METHOD OF COMPLEX INTRAPLEURAL SANITATION IN THE TREATMENT OF PLEURAL EMPYEMA Russian patent published in 2023 - IPC A61B17/00 A61M5/00 A61M1/00 A61K9/08 A61K31/155 A61P11/00 

FIELD: medicine, in particular, to thoracic surgery.

SUBSTANCE: Early thoracoscopy is performed in the first 24 hours from the moment the patient is admitted to a specialized department. the nature of the purulent-destructive process in the lungs and pleura, the stage of empyema is evaluated. Fibrinous plaque and purulent-necrotic tissues are removed from the surface of the pleura and lungs. Then the pleural cavity is drained under visual control. The drains are connected to the AMP-01 device. Drainage for irrigation of antiseptic is injected into the pleural cavity of the patient simultaneously with a tip for bubbling fluid. After drainage, the pleural cavity is sanitized, one session of which includes four consecutive cycles: irrigation of 0.1% polyhexanide solution, intrapleural bubbling of 0.1% polyhexanide solution with simultaneous effect of bubbling fluid flow on the parietal and visceral pleura, active aspiration of the spent solution, vacuuming of the pleural cavity to the drainage volume while maintaining a predetermined vacuum level in the 100-120 mm Hg. Depending on the size and stage of development of the empyema, an individual rehabilitation regime is established. At the same time, the required one-time volume of 100-800 ml of bubbled solution is pumped at a rate of 100 ml /min during irrigation. The volume of 100-900 ml of the spent solution is removed from the pleural cavity during aspiration at a rate of 110-120 ml / min. The pause between irrigation and aspiration is set within 1-10 minutes with the duration of bubbling 1-6 minutes and the time of vacuuming 2-10 minutes. Drains are removed after relief of the inflammatory process in the pleural cavity and negative results of bacteriological examination of pleural effusion.

EFFECT: The present invention enables to increase the effectiveness of treatment of pleural empyema. 8 cl, 1 ex, 1 tbl