Possibilities of using thoracoscopy under local anesthesia and proteolytic enzymes in the removal of coagulated hemothorax

Abstract

The work analyzes the experience of treatment of 57 victims with chest damage, accompanied by the formation of a coagulated hemothorax. Evaluation of the results of treatment was carried out at different times from the moment of injury, taking into account the fact of untimely diagnosis of this consequence of closed chest trauma. Among the cases of chest injuries accompanied by coagulated hemothorax, three groups of clinical observations were identified: in the first group, the sanation of the pleural cavity was carried out by means of a video thoracoscopy under anesthesia (15 cases); in the second — the basis of therapeutic measures was thoracotomy 4 (observation); in the third, proteolytic enzymes (38 patients) were used to sanitize the pleural cavity. It is shown that the use of terrylitin in the complex treatment of victims allows, without the use of such invasive technologies as video thoracoscopy under anesthesia and thoracotomy, adequately and appropriately sanitating the pleural cavity, releasing it from clotted blood in 95 % of cases.