[Etiology, pathogenesis and treatment of different forms of acute suppuration of the lungs].
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Biomedical subjects
Publications and source records attributed to G S Chepcheruk.
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On the basis of experimental and laboratory investigations high fibrinolytic effect of the home proteolytic enzyme terrilythin and the absence of general toxic reactions after intrapleural administration of the drug have been proved. The article describes results of clinical results of clinical tests of the effectiveness of terrilythin in coagulated hemothorax after traumas of the chest and operations on the lungs and in 55 patients with acute pro-fibrinous pleurisy. The successful preventive sanitation was performed in 43 of 50 patients with coagulated hemothorax and initial symptoms of the infectious process as well at the development of pleural empyema were averted.
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A table of compatibility of proteases and antibacterial drugs was developed on the basis of investigation of fibrinolytic effect of proteolytic enzymes (fibrinolysine, chimotrypsin, streptokinase, terrilitin) and their combinations with most popular antibiotics and antiseptic solutions. According to the data of the authors, terrilitin and streptokinase are most efficient of the proteolytic enzymes studied and less dependent upon antibiotics and antiseptic solutions when used in combinations.
Experimentally it has been shown that diluted Pervomur (1:3) may be used for the intraoperation washing of the pleural cavity. The use of the diluted drug during the operations for acute purulent diseases of the lungs and pleura made it possible to prevent postoperative pleural empyemas and suppluration of soft tissue wounds in most patients.
Coagulative properties of the blood and exudate accumulated in the pleural cavity following lung operations were studied. On the grounds of the studies of plasmin potential and active antiplasmin of the exudate a method of local fibrionolytic therapy of coagulated hemothorax with intrapleural injections of fibrinilysis activators was devised. Fibrinolytic therapy was applied in 106 patients, streptokinase preparations were injected to 28 of them.
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An estimation of the postoperative course after pneumonectomy in 328 patients, depending on the character and rate of distinguishing the pleural fluid, is given. The development of collapsed hemothorax and early (during the first week) fibrinothorax is predominantly related with separation of massive pleural adhesions, it aggravates the postoperative period and predisposes to the development of pleural empyema. Rethoracotomy with the removal of clots especially in later terms fail to prevent this complication. Intrapleural injections of fibrinolytic drugs is found to offer more perspectives.
Clinical signs of postoperative complications were studied in 642 patients with abdominal wounds, including 102 (15.9%) cases with relaparotomy features. The article makes a comparison between the frequency of various complications on the one hand, and the character of internal lesions, size of the first surgical intervention and the time of the secondary surgical care on the other hand. The authors determine the basic trends of complex intensive therapy taking into account metabolic disorders in patients with gunshot abdominal injuries.
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