RESUMO
The efficiency of endobronchial therapy with low-frequency ultrasound (LFUS) and ultraviolet laser radiation (UVLR) were studied in patients with pyoinflammatory diseases of the lung. A hundred and sixty two patients with chronic bronchitis (CB) and bronchoectatic disease (BD) were clinically followed up. The complex treatment of pyoinflammatory diseases of the bronchi was supplemented by endobronchial LFUS in 86 patients, by UVLR in 29. Routine bronchoscopy (without endobronchial application of LFUS and UVLR) was included into the treatment of 47 patients with CB and BD. Bronchoscopy with LFUS and UVLR was found to have a high efficiency in patients unresponsive to drug therapy. The number of bronchoscopies per treatment regimen could be reduced, the time of a remission and the interval of hospitalization were increased.
Assuntos
Bronquite/terapia , Terapia a Laser , Terapia por Ultrassom , Broncoscopia , Doença Crônica , Endossonografia/métodos , Seguimentos , Humanos , Indução de Remissão , Estudos Retrospectivos , Supuração/terapia , Resultado do Tratamento , Raios UltravioletaRESUMO
The work analyses the results of spectroscopy conducted at the Faculty Surgical Clinic of the Moscow Medical Academy in 105 patients with various pulmonary diseases. Sixty-four patients had carcinoma of the lung, 9 had benign tumors, and the rest had inflammatory diseases and tuberculosis of the lungs. He-Ne laser (wave length 633 nm) was employed. The radiation was recorded with a multichannel spectrum analyzer with the use of a specially designed fiber-optical catheter. The system provided for normalization of the spectra according to the intensity of the laser component scattering. The spectroluminescence characteristics of normal and inflammatory pulmonary tissue and of lung tumors were studied during bronchoscopy, during and after the operation. Analysis of the results showed the high specificity and sensitivity of the spectra of malignant pulmonary tumors. Essential differences between the spectral characteristics of normal pulmonary tissue and those of carcinoma were noted. The dependence of reduced intensity of tissue fluorescence on the distance from the visible tumor border was studied, maximum fluorescence was encountered not on the surface of the tumor or inside it, but at a distance of 1-3 cm from the border of the tumor. Increased tissue fluorescence in suppurative diseases and benign tumors of the lungs was not recorded. Laser fluorescence spectroscopy may be recommended in bronchoscopy for widening its diagnostic possibilities and in intraoperative differential diagnosis of lung carcinoma, benign tumors, tuberculomas, and chronic abscesses during diagnostic thoracotomy.
Assuntos
Broncoscopia/métodos , Lasers , Pneumopatias/diagnóstico , Neoplasias Pulmonares/diagnóstico , Espectrometria de Fluorescência/métodos , Adulto , Diagnóstico Diferencial , Tecnologia de Fibra Óptica , Humanos , Cuidados Intraoperatórios , Pneumopatias/cirurgia , Neoplasias Pulmonares/cirurgia , Masculino , Pneumonectomia , Cuidados Pós-Operatórios , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , ToracotomiaRESUMO
Gentamycin pharmacokinetics and its concentrations in bronchial secretion were studied in routine endobronchial introduction versus endobronchial aerosol spraying with application of low-frequency ultrasound. The latter technique warranted gentamycin concentrations in bronchial secretion 24 hours after the procedure many times that minimal for inhibition of the pathogen isolated. Secretion levels of gentamycin remained high for 4 days. No side effects were reported. The findings provide evidence in favor of endobronchial aerosol spraying of the drugs for treatment of purulent endobronchitis in bronchiectasis and chronic bronchitis.
Assuntos
Bronquiectasia/terapia , Bronquite/terapia , Gentamicinas/administração & dosagem , Terapia por Ultrassom/métodos , Adolescente , Adulto , Aerossóis , Idoso , Brônquios/efeitos dos fármacos , Terapia Combinada , Desenho de Equipamento , Humanos , Pessoa de Meia-Idade , Fonoforese/instrumentação , Fonoforese/métodos , U.R.S.S.RESUMO
The authors present clinical evidence further illustrating difficulties when diagnosing bronchial obstructive syndrome, consider variants of clinical course of various tracheal and main bronchi diseases associated with status asthmaticus, emphasize the necessity of thorough examination of the patients who must undergo bronchoscopic and x-ray investigations.