Рецензия на «ОПТД 1982» (Центр Торакальной Хирургии)

EXPERIENCE IN APPLICATION OF PHYSIOTHERAPY IN THE REGIONAL ANTI-TUBECCculus
DISPENSER. (Orel city)
UNDER THE CONDITIONS OF SHORT-TERM CHEMOTHERAPY OF DIRECT OBSERVATION.
DEPARTMENT OF INSTRUMENTAL DIAGNOSTICS AND TREATMENT OF REGIONAL ANTI-TUBERCULOSIS DISPENSARY. (Orel city)
Physiotherapist Kazakov. Yu.V.
2002 year http://proza.ru/2011/08/21/644

Physiotherapy in the treatment of tuberculosis patients solves the following problems: increasing the effectiveness of chemotherapy (improving the penetration of anti-tuberculosis drugs into the zone of tuberculous inflammation and into the mycobacterial cell, increasing the concentration of anti-tuberculosis drugs); improved tolerance to chemotherapy; correction of pathological changes (bronchodilator, immunocorrective effect, normalization of oxidative status, improvement of microcirculation, reduction of pressure in the vessels of the pulmonary circulation, etc.); direct bactericidal or bacteriostatic effect on Mycobacterium tuberculosis.

The ultimate goals of using physical factors in phthisiology are to increase the effectiveness of treatment of patients with tuberculosis (acceleration and increase in the frequency of abacillation and closure of caries cavities in patients with tuberculosis of the respiratory system), to reduce residual effects, the number of relapses, and to reduce the cost of treatment. Physiotherapy techniques used in phthisiology help to overcome the lethargy characteristic of the course of tuberculosis in modern conditions.

For all physiotherapy techniques used in the treatment of patients with pulmonary tuberculosis, there are general contraindications:

1) progressive pulmonary tuberculosis (except for aerosol therapy);

2) the impossibility of conducting adequate chemotherapy (except for aerosol therapy);

3) pulmonary hemorrhage and hemoptysis;

4) severe dysfunctions of the body: circulatory failure, respiratory failure II - III degree, renal failure - III degree, severe multiple organ failure, cachexia;

5) severe concomitant diseases: stage III hypertension, thyrotoxicosis II - III degree, malignant neoplasms, hematological cancers (the latter two do not belong to aerosol therapy);

In Russia, when in various anti-tuberculosis institutions, treatment with chemotherapy drugs began to be carried out in short-term courses under the direct supervision of medical personnel, it became possible not only to divide the flows of patients into bacillary and non-bacillary with a separate separation of the flow of patients with resistant forms of tuberculosis, in which Koch's bacilli are sensitive only to drugs, recently developed, but organizational decisions have also arisen when it is possible to control the intake of drugs by patients not only by the sensitivity to the chemotherapy drug, but also by the time it was received during the day, the effectiveness of the drugs taken by the patients was decided to be increased using physiotherapeutic methods.

This work shows practical developments, based on theoretical data and practical recommendations of the leading physiotherapy departments and institutes of the country, attempts are made to make the most rational use of organizational models of Short-Term Chemotherapy under Direct Observation in order to achieve the highest possible result of curing tuberculosis patients, taking into account the realities in which Russia is located, and presented materials on what and how is done in the Oryol TB dispensary by the physiotherapy service in order to increase the effectiveness of the chemotherapy drugs used.

MEDICINAL ELECTROPHORESIS

Medicinal electrophoresis is a method that combines the effect on the body of a direct electric current and drugs administered with its help.
In the department of instrumental diagnostics and treatment, the following types of drug electrophoresis are carried out:

Classic - when the medicine is applied to the pad.

Interstitial - when a medicine is injected into the blood in one way or another.

Intraorganic - when a drug is injected into the affected organ before electrophoresis, for example, by inhalation of the bronchopulmonary system, in this case, the drug circulates in the blood of the bronchopulmonary system for more than two hours.
Electrodraining is when a medicine is applied to the skin or mucous surface.

There are many methods of administration for each type,
Each technique is dosed according to the intensity of the current, according to the area of ​​influence, depending on the age, weight of the patient, on the amount and concentration of the injected substance, according to the duration of the procedure, according to the frequency of repetition of the procedure per day, every other day, once a week, the duration of the course of exposure, all this should determined by a physician physiotherapist.

With long courses, the best option is the duration of drug electrophoresis for 20 minutes, the current strength was determined according to the patient's feelings, the area of ​​the pads did not exceed 300 square meters. cm.

A nurse conducting medicinal electrophoresis procedures must accurately withstand all the exposure parameters prescribed by physiotherapists in a special direction card (registration form 44) and make notes there about the procedure performed and the patient's noticed changes during the procedure, and in the long term.

Юрий Казаков   21.05.2021 14:20   •   Заявить о нарушении