[Retrosternal lymphotropic chemotherapy and pneumoperitoneum in the treatment of drug-resistant destructive pulmonary tuberculosis].

Abstract

The efficiency of combined treatment with retrosternal lymphotropic administration of drugs and pneumoperitoneum was comparatively analyzed in 148 new cases of destructive pulmonary tuberculosis. Both methods were applied during combined chemotherapy in a study group of 48 patients. In Group 2 (n = 54), lymphotropic procedure was employed alone during standard chemotherapy; in Group 3 (n = 46), only pneumoperitoneum was used in combination of chemotherapy. In 40 patients, pulmonary tuberculosis was acutely progressive. Drug resistance was identified in 81.7%, including multidrug resistance in 27.7%. With the combined use of retrosternal lymphotropic therapy and pneumoperitoneum, bacterial excretion ceased in 96.2% of new cases of drug-resistant tuberculosis; decay cavity resolved in 80.8%. The proposed therapeutic technology used in patients with persistent bacterial excretion and decay cavities after ineffective 4-9-month treatment could achieve abacillation in 90.9% of patients and resolve decay cavities in 77.3%. Retrosternal drug injection reduces a risk for complications due to bronchial tuberculosis involvement when pneumoperitoneum is applied.