METHOD OF SELECTING A PATIENT MANAGEMENT APPROACH TO DISEASES OF VISCERAL PLEURA AND UNDERLYING LUNG TISSUE ACCOMPANYING PATHOLOGICAL ACCUMULATION OF FLUID AND/OR AIR IN PLEURAL CAVITY Russian patent published in 2019 - IPC A61B6/03 G01B9/02 G01N21/17 A61M27/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to pulmonology, thoracic surgery, oncology. Drainage is performed in the area of the most evident accumulation of pathological contents under local anesthesia with placement by means of trocar in cavity of pleura of drain tube, evacuation of contents, conducting of investigations. OCT examination is carried out. For this purpose, an OCT probe is inserted through the drain tube into the pleural cavity, fixed by the OCT probe perpendicular to the surface of the visceral pleura in the area of interest and at the height of the patient's inspiration, 2-3 recurrent OCT images are obtained. When recording OCT images, recording comments, including information on time, scanning area, features of clinical picture, the visceral pleura is evaluated by measuring the height of the first layer of the OCT image – normally a light "bright" horizontal line of high signal intensity. Size of OCT structures in the second layer reflecting the subject lung tissue is evaluated, in which normally there should be visualized "dark" zones of low intensity of the signal of round or polygonal shape, area of which prevails in total area of OC-tomograms – cavities of alveoli, delimited by "light" zones with higher intensity of signal, but less in brightness of the first layer – between interalveolar partitions. After 12 hours or as required OCT-examination is repeated. Obtained results are compared with previous ones, with tendency to recovery of "cellular", in which on the tomograms a network of clearly differentiated polymorphic structures is visualized, interpreted as the cavities of the alveoli, separated by even, contrast, continuous interalveolar partitions, the prescribed therapy is continued, and if the thickness of the first layer – visceral pleura, which is accompanied by "cellular" regurgitation, is increased, further studies are performed and the treatment is corrected. OCT-examination is performed once a day or repeated as required until removal of drainage.

EFFECT: method enables visualizing the visceral pleura and underlying lung tissue without damaging the analyzed structures themselves, which enables to solve the problem of dynamic observation of the tissue state with evaluating the clinical effectiveness and selecting a further approach to the patient.

1 cl, 2 ex, 8 dwg