Possibilities of using thoracoscopy under local anesthesia and proteolytic enzymes in the removal of coagulated hemothorax

Authors

  • Давид Александрович Зайцев North-Western State Medical University named after I. I. Mechnikov, 41, Kirochnaya ul., St. Petersburg, 191015, Russian Federation; Nikiforov Russian Center of Emergency and Radiation Medicine (EMERCOM of Russia), 4/2, ul. Academician Lebedev, St. Petersburg, 194044, Russian Federation
  • Константин Николаевич Мовчан North-Western State Medical University named after I. I. Mechnikov, 41, Kirochnaya ul., St. Petersburg, 191015, Russian Federation; Saint Petersburg Medical informational and analytical centre, 30, ul. Shkapina, St. Petersburg, 198095, Russian Federation
  • Виктор Владимирович Лишенко Nikiforov Russian Center of Emergency and Radiation Medicine (EMERCOM of Russia), 4/2, ul. Academician Lebedev, St. Petersburg, 194044, Russian Federation
  • Анна Сергеевна Слободкина North-Western State Medical University named after I. I. Mechnikov, 41, Kirochnaya ul., St. Petersburg, 191015, Russian Federation
  • Александр Владимирович Кочетков Nikiforov Russian Center of Emergency and Radiation Medicine (EMERCOM of Russia), 4/2, ul. Academician Lebedev, St. Petersburg, 194044, Russian Federation
  • Рустам Мухаметович Гедгафов Saint Petersburg Medical informational and analytical centre, 30, ul. Shkapina, St. Petersburg, 198095, Russian Federation
  • Ксения Игоревна Русакевич North-Western State Medical University named after I. I. Mechnikov, 41, Kirochnaya ul., St. Petersburg, 191015, Russian Federation

DOI:

https://doi.org/10.21638/11701/spbu11.2018.304

Abstract

The work analyzes the experience of treatment of 57 victims with chest damage, accompanied by the formation of a coagulated hemothorax. Evaluation of the results of treatment was carried out at different times from the moment of injury, taking into account the fact of untimely diagnosis of this consequence of closed chest trauma. Among the cases of chest injuries accompanied by coagulated hemothorax, three groups of clinical observations were identified: in the first group, the sanation of the pleural cavity was carried out by means of a video thoracoscopy under anesthesia (15 cases); in the second — the basis of therapeutic measures was thoracotomy 4 (observation); in the third, proteolytic enzymes (38 patients) were used to sanitize the pleural cavity. It is shown that the use of terrylitin in the complex treatment of victims allows, without the use of such invasive technologies as video thoracoscopy under anesthesia and thoracotomy, adequately and appropriately sanitating the pleural cavity, releasing it from clotted blood in 95 % of cases.

Keywords:

coagulated hemothorax, proteolytic enzymes, terrilitin, thoracoscopy, thoracotomy, local anesthesia, therapeutic tactics

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References

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Published

2018-09-20

How to Cite

Зайцев, Д. А., Мовчан, К. Н., Лишенко, В. В., Слободкина, А. С., Кочетков, А. В., Гедгафов, Р. М., & Русакевич, К. И. (2018). Possibilities of using thoracoscopy under local anesthesia and proteolytic enzymes in the removal of coagulated hemothorax. Vestnik of Saint Petersburg University. Medicine, 13(3), 271–281. https://doi.org/10.21638/11701/spbu11.2018.304

Issue

Section

Surgery

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