[Therapeutic plasmapheresis in patients with destructive pulmonary tuberculosis].

ABSTRACT

Therapeutic plasmapheresis was performed in 159 patients with pulmonary tuberculosis treated in the clinic in 2000 to 2005. Four hundred and seventy-seven manipulations were made. Among its clinical forms, there was prevalent fibrocavernous tuberculosis (in 136 patients); 9 had infiltrative tuberculosis; caseous pneumonia was present in 5 patients; 4 had tuberculoma; 3 and 2 patients had focal and disseminated tuberculosis, respectively. Out of the 159 patients, 42 (26.4%) underwent therapeutic plasmapheresis at the stages of surgical treatment. Plasmapheresis was made in 61.9% (26/42) before surgery and in 38.1% (n = 16). The study defined indications for and contraindications to therapeutic plasmapheresis in patients with destructive pulmonary tuberculosis, including adolescents and patients at the stages of surgical treatment. A procedure has been developed for discrete and membranous plasmapheresis for this category of patients. In patients with destructive patients, therapeutic plasmapheresis was shown 1) to level the symptoms of antituberculous chemotherapy intolerance; 2) to correct homeostatic disorders; 3) to enhance the efficiency of basic drug therapy and to promote timely preparation of patients for surgery; 4) to improve the quality of life.