Collection Occupational hygiene, Issue 30, 1999 year
Features of dispensary observation of patients with pneumoconiosis with residual changes in cured tuberculosis
Tkach S.I., Koltsov V.A., Chernova S.D., Prilipskaya N.I.
doi
Medical Academy of Postgraduate Education, Kharkov
State Enterprise Research Institute of Occupational Hygiene and Occupational Diseases, Kharkov
A dynamic observation of 125 patients with pneumoconiosis (PC) with residual changes in cured tuberculosis (ICIT) was carried out. A stable course of the disease was detected only in 14% of patients. Almost 2/3 of patients showed its progression. In addition to the unfavorable course of tuberculous inflammation, deterioration of PC was revealed in 76% of patients. Most often, relapses of a specific process were recorded in the period from 6 to 15 years (in 48%) and in the first 5 years from the diagnosis (in 32%). Most often, relapses of tuberculosis were diagnosed among persons removed from the dispensary registration (in 87%) or who did not receive regular treatment with anti-tuberculosis drugs. In the overwhelming majority of PC patients with ICIT, complete cure of tuberculosis did not occur, but various residual changes were formed, in which, in most cases, the activity of specific inflammation of varying severity remained.
Key words: patients, pneumoconiosis, residual changes in cured tuberculosis, progression, relapse, dispensary registration, treatment, activity, inflammation.
In recent years, there has been an increase in pulmonary tuberculosis among workers in dusty professions in various industries, including in mechanical engineering [1,2]. Therefore, it is important to clarify the reasons and factors contributing to the increase in the number of patients with tuberculosis.
In case of coniotuberculosis, due to fibrosis of tuberculous foci, their complete resorption is almost impossible. In the overwhelming number of patients with ICIT, various residual changes are formed, which can be sources of mycobacterium tuberculosis and contribute to the recurrence of a specific process, mainly among people who have been removed from dispensary registration (in 87%) or have not received regular anti-relapse treatment (in 54%). This indicates the need for compulsory lifelong monitoring of such patients in TB dispensaries, TB offices. When examining this category of patients, along with traditional methods, methods should be used that allow for an earlier diagnosis of the disease, to reveal the presence of latent inflammation (ESR at a temperature of I 37 ° C, intoxication indices, immune tests with tuberculin). Taking into account all the above facts allows timely diagnosis of tuberculosis in patients with PC, to clarify the prognosis of the course of the disease, to provide adequate treatment, to reduce the possibility of recurrence of a specific process and progression of pneumoconiotic fibrosis.
References
- Tkach S.I. Problemy koniotuberkulʹozu u robitnykiv mashynobuduvannya (klinika, diahnostyka, prohnozuvannya, dyspanserizatsiya) /Avtoref.dys. ...dokt.med.nauk,- Kyyiv, 1995,- 44 s.
- Krasnyuk E.P. Osobennosty professyonalʹnoy patolohyy bronkholehochnoy systemy // Materialy II z'yizdu ftyziatriv i pulʹmonolohiv Ukrayiny.- Kyyiv, 1998. -S.258- 261.
- Shalʹmyn A.S. Klynycheskoe znachenye ostatochnykh yzmenenyy v bronkhakh posle yzlechennoho tuberkuleza lehkykh: / Avtoref. dys. ...dokt.med.nauk.- K.,1982. -17 s.
- Slynchenko N.Z. Patohenez y patohenetycheskaya profylaktyka syderosylykoza, kak aktualʹnaya problema professyonalʹnoy patolohyy: /Avtoref.dys ...dokt.med.nauk.- K., 1988.- 35 s.
- Holʹdelʹman A.H., Zyslyn D.M. Sylykotuberkulez kak klynycheskaya problema. - Sverdlovsk, 1989. - 176 s.