Nikolov, R.

Sheitanov, A.

English

Varna Medical University Press: Journals

METHOD OF TOPICAL DIAGNOSIS OF BRONCHOPLEURAL COMMUNICATIONS IN C H I L D R E N WITH H E A V Y A C U T E P U R U L E N T - D E S T R U C T I V E PULMONAL DISEASES R. Nikolov, A . Sheitanov The method of topical diagnosis (MTD) of bronchopleural communica-tions in patients with acute purulent-destructive pulmonal diseases was first invented and applied by Rafinski (1968). The localization of the communica-tion was determined by the foam-secretion coming out of the conductive bronchi. Its hermetization was provided by a little sunthetic sponge tied to a thread which is pulled out through the vocal fissures (4). Geraskin, V . I . (1974, 1978) improved MTD suggesting the so-called «search-obturation»; by a preliminary applied pleural drainage and combined obtura-tion of lobar bronchia indicating no air out of the drainage, the author deter-mines the precise location of any bronchopleural communication. Similar synthetic sponge is used to provide hermetic conditions in the bronchi (1 , 2). Though both MTD show certain advantages, their application si quite traumatic and difficult to realize. Those inadequacies of the technique are the reason that we propose our own method in the practice (rationalization No. 11807/ 18 t h Apri l , 1979). The method itself is the following: instead of the synthetic sponge we apply Fogart catheter. A bronchoscopia is performed and orientation-diagnosis of bronchial communication is done. The necessary number Fogart catheter is calibrated in advance; by a syringe the top ballon is puffed up to a size which corresponds to the suggested bronchial calibre, thus obturating it. After reach-ing and canuling the respective bronchi we apply the same air amount to blow the balloon. The searching order of communication places can be seen on fig. No.No. 1— 10. Canule insertion in all secondary bronchia is not difficult when there is a satisfying bronchoscopia. The difficulty in putting a canule in the upper-lobe bronchi can be overcome by using the method of Tchistihin, V . S. (1973). The method itself is applied after placing of a pleural drainage (3). By bronchial obturating in the region of the communication it can be immedia-tely established: no air comes out of the drainage when a Fogart catheter is blown. Most often location of any bronchopleural communication is in a single lobe only. The multiple communications including 2—3 lobes are quite rare, which causes additional problems in their determination and location. How-ever, by applying our method and 2 Fogart catheters simultaneously, we dia-gnose precisely the communications regardless of their number and location. The advantages of our method are the following: no trauma, shorter time of proceeding, insured sterility, constant visual control, lighter technical per-formance. Method of topical diagnosis of. 123 100 patients with acute purulent-destructive pulmonaljdiseases were recent­ly admitted to the Clinic of Child-Surgery, Higher Institute of Medicine, Varna city. Our MTD was applied to 2 of the patients. In both cases we provid­ed a precise topical diagnosis which was confirmed in the followed course of examination and treatment. R E F E R E N C E S 1. Г е p а с к и н, В. И. Хирургия, 7, 1974, 36—42. — 2. Г е р а с ь к и н, В. И. Гнойный плеврит. Руководство по торакальной хирургии у детей. М., Медицина, 1978, 155—157. — Ч и с т и х и н, В. С. Катетеризация сегментарных бронхов. Бронхо-логия. М., Медицина, 1973,79—80.- 4. R a f i n s k i, R. Msch. Kinderh., 116, 1968, 4, 471-475. М Е Т О Д И К А Т О П И Ч Е С К О Й Д И А Г Н О С Т И К И Б Р О Н Х О П Л Е В Р А Л Ь Н Ы Х К О М М У Н И К А Ц И Й П Р И Т Я Ж Е Л Ы Х О С Т Р Ы Х Г Н О Й Н О - Д Е С Т Р У К Т И В Н Ы Х З А Б О Л Е В А Н И Я Х Л Е Г К О Г О ( В [ Д Е Т С К О М В О З Р А С Т Е Р. Николов, А. Шейтанов Р Е З Ю М Е Существующие в настоящее время методы топической диагностики бронхоплевраль-ных коммуникаций Рафинскосо Р. (1968) и Гераськина В. И. (1974, 1978), несмотря на их большую диагностическую ценность, отличаются значительной травматичностью и сложностью выполнения. Авторы предложили и ввели в клиническую практику адаптированный метод топи­ческой диагностики (рационализация № 11 807/1979 г.), отличающийся своей атравматич-ностью, легкостью выполнения и рядом других преимуществ. 

METHOD OF TOPICAL DIAGNOSIS OF BRONCHOPLEURAL COMMUNICATIONS IN CHILDREN WITH HEAVY ACUTE PURULENT-DESTRUCTIVE PULMONAL DISEASES

https://journals.mu-varna.bg/index.php/ssm/article/download/3306/2773

METHOD OF TOPICAL DIAGNOSIS OF BRONCHOPLEURAL COMMUNICATIONS IN CHILDREN WITH HEAVY ACUTE PURULENT-DESTRUCTIVE PULMONAL DISEASES

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