The change of ventilation and gas exchange function of the lungs as the result of endoscopic valvular bronchial blocking in patients with recurrent fibro-cavernous tuberculosis after lung resection

Abstract

In the complex treatment of patients with tuberculosis with destruction of pulmonary tissue in the presence of drug-resistant pathogen in 10.2 % of cases it is necessary to resort to surgery in the form of resection or pulmonectomy. In the postoperative period, there are cases of progression of a specific process in the lungs with the formation of destruction. In such a situation, the optimal choice of treatment strategy is endoscopic valve bronchomalacia (ECB) with maximum preservation of functioning lung tissue. The aim of this work is to study the dynamics of ventilation and gas exchange function of the lungs in patients with acute pulmonary tissue destruction after surgery. The study revealed a change in the functional state of the lungs in 56 % of cases: negative in 39 % of patients and positive — in 17 %. The nature of the changes associated with the initial state of the bronchopulmonary apparatus and the characteristics of drug resistant. Deterioration of function is more often observed in a two-sided process and/or in the presence of two or more caverns. The initial state of the lung ventilation capacity and the presence of signs of restrictive disorders have the opposite effect on the functional outcome of bronchoblocation: at normal values of FEV1 and ESRD IS accompanied by more frequent broncho-obstructive disorders and deterioration of gas exchange rates than at their reduced values. The same paradoxical functional dependence of the dynamics can be traced in the volume «off» when drug resistant and its effectiveness.