THE USE OF VALVULAR BRONCHOBLOCKADE AT DIFFERENT STAGES OF TREATMENT AFTER GUNSHOT OR MINEEXPLOSIVE TRAUMA

Abstract. Introduction. Bronchoblockage is a type of interventional bronchoscopy that involves creating therapeutic hypoventilation with the subsequent development of atelectasis in the affected area of the lung while preserving the drainage function of the blocked bronchus and closing the lung parenchymal defect by using an endobronchial valve. Purpose: to evaluate the results of the use of valvular bronchoblockade in patients after injury without surgical treatment and as a staged application in the postoperative period. Materials and methods. 87 bronchoblockades were performed in patients after receiving a chest wound. The patients were divided into three groups. Group I – 26 patients who were installed with a bronchoblocker at an early stage after receiving the wound up to 1.5 months. Group II – 45 patients in whom the treatment period before performing the bronchoblockade was at least 2.5 months, Group III – 16 patients, these are patients in whom the treatment period was more than 6 months and who have multi-organ failure, are on a ventilator. Results. Group I – patients who underwent bronchoblockade during treatment up to 1.5 months after injury, positive results were observed in 23 cases, which was 88.5%. Group II – patients who underwent valve bronchoblockade are patients who had a longer treatment with minor complications and staged surgical treatment. This group included 45 cases, a positive result was achieved in 38 patients, which was 84.6% of the total. Group III – observation group consisted of patients with long-term treatment, more than 6 months and existing multi-organ failure. Positive dynamics were achieved in 11 patients, which was 68.8%. Conclusions. Valved bronchoblockage is the method of choice in the treatment of patients with gunshot wounds of the lungs with some complications (pleural empyema with bronchopulmonary fistula, failure of the bronchial stump in the postoperative period). As well as a staged treatment when using a surgical method of treatment. The earlier the closure of the lung parenchymal defect is performed, the better the result and the faster the result.