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11МЕДИЦИНСКИЕ НАУКИ
INTRABRONCHIAL LASER THERAPY IN CHILDREN
WITH BRONCHOECTATIC DISEASE
AND CHRONIC BRONCHITIS
1 2 Shamsiev A.M. , Muhamadieva L.A.
1Shamsiev Azamat Mukhitdinovich - Rector, Professor, DEPARTMENT OF PEDIATRIC SURGERY;
2Muhamadieva Lola Atamuradovna - PhD in Medicine, DEPARTMENT OF PEDIATRIC DISEASE, SAMARKAND STATE MEDICAL INSTITUTE, SAMARKAND, REPUBLIC OF UZBEKISTAN
Abstract: the observation studied 29 children with purulent endobronchitis at the age from 1 to 13 years old. Among them-there were 16 boys and 13 girls. 9 of children had recurrent bronchitis, 10 children bad bronchoectatic disease, and 10 children were with foreign bodies II the bronchus. The results obtained after treatment in children with bronchoectatic disease receiving laser therapy show reliable decrease of neutrophils number to 73,1±3,5 in comparison with the data before treatment-90,4±6,3 (p<0,01). The number of alveolar macrophages increases to 15,1±3,1 in comparison with the data before treatment -2,8±0,1 (p<0,01), the amount of cytosis decreases in comparison with the data before treatment 6,9±1,2 (p<0,01).
Keywords: children, chronic bronchitis, bronchoectatic disease, laser therapy.
UDC: 616.233-007.64.+233-002
Treatment of nonspecific lung diseases (NLD) is provided with traditional sanation bronchoscopy with use of different medications (antibiotics, steroids, enzymes, etc.) [1, 7, 8]. For the treatment of purulent endobronchitis in NLD it is also used helium-neon laser. Intrabronchial inflammatory lung diseases are considered to be an actual pediatric problem as their frequency increases in recent years and clinical manifestations are characterized by severe course and early disability of patients [2-6,9].
The aim of the presented investigation was the improvement of the treatment results of the purulent endobronchitis in children with nonspecific lung diseases with intrabonchial use of gallium-arsenide laser.
The observation studied 29 children with purulent endobronchitis at the age from 1 to 13 years old. Among them-there were 16 boys and 13 girls. 9 of children had recurrent bronchitis, 10 children bad bronchoectatic disease, and 10 children were with foreign bodies II the bronchus. The lung washing out (lavage) of 10 children with urolithiasis served as a model ofbconchoalveolar-lavage fluid (BALF) in "healthy lung". The children had not pathology of the respiratory tract, the lavage was taken during the surgical operation through the intubation tube. In the comparison group there were children with bronchoectatic disease, recurrent bronchitis and foreign bodies of the bronchus.
These children received traditional therapy, during their bronchoscopy it was not used laserotherapy. In order to perform endobronchial laser irradiation it was used low-intensive semiconducting laseronthe gallium-arsenide base (ALT "Sogdiana", Uzbekistan), with persistent acting in there diapason with the length of wave 0.67 mkm, in the dose 4.87 Jg\sm3.
Laserotherapy was performed in the following way. During the bronchoscopy it was carried out lavage with use of physiologic saline until the clear irrigated waters from the orifice of segmental bronchus. Subsequently, it was irradiated by the use of the light of gallium-arsenide laser with exposition during 1 minute.
From the sediment of BALF centrifugation it was prepared the smear with the following fixation. Calculation of the cells elements was performed under the immersion for 100 cells
with the percentage evaluation of the cytological composition. The distinctive clinical features of die diseases in children were the frequency of cough and the amount of expectoration; these cough was more frequent and the expectoration amount was larger in children who had bronchoectatic disease. Also, auscultative data were distinguished: the presence of the local bubbling rales in children with bronchoectatic disease, scattered dry and single bubbling rales in children with recurrent bronchitis.
During the bronchological investigation in all patients it was diagnosed purulent end bronchitis. The control group was characterized with prevailed amount of alveolar macrophages (AM) 91.4±2.0; low amount of neutrophils (NP) 10.8+2.0 and lymphocytes (LC 7.8±1.2. In all examined children, except children from the control group, it was determined the increasing amount of neutrophils and lymphocytes and die sharp decreasing amount of alveolar macrophages.
After treatment of children with CB, receiving laser therapy, reliable decrease of neutrophils number to 68,1±6,4 is noted in comparison with the data before treatment 88,7±2,7 (p<0,01), the number of alveolar macrophages increases to 24,8±7,4 in comparison with the data before treatment 5,9±1,7 (p<0,01), the amount of cytosis decreases to 1,8±0,7 in comparison with the data before treatment - 11,7±0,6. The number of lymphocytes also increases.
The results obtained after treatment in children with CB receiving laser therapy show reliable decrease of neutrophils number to 73,1±3,5 in comparison with the data before treatment-90,4±6,3 (p<0,01). The number of alveolar macrophages increases to 15,1±3,1 in comparison with the data before treatment -2,8±0,1 (p<0,01), the amount of cytosis decreases in comparison with the data before treatment 6,9±1,2 (p<0,01).
Thus, treatment with the use of gallium-arsenide laser is one of the acceptable and effective methods of treatment of purulent endobronchitis in children with NLD. This method allows reaching during the short time a restoration of the bronchial patency, regression of the inflammatory process in bronchus and also restoration of the local lungs defense.
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