Comparative analysis of the results of examination and surgical treatment of patients with pulmonary tuberculosis in the antituberculosis and general medical network

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Resumo

Background. More than half of the patients registered with the antituberculosis dispensary for pulmonary tuberculosis undergo examination and treatment in the general medical network of the republic before hospitalization in the dispensary. Often, similar clinical and radiological picture of pulmonary tuberculosis and other lung diseases is the cause of frequent diagnostic errors.

Objective. Analysis of the situation in the Kabardino-Balkarian Republic on the diagnosis and surgical treatment of pulmonary tuberculosis in the antituberculosis and general medical network.

Methods. The results of the examination of 1318 patients with pulmonary tuberculosis in the antituberculosis and general medical network of the Kabardino-Balkarian Republic in the period from January 2018 to December 2022 were analyzed.

Results. When analyzing the results of the examination of tuberculosis patients, it was found that more than half of them (59.9%) received an average of 23.3 ± 6.8 kcal/day during inpatient treatment in the general medical network (GMN) before admission to the dispensary; half of them (46.5%) were found to have bacterial excretion during examination in the antituberculosis dispensary. In addition, bacillary pulmonary tuberculosis patients remained in the GMN somewhat longer (26.6±6.9 bed-days), which led to a destructive course, as well as an increase in the frequency of errors in the differential diagnosis of infiltrative pulmonary tuberculosis and community-acquired pneumonia, which reached 30–68%, and the time to establish a diagnosis exceeded 1–3 months.

Conclusion. In order to quickly diagnose patients with pulmonary tuberculosis and reduce «unjustified» lung surgeries in patients with tuberculosis in GMN, it is necessary to properly organize the work of the GMN, namely, to introduce modern methods of etiological diagnosis of tuberculosis, organize a consultation with a phthisiatrician or an analysis of a specific clinical case at pulmonology commissions before thoracic surgery for an unspecified lung disease.

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Sobre autores

N. Samorodov

Antituberculosis Dispensary

Email: 89151479832@mail.ru
ORCID ID: 0000-0002-0013-5752
Rússia, Nalchik

Zh. Sabanchieva

Kabardino-Balkarian State University n.a. Kh.M. Berbekov

Email: 89151479832@mail.ru
ORCID ID: 0000-0002-9103-0648
Rússia, Nalchik

S. Shmeleva

Kabardino-Balkarian State University n.a. Kh.M. Berbekov

Autor responsável pela correspondência
Email: 89151479832@mail.ru
ORCID ID: 0000-0003-0390-194X

Dr. Sci. (Med.), Professor

Rússia, Nalchik

N. Logachev

Moscow State University of Geodesy and Cartography, State University of Management

Email: 89151479832@mail.ru
ORCID ID: 0000-0002-5001-8503
Rússia, Moscow

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2. Fig. 1. Clinical, radiological and epidemiological characteristics of patients with pulmonary tuberculosis operated on in the OLS of the Kabardino-Balkarian Republic in 2018-2022 (n=19)

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3. Fig. 2. Clinical and radiological characteristics of patients with tuberculosis, operated in the anti-tuberculosis network and emergency medical services of the Kabardino-Balkarian Republic in 2018-2022.

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4. Fig. 3. Structure of surgical interventions performed on TB patients in the anti-tuberculosis network and emergency medical services of the Kabardino-Balkarian Republic in 2018-2022.

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5. Fig. 4. Treatment results of patients with tuberculosis, operated in the anti-tuberculosis network of the Kabardino-Balkarian Republic in 2018-2022, depending on the clinical and radiological form of tuberculosis (n=255)

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