USE OF AUTOMATIC PLATFORM FACTOR IN THE STRUCTURE OF VIDEOTORACOSCOPIC OPERATIONS IN THE GENERALIZED FORM OF LUNG EMPHYSEMA
Introduction. The generalized form of pulmonary pulmonary emphysema is one of the most severe conditions of pulmonary pathology that a surgeon encounters when performing video-assisted thoracoscopic surgery. The developed method of autohemopleurodesis is based on processes characteristic of the development and transformation of hemothorax, and irrigation of the pleural cavity is carried out not by whole autologous blood, but by its components, for which a platelet factor (ATP) is used.
The aim of the study is to study the effectiveness of the developed method of autohemopleurodesis with autologous platelet factor (autohemopleurodesis with ATP) compared with chemical pleurodesis with 70.0% alcohol in patients with generalized form of pulmonary emphysema.
Materials and research methods. The study was performed in 15 patients after autohemopleurodesis with ATP and in 13 patients after chemical pleurodesis with 70.0% alcohol.
Research results and discussion. In all patients after chemical pleurodesis with 70.0% alcohol, there was a marked thickening of the pleura along the posterior surface of the chest wall to 6.2-6.5 mm, a moderate thickening of the pleura to 3.9 mm in the costal-diaphragmatic sinuses, associated with the pleura reaction to effusion and a slight thickening of the pleura in the aperture. On day 14 in the aperture and sinuses, pleural thickness averaged 2.0 mm, which indicates the restoration of fibrinolysis after the end of the action of a chemical stimulus. In patients after autohemopleurodesis with ATP, there was a moderate thickening of the pleura in all the studied areas, which, in our opinion, was a consequence of the slight primary irritating effect of ATP. However, a significant thickening of the pleura on the 14th day to 5.2 mm in the aperture, 4.7 in the costal diaphragmatic sinuses and up to 5.8 on the posterior surface of the chest can indicate a progressive prevalence of fibrinogenesis over fibrinolysis
Conclusions. The developed method of autohemopleurodesis with ATP makes it possible to more effectively create the so-called fibrin cortex, which is based on the formation of platelet growth factor and liquid fibrin, which are a new generation of platelet and stem cell concentrate in the form of a three-dimensional structure.
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