SU1419699A1 - Method of treatment of patients ill with destructive pneumonia - Google Patents

Abstract

This invention relates to pulmonology. The purpose of the invention is to increase heat transfer, improve gas exchange and prevent hypoxic brain edema. The patient is placed in an isolated chamber and blown with abacterial air at a temperature of 20-22 ° C. During the acute period, the patient's head and neck I-2 are cooled twice a day with air cooled to 8-12 ° C. In the sub-acute period, the head and neck are blown with air, the temperature of which is raised to equalize with the temperature of the chamber. In addition, the patient receives medication. On days 18-19, patients are in satisfactory condition. &

Description

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This invention relates to medicine, namely ulmonology, and can be used in treatment. destructive ntieBMOHHH.

The purpose of the invention is to increase heat transfer, improve gas exchange and reduce the effects of hypoxia, reduce the duration of treatment

The method was carried out as follows.

The patient will be placed in an isolated chamber with an abacterial medium; in the acute period, the patient’s head and part of the patient’s neck are blown with air at a temperature of 8-12 ° C for 1.8-2.2 hours twice a day, and the rest of the time with air at a temperature of 20-22 ° C, and during the subacute period, the air temperature during this session is increased every day by 1 to compare it with the temperature of the room.

Example I. Patient Y., 5 years old, was admitted to the clinic with a diagnosis of right-sided infiltration pneumonia, reactive pleurisy. On admission, the body temperature is 39.2 ° С, pronounced odipka up to 46 in one minute with the participation of auxiliary muscles. Pulse 140 beats per minute with average properties. Pronounced cyanosis of the nasolabial triangle and periotic cyanosis. Auscultatory left breathing hard, right significantly weakened. On the radiograph expressed intense shading of the entire right 1 of the lung with the exception of part of the upper lobe. The microdrainage of the right p. Of the 1st of the oral cavity was performed. Up to 150 ml of a serous turbid effusion were obtained (bacteriological seeding isolated the blue-stick stick). Antibiotics gentamicin intravenously and carbicillip intramuscularly are prescribed. For the purpose of detoxification, hemodez, a 10% glucose solution, was intravenously administered intravenously every day, after 2–3 days plasma. Assigned vitamins, intramuscular pipolfen, intravenous Korglikon. From physiotherapy - UHF on the chest. Carbenicillin was injected into the pleural cavity once a day. From the first day the patient was placed in an aerotherapeutic installation. Twice daily, at 12 and 18 hours, the bacterial air with a temperature of 12 ° C was supplied to the region of the head and neck of the patient for two hours. It was noted that the child became calmer during this period, often fell asleep. Breathing became smoother, decreased oddippka and heart rate, and also become less pronounced; 1c cyanosis of the nasolab) of the 1st triangle.

After 5 days, the child’s condition is. First, the temperature became subfebral (37.3- -37.5 C). By wils appetite. From the pleural cavity 11rekrati, 1cc discharge of fluid. Dyspnea decreased. On X-ray diffraction, the intensity of the shading field was reduced by half. Starting from the 6th day, the temperature in two-hour sessions was increased daily by 1 ° C until the room temperature (21 ° C) was reached. On the 18th day, with a generally satisfactory condition, normal blood counts and almost complete resorption of the infiltrate on the roentgenogram, the child was discharged home. Viewed through the month c. No complaints. Healthy

Example 2. Patient S., Flying, was admitted to the department of purulent surgery in a very bad condition with a diagnosis of right-sided destructive pneumonia, right-sided pyothorax. When entering the temperature of 38.5 ° C, shortness of breath pronounced up to 52 breaths

per minute with auxiliary muscles. Pulse up to 150 beats per minute of average properties. Muffled heart sounds, its borders are shifted to the left. In the lungs on the left, breathing is hard, on the right, sharply weakened. On the radiograph of the chest, there is a total shading of the entire right half of the chest with a displacement of the mediastinum in the opposite direction. Produced drainage of the right pleural cavity. Up to 600 ml of liquid pus was obtained (bacteriological examination isolated culture of Staphylococcus aureus). The pleural cavity was rinsed daily with a 1: 5000 furatsillin solution, after which it was connected to a passive aspiration system. Antibiotics are prescribed: cefamisin and carbenicillin. Intravenous, for the purpose of detoxification, hemodez, reopolyglukine was administered. After 2-3 days, antistaphylococcal plasma transfusion. Symptomatic drugs - Korglikon, vitamins of group B, C, desensitizing drugs (suprastin). Physiotherapy - UHF, inhaled bronchodilator. The patient was isolated from the time of admission in the aerotherapeutic installation. Daily twice a day for two hours at 12 and 18 hours

For the patient, air with a temperature of 8 ° C was supplied to the head and neck area, after which the temperature of the abacterial air was again raised to the temperature of the room and the patient was blown over the rest of the day. After 7 days, the child's condition improved. The body temperature during the day ranged from 36.6 to 37.5 ° C. The child has become more active. The cough became wet with sputum discharge. Dyspnea is insignificant up to 30 breaths b minute, pulse stabble 100-110 beats per minute, satisfactory properties. In the lungs, the breathing on the right became held throughout, moderately weakened. From the pleural cavity a small amount of sero-purulent fluid was discharged through the drainage. Starting from this period, the air temperature in two-hour sessions of cool abacterial air supply began to increase daily by 2 ° C per day and for weeks.

five

Has reached room temperature (22 ° C).

On the 19th day, the patient's condition was satisfactory, and on the 21st day he was discharged for outpatient follow-up care. At the time of discharge, small pleural layers were radiographically. General blood and urine tests and biochemical parameters without pathology. Viewed through the month c. Healthy No complaints.

Treatment received 27 patients with various forms of destructive pneumonia.

Patients were usually admitted in severe or very severe condition (87% of all patients) with severe respiratory failure, hemodynamic disturbances, neurotoxicosis, and abdominal syndrome.

In patients in the infiltration stage, according to x-ray data, the lesion area ranged from 2/3 to a total darkening of the entire lung. In 73% of cases, these patients in the pleural cavity contained a reactive effusion in an amount of from 10 ml to 500-700 ml, from a transparent yellowish color to a cloudy fibrin.

In patients with pleural complications (1/3 - patients with pyothorax, the rest with pyopneumothorax), the severity of the local process was determined by the presence of a large amount of pus and the functioning of bronchial fistulas, during which

When inhaling through the drainage tube, the inhaled air was discharged, depending on the diameter or number of bronchial tubes, the degree of hypoxia.

The method allows to increase the effectiveness of treatment of destructive pneumonia by preventing infection within hospital strains, improving gas exchange as a result of better aeration of the lungs, preventing hypoxic brain edema.

Claims (1)

Invention Formula A method of treating patients with destructive pneumonia, including the introduction of drugs and exposure to cooled air, characterized in that, in order to increase heat transfer, improve gas exchange and prevent hypoxic brain edema, the patient is placed in an isolated chamber and blown with abacterial air at a temperature of 20-22 ° C, while in the acute period of the disease, the patient’s head and neck are additionally blown for 1.8-2.2 hours 1-2 times a day with air cooled to 8-12 ° C until the end of the acute period, and during suction during the third period, the head and neck are blown with air, the temperature of which is increased every day by 1-2 ° C until it is level with the temperature of the chamber.