Kravchenko R. Optimisation of surgical treatment for patient with chronic pleural empyema.

Object of the study: Chronic pleural empyema. Purpose of the study: To improve the results of surgical treat-ment of the patients with chronic pleural empyema by develop-ment of a complex of therapeutic measures aimed at normalization of PSS, to improve surgical treatment of bronchial fistulas and pleural cavity drainage. Methods of the investigation: General clinical, immunological, biochemical studies. The study of the function of the external res-piration and blood circulation, ultramicroscopic study of the respi-ratory portions of the lungs, x-ray of the chest and pleural cavity, statistical methods. Practical significance of the obtained results: The use of Lipin and ambroxol with the purpose to correct the state of PSS allows improve and to reduce the term of pre-operational preparation of the patient with CPE. The use of the developed devise for drainage of the pleural cavity allows to improve the efficacy of the treatment. The use of absorbing hemostatic material TachoComb at surgical treatmentof CPE is an effective means of prevention and treatment of brinchial fistulas. Introduction of the results of the work into the practice allows to reduce the number of complications from 12 to 7%. Novelty: It was established that in patients with CPE, reverse pathological changes take place in the structural elements of PSS against a background of reduction of the functional reserve, increase of the sputum viscosity, immune and hemostasis disorders. For the first time, the changes in the cellular link of PSS in patients with CPE and the degree of influence of the correcting therapy on their state were studied. A new method for correction and disorders of PSS with the purpose of reduction of post-operative complications was substantiated and suggested. A device for drainage of the pleural cavity with the account of the thorax anatomy and a method for prevention of bronchial fistulas were invented. Degree of introduction: The findings of the research were introduced into the work of thoracis surgery departmentof Institute for General and Urgent Surgery (Academy of Medical Science of Ukraine), city clinical hospital No. 13 (Kharkiv), Sumy Regional Anti-tuberculosis Hospital Sphere of application: Medicine, surgery.