Sanitation of a bronchial tree

Description:

Sanitation of a bronchial tree is most effective in treatment of a bronchoectatic disease. Methods of sanitation can be divided on passive to which carry a postural (position) drainage and expectorants, and the active, consisting in aspiration of contents of bronchial tubes, their washing (lavage) and subsequent introduction to bronchial tubes of medicinal substances [Struchkov V. I., Lokhvitsky S. V., 1972].

Obligatory it is necessary to consider a position drainage of a bronchial tree which is carried out in strict accordance with localization of bronchiectasias. At basal bronchiectasias the secret from bronchial tubes is deleted by a trunk preponderating too much of a bed or a considerable raising of the foot end of a bed; at localization of bronchiectasias in IV and V segments — lying on spin with the lowered head end of a bed and with the pillow enclosed under a sick side [Crofton J., Douglas A., 1974].

The postural drainage is carried surely out by the patient with a bronchoectatic disease at least by 2 times a day (in the morning after a dream and in the evening before going to bed). During an exacerbation of a disease the drainage should be reused, every time before perhaps liberation of a bronchial tree from contents.

The effect of a postural drainage can be strengthened by purpose of expectorants: 3% of solution of potassium iodide, thermopsis grass infusion (0,6: 180,0) on 1 tablespoon of each solution 4 — 6 — 8 times a day; Bromhexine or Bisolvon in tablets on 4 — 8 mg 3 times a day or in the form of inhalations; a mukovist in the form of an aerosol on 3 ml of 20% of solution, etc. It is shown that the postural drainage in combination with vibromassage and expectoration at patients with chronic diseases of lungs raises an indicator of the forced vital capacity of lungs [Feidman I. et al., 1979].

Active methods of sanitation of bronchial tubes. Emphasizing value of passive methods of sanitation of a bronchial tree, it should be noted, however, that the expressed oppression of a reflex of self-cleaning of bronchial tubes at sick HNZL and especially a bronchoectatic disease does not allow to count on effective release of a bronchial tree from its contents by use only these methods.

Crucial importance was gained by active, some kind of invasive methods of drainage of bronchiectasias and the affected bronchial tubes — microdrainage of a trachea and bronchial tubes (a transdermal microtracheostoma), a bronchoscopic drainage, lavage of a bronchial tree, the endobronchial directed catheterization under radiological control with aspiration of contents of bronchiectasias and the subsequent administration of antimicrobic, anti-inflammatory, broncholitic and other medicines.