[The effect of pelotherapy on the external respiratory function of patients with pulmonary tuberculosis].
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Biomedical subjects
Publications and source records attributed to A K Strelis.
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The results of the study of pulmonary ventilation function, respiratory biomechanics and capillary blood flow in 16 patients with cavernous tuberculosis before and after partial resections are given. An obstructive component due to the inflammatory changes in the bronchial tree was found to underlie moderate impairments in pulmonary mechanical properties. The capillary blood flow depends on the magnitude of secondary changes in lung tissue. Partial resections lead to deterioration of elastic properties of the lungs in combination with reduced capillary network. Recovered functional parameters in the long-term period of the follow-up confirms that it is expedient to use partial resection in the early stage of a combined treatment of patients with cavernous pulmonary tuberculosis.
Isoniazid concentration in the resected areas of a lung was studied in 47 patients with tuberculosis. It has been proved that galvanization of the chest against the background of intermittent intravenous chemotherapy allows to create a high concentration of the preparation in the damaged part of a lung situated at the interelectrode space. Isoniazid content in the wall of the caverna and paracavernous tissues in patients after the direct current influencing was (5.3 +/- 1.0) and (15.2 +/- 1.2) mukg/g. These indices were significantly higher than in patients, who sustained enteral, or intravenous drip administration of the preparation 3 times a week. Intravenous intermittent chemotherapy in combination with galvanization is indicated at the time of preoperative preparation of the patients.
The state of the T- and B-systems of immunity were evaluated in 137 patients with infiltrative pulmonary tuberculosis. Peloidin phonophoresis was used in group I; intramuscular injections of humisol were used in group II; subcutaneous injections of torfotum were used in group III. The control group did not receive mud preparations. It was established that peloidin, humisol and torfot produced a distinct increase of the cellular immunity indices. The effect of mud preparations on the humoral immunity is less significant and is confirmed only by a clear reduction of immunoglobulins G in groups I and II. The most rapid restoration of immunological indices was noted in case of peloidin phonophoresis.
The results of a combined treatment of 179 patients with newly diagnosed destructive pulmonary tuberculosis are presented. Patients of the main group (89 subjects) were given intermittent intravenous chemotherapy with simultaneous galvanization of the affected pulmonary zone, while patients of the control group (90 subjects) received the same treatment but without galvanization. In pulmonary tuberculosis patients who had undergone intracutaneous electrophoresis, the body temperature normalized significantly more rapidly (within 2.2 +/- 0.2 weeks), weakness and weakness disappeared (within 1.2 +/- 0.2 months) and cough ceased (1.6 +/- 0.2 months); sputum expectoration disappeared or substantially reduced (within 1.5 +/- 0.1 months); leukocytosis came to an end (within 1.5 +/- 0.1 months). The basic parameters of a spirogram improved in a shorter period and to a greater degree. Bacillary excretion ceased more rapidly (within 2.2 +/- 0.4 months), so did the infiltrative phenomena resolute (within 3.0 +/- 0.1 months) and pulmonary destructive changes disappear (within 3.3 +/- 0.2 months).
The article discusses the results of studying the ventilation function of the lungs, biomechanics of respiration, and condition of the capillary blood flow in 36 patients with fibrous-cavernous tuberculosis before and after partial resection. In 69.4% of cases obstructive signs were attended by restrictive signs of deficient ventilation. The disorders of capillary blood flow corresponded to or were more extensive than the zone of affection demonstrated by roentgenography, which made it possible to determine the volume of the surgical intervention objectively. Signs of rigidity of the bronchopulmonary system prevailed in the early period after partial lung resection and deterioration of microcirculation was encountered. Restoration of the functional parameters and improvement of the capillary blood flow in the late-term follow-up period confirmed the efficacy of partial resections conducted in the early stage of complex treatment of patients with fibrous-cavernous pulmonary tuberculosis.
It was shown with using the clinical materials relating to 400 patients with pulmonary tuberculosis that peloids such as humisole, torfot and peloidin used in combination with antituberculous drugs had a favourable effect on involution of specific and nonspecific processes in the bronchi and restoration of bronchial patency. This also permitted a decrease in the terms for elimination of inflammatory lesions in the tracheobronchial tree. Phonophoresis with peloidin proved to be the most efficient procedure of pelotherapy since its use provided summation of the therapeutic effects of the mud preparation and ultrasound vibrations as well as local action on the affected organ.
Data on 400 patients with pulmonary tuberculosis indicate that inclusion of mud drugs (peloidin, gumisol, torfot) according to proposed methods reduces abacillation time, closure of disintegration cavities and at the same time does not produce negative effects on the functional state of the cardiovascular system. Peloid therapy favours normalization of the cardiac rhythm in cases of initial tachycardia and normalization of the arterial pressure in initial hypotonia.
At the late period after partial lung resections for fibrocavernous tuberculosis, 28 patients were examined. In patients with exacerbation of the tuberculous process, the reduction in lung ventilation caused by the impaired mechanical properties of the bronchopulmonary system and capillary blood flow, sharp reduction in lung expansion, increase in bronchial resistance and respiratory work were established.
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