Results of complex treatment of limited fibrous-cavernous pulmonary tuberculosis

Abstract

The results of conservative treatment, resection and thoracoplasty interventions in limited forms of fibrotic- cavernous pulmonary tuberculosis and their effect on the average duration of the disease were analyzed. In 2005-2012 years, 194 people were observed with limited forms of fibrotic-cavernous pulmonary tuberculosis. All patients were divided into three groups to assess the effective-ness of the surgical method in the complex treatment of pa- tients with pulmonary tuberculosis and their impact on the results of treatment. A control group of 86 patients treated with conservative therapy. 45 patients were re- sected lung in the volume of a lobectomy. 63 patients was underwent thoracoplasty. The average duration of pulmonary tuberculosis in the study period in the Russian Federation ranged from 3.1 years to 2.9 years in 2013. The average duration of disease of fibrous-cavernous lung tu-berculosis is ten times higher. It amounted to a maximum in 2010 is 20.7 years. Conservative therapy leads to cli- nical cure in 19.8% of cases. By including in the complex therapy surgical methods efficiency increases to 41.3% in thoracoplasty and 86.7% of cases with lung resection. When analyzing the time of occurrence of the event by Kaplan-Mayer method, the greatest efficiency of treat- ment of patients with fibrotic-cavernous pulmonary tu- berculosis is achieved in the first 2 years of observation. This corresponds to the average duration of pulmonary tuberculosis, which were calculated on the main epide- miological indicators. After the second year of observa- tion, the effectiveness of treatment decreased and after the sixth year of observation we have not positive results in any study group. The efficiency decreases in the con- trol group of patients and in the group of patients with thoracoplasty a after the fifth year of observation and the proportion of patients with signs of active pulmonary tu- berculosis was 49.8% with thoracoplasty and 71.2% with conservative treatment. All these patients continue to be potential sources of infection.