[Up-to-date technologies in preoperative preparation and postoperative period in patients with progressive...

The impact of complex pathogenetic treatment involving the latest advances of science and technology in the correction of pulmonary surfactant system (PSS) disorders, extracorporeal therapy and immunomodulation on the enhancement of efficiency of surgical treatment in patients with progressive destructive tuberculosis of the lung. The results of examinations and treatment were studied in 199 patients with progressive and complicated pulmonary tuberculosis. According to the used treatment, the patients were divided into 2 groups: a study group (n = 102) and a control one (n = 97). In the pre- and postoperative periods, the study group patients received complex pathogenetic therapy by the developed algorithm: for pharmacological activation of PSS, nebulizer aerosol therapy with lasolvan (ambroxol) was first used in various modifications by the developed algorithms. The efficiency of preoperative preparation in the study group patients in accordance with the applied methods of pathogenetic therapy indicated that the best results were achieved in the context of stabilization of a specific process, compensation of complications and comorbidity in the patients who underwent modified drug-induced PSS activation with small-volume plasmapheresis and leukinferon (LI) in 93.3% and drug-induced PSS activation with small-volume medical plasmapheresis (MI) in 81.4%. Overall, comprehensive preoperative preparation involving correction of homeostatic disorders by the developed algorithm proved to be 30.9% more effective (81.4%) than the conventional preoperative preparation in the controls (50.5%). Analysis of the results of surgical treatment depending on the methods of pathogenetic therapy used in the pre- and postoperative period showed that the efficiency of surgical treatment was observed in 25 (80%) patients receiving nebulizer aerosol therapy and MP, in 20 (86.9%) who had nebulizer aerosol therapy + MP and in only 8 (65%) treated with nebulizer aerosol therapy.