FIELD: medicine; endoscopy; pulmonology; phthisiology.
SUBSTANCE: diagnostic bronchoscopy is performed to assess the condition of the bronchi in the affected area, while taking bronchial flushes to confirm fungal invasion and determine drug sensitivity. In the absence of contraindications to the installation of the endobronchial valve at the next fiber-optic bronchoscopy, the endobronchial valve is installed in the lobar, zonal or segmental bronchus, ventilating section of the lung in which the cavity with the mycetoma is located. After 3-5 days during bronchoscopy, a plastic catheter is inserted between the wall of the endobronchial valve and the wall of the bronchus in which the valve is installed until the distal end of the catheter exits the valve. An aqueous solution of an antifungal drug for intravenous injection containing a single dose of the drug is injected through the catheter. After that, the catheter is released from the solution by the introduction of injection water. Then, the catheter is removed into the channel of the fiber-optic bronchoscope and together with it from the respiratory tract.
EFFECT: method allows providing a high concentration of the drug in the affected area, destroying the mycetoma after a single injection of an antifungal drug, promoting rapid and effective healing of the cavity, reducing the risk of relapse and complications.
5 cl, 3 ex, 9 dwg
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Authors
Dates
2021-06-11—Published
2020-05-20—Filed