LONG-TERM OUTCOMES OF TUBERCULOUS PLEURISY TREATMENT WITH REGARD TO DIAGNOSTIC TECHNIQUE USED FOR PLEURAL EFFUSION SYNDROME DIAGNOSIS

Keywords: pleural effusion syndrome, pleurisy, tuberculosis, diagnosis, long-term outcomes

Abstract

Introduction. Despite the overall positive epidemiological trend, the burden of tuberculosis in Ukraine remains significant. The most common form of extrapulmonary TB is tuberculous pleurisy. The share of the latter in the structure of all tuberculosis forms is within 10–12% or more. The clinical picture of specific pleurisy is diverse, so its diagnosis is often complicated and ultimately leads to various negative consequences. The authors suggested using a diagnostic system based on ultrasound findings to detect pleural effusion syndrome.

Methods. We examined 329 patients with tuberculous pleurisy, who were divided into two groups. There were 142 subjects in the main group and 187 subjects in the comparison group. The radiodiagnostic examination was based on traditional chest radiography. The patients of the main group were examined according to the pleural diseases diagnostic algorithm implemented by the fellows of the department (utility model patent of Ukraine No. 114430).

Results. In the long-term period, residual changes (thickening) in the pleural cavity were found in 6.8% of patients in the main group vs. 19.8% of patients in the comparison group (p < 0.05), changes in diaphragmatic skeletopy were observed in 13.5% vs. 25.9%, respectively (p < 0.05), and diaphragmatic mobility disorder – in 5.4% vs. 18.5%, respectively (p < 0.05). Patients with tuberculous pleurisy who had been examined according to the proposed algorithm developed chronic pleurisy 7.1 times less often (1.4% vs. 9.9%, p < 0.05) and pulmonary disease – 2.7 times less often (4.1% vs. 11.1%, respectively, p ˃ 0.05).

Conclusion. Taking into account the early detection of pleural effusion and timely verification of the disease, the proposed diagnostic algorithm for pleural diseases allows to reduce the long-term effects on the chest wall, lungs, and pleura.

References

1. Zakon Ukrainy vid 22.03.2012 № 4565-VI «Pro vnesennia zmin do Zakonu Ukrainy «Pro borotbu iz zakhvoriuvanniam na tuberkuloz» ta inshykh zakonodavchykh aktiv Ukrainy» [On Amendments to the Law of Ukraine "On Combating Tuberculosis].
2. Pro zakhyst naselennia vid infektsiinykh khvorob [On the protection of the population from infectious diseases]: Zakon Ukrainy vid 06 kvit. 2000 r. № 1645–III (1645–14) (u redaktsii vid 01.06.2012 r.). Vidomosti Verkhovnoi Rady Ukrainy. 2000; 29: 228.
3. Friesen I, Ulrichs T, Hryshchuk L, Saturska H. [Comparative characteristics of the epidemiological situation of chemoresistanttuberculosis in Germany and Ukraine]. Tuberculosis, Lung Diseases, HIV Infection. 2021;4: 27–35. doi:10.30978/TB-2021-4-27
4. Duzhyi ID, Oleshchenko GP, Shevchenko MYu, Shevchenko YuYu, Yarkova NV. [Analysis of the cases for the first detected active extrapulmonary tuberculosis in Ukraine and Sumy region]. Tuberculosis, Lung Diseases, HIV Infection. 2022;1: 37–43. doi:10.30978/TB-2022-1-37
5. Babich MI, Opanasenko MS. Znachennia videotorakoskopii v kompleksnomu likuvanni khvorykh na tuberkuloznyi plevryt [The role of videothoracoscopy in complex treatment of patients with tuberculous pleurisy]. Ukr. Pulmonol. J. 2013; 2: 46–50.
6. Petrenko VI, Dolynska MH, Roznatovska OM. Pozalehenevyi i miliarnyi tuberkuloz u khvorykh na koinfektsiiu tuberkuloz/VIL [Extrapulmonary and miliary tuberculosis in patients with tuberculosis/HIV co-infection]. Kyiv: DKS tsentr, 2015. 112 р.
7. Ivashchenko VЕ, Kalabukha IA. Optymizatsiia torakoskopichnykh vtruchan u khvorykh na syndrom plevralnoho vypotu [Optimization of videothoracoscopic interventions in patients with pleural effusion syndrome]. Ukr. Pulmonol. J. 2016; 1:33–36.
8. Oleshchenko HP, Lytvynenko OM. Deiaki definitsii klinichnykh syndromiv u razi zakhvoriuvan plevry (Kompendium) [Some definitions of clinical syndromes in the case of pleural diseases (Compendium)]. Sumy: Vyd-vo SumDU, 2021. 51 p.
9. Duzhyi ID, Blyzniuk MD, Yurchenko AV. Systema diahnostyky zakhvoriuvan plevry ta syndromu plevralnoho vypotu [Diagnostic system for pleural diseases and pleural effusion syndrome]. Sumy: Vyd-vo SumDU, 2010. 38 p.
10. Dmitriyeva EYu, Katilov AV, Otkalenko ES, Brovinskaya LN. Spornyye voprosy ultrazvukovoy diagnostiki pri zabolevaniyakh organov grudnoy kletki [Controversial issues of ultrasound diagnostics in diseases of the chest organs]. Zdoroye Ukrainy, 2010 Feb; 60–62.
11. Khosla, R. Lung Sonography. In: Thoirs, K., editor. Sonography [Internet]. London: IntechOpen; 2012 [cited 2022 Jun 09]. Available from: https://www.intechopen.com/chapters/27888 doi:10.5772/27400
12. Soni NJ, Franco R. Ultrasound in the diagnosis and management of pleural effusions. J. Hosp. Med. 2015, Dec; 10 (12): 811–816.
13. Nakaz Ministerstva okhorony zdorovia Ukrainy vid 21 hrudnia 2012 roku № 1091 «Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry tuberkulozi» [On approval and implementation of medical technological documents on standardization of medical care at tuberculosis].
14. Nakaz Ministerstva okhorony zdorovia Ukrainy vid 4 veresnia 2014 roku № 620 «Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry tuberkulozi» [On approval and implementation of medical technological documents on the standardization of medical care for tuberculosis].
15. Nakaz Ministerstva okhorony zdorovia Ukrainy vid 25.02.2020 № 530 «Pro zatverdzhennia standartiv okhorony zdorovia pry tuberkulozi» [On the approval of health care standards for tuberculosis].
16. Nakaz Ministerstva okhorony zdorovia Ukrainy Ukrainy vid 06.10.2021 № 2161 «Pro vnesennia zmin do standartiv okhorony zdorovia pry tuberkulozi» [About making changes to health care standards for tuberculosis].
17. Duzhyi ID, Oleshchenko HP, Hresko IYa, Oleshchenko VO, inventors. Sposib poperednoi veryfikatsii syndromu plevralnoho vypotu [Method of preliminary verification of pleural effusion syndrome]. Ukrainian patent, no.114430, 2016.
Published
2022-06-30
How to Cite
Ihor D. Duzhyi, Halyna P. Oleshchenko, & Valentyna H. Psarova. (2022). LONG-TERM OUTCOMES OF TUBERCULOUS PLEURISY TREATMENT WITH REGARD TO DIAGNOSTIC TECHNIQUE USED FOR PLEURAL EFFUSION SYNDROME DIAGNOSIS. Eastern Ukrainian Medical Journal, 10(2), 124-130. https://doi.org/10.21272/eumj.2022;10(2):124-130