Efficiency videothoracoscopy debridement and local therapy proteolytic enzymes of a pleural cavity at patients closed empyema pleura
Investigation of 65 patients with extended and total closed empyema pleurae in a fibrinopurulent was carried out. The patients were divided into three groups in randomized order. Distinctions between groups consisted in the way of pleural cavity debridement. Patients of the first group (n=21) underwent local proteolytic therapy terridecasum. The second group of 22 patients underwent videothoracoscopy debridement. Videothoracoscopy debridement in a combination with intracavital insertion of terridecasum was performed for patients of the third group (n=22). Recovery was reached for all patients. There was no authentic difference in the results of first and second groups' treatment. By the 14th day of treatment the quantity of leukocytes, leukocyte intoxication index, as well as the volume and cytosis of exudate in patients of group III were authentically lower compared to other groups. In addition, the maximum size of pleural thickening was authentically less in group III in comparison with group II. The treatment duration for group III was 20,5±1,4 days which was authentically less compared to groups I and II (27,4±1,5 and 26,5±1,6 days (p<0,05)). The use of videothoracoscopy pleural cavity debridement in a combination with local proteolytic therapy terridecasum allows to accelerate inflammation reserving, compared to the application of each method separately.