[Therapeutic plasmapheresis in patients with destructive pulmonary tuberculosis]

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.