在对一名多重耐药病原体患者的复杂治疗中使用崩溃治疗法和支气管定位术的效果:临床观察

N. Chumovatov, O. G. Komissarova, N. Chernyh, V. V. Romanov
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摘要

目前,根据世界卫生组织的数据,肺结核患者的治疗效果目标并未实现。在这方面,迫切需要寻找治疗肺结核患者的最佳综合方法。这项工作的目的是证明,在对一名肺结核病程广泛的患者进行综合治疗时,使用塌陷疗法和 CBB 方法具有很高的有效性。对患者的医疗文件进行了分析,研究了疾病的病史数据、X光档案分析、临床、实验室和仪器检查数据。结核分枝杆菌(MBT)的多药耐药性(MDR)在住院第一天就已确定。患者接受了全面的综合治疗:按照 MDR 结核病治疗方案进行化疗,腹腔积气 8 个月,CBB 6 个月。该临床病例表明,在病毒性肺炎病程严重导致免疫力显著下降的背景下,之前未被发现的肺结核也开始逐渐发展。由于对一名肺结核病程广泛的患者采用了综合治疗,临床症状得到了改善,肺组织中的大量腐烂空洞得到了闭合,病灶浸润性病变得到了吸收。一个临床实例证明了在复合治疗中使用崩解治疗方法的高效性和安全性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effectiveness of the Use of Collapse Therapy Methods and Bronchoblocation in the Complex Treatment of a Patient with Multidrug Resistance Pathogen: Clinical Observation
Currently, according to the World Health Organization, the targets for the effectiveness of treatment of patients with pulmonary tuberculosis do not achieve their goals. In this regard, it is urgent to search for optimal integrated approaches in the treatment of patients with pulmonary tuberculosis.The aim of the work is to demonstrate the high effectiveness of the use of methods of collapse therapy and CBB in the complex treatment of a patient with a widespread tuberculosis process.Materials and methods. The analysis of the patient’s medical documentation was carried out, the data of the anamnesis of the disease, the analysis of the X-ray archive, the data of clinical, laboratory and instrumental examinations were studied.Results. Multidrug resistance (MDR) of Mycobacterium tuberculosis (MBT) was established on the 1st day of hospitalization. Comprehensive treatment was carried out in full: chemotherapy according to the MDR-tuberculosis regimen, pneumoperitoneum for 8 months, CBB for 6 months.Discussion. The presented clinical example demonstrates that against the background of a significant decrease in immunity due to the severe course of viral pneumonia, previously undetected pulmonary tuberculosis has taken a progressive course. Due to the use of complex treatment in a patient with a widespread tuberculosis process, clinical improvement was achieved, the closure of massive decay cavities in lung tissue and resorption of focal infiltrative changes was radiologically achieved.Conclusion. A clinical example demonstrates the high effectiveness and safety of the use of collapse therapy methods in the complex treatment.
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