisenkova, P.N. Zubareva. - St. Petersburg: Hippocrates, 2002 .-- p.238-239.

3. RF patent 2232549 (13) C2, Agadzhanyan V.V. et al. 04/19/2002.

4. Bogolyubov V.M. Physiotherapy and balneology. - M .: Publishing house "BINOM", 2008. - S.114-115.

5. Bogolyubov V.M. Balneology and Physiotherapy: A Guide for Physicians. - M .: "Medicine", 1985. - V.2. - S. 433.

6. Ponomarenko G.N. Private physiotherapy. - M .: "Medicine", 2005. - S.113-115.

Claims (1)

A method of treating a chest injury complicated by serous-hemorrhagic pleurisy using intraorgan electrophoresis, including pleural punctures with removal from the pleural cavity of blood, exudate and drainage of the pleural cavity according to Bulau, the introduction of hemostatic and disaggregant drugs, immunocorrective and symptomatic antibiotics, the use of and expectorants, inhalation, characterized in that in the early post-traumatic period immediately after removal from the pleura of a serous-hemorrhagic exudate cavity, a physiological solution is injected into the pleural cavity through the pleural drainage, followed by removal of wash water through the drainage tube, the procedure is performed at least two times, after which a novocaine solution is added to the pleural cavity with the addition of a broad-spectrum antibiotic, pleural drainage pinch for at least 10 minutes and conduct intraorgan electrophoresis.