medecolМедицина и экологияMedicine and ecology2305-60452305-6053Карагандинский медицинский университет10.59598/ME-2305-6053-2025-117-4-211-221medecol-1168Research ArticleНАБЛЮДЕНИЯ ИЗ ПРАКТИКИCLINICAL CASESЛечение хронического гнойного стерномедиастинита физиопроцедурами на основе ультрафиолетового и лазерного облученияTreatment of chronic purulent sternomediastinitis with physioprocedures based on ultraviolet and laser irradiationЕсжановаК. К.EszhanovaK. K.

Куляш Кенесбековна Есжанова 

010009, г. Астана, пр-т Абылай хан, 42

Kulyash Kenesbekovna Eszhanova

010009, Astana с., Abylai khan ave., 42

astana_kulyash@mail.ruАО «Национальный научный медицинский центр»КазахстанNational Scientific Medical Center JSCKazakhstan20252301202604211221Copyright © Есжанова К.К., 20252025Есжанова К.К.Eszhanova K.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medecol.qmu.kz/jour/article/view/1168

Гнойный стерномедиастенит является тяжелым осложнением кардиохирургических операций открытого типа. Хотя частота развития послеоперационного стерномедиастенита составляет 1-3%, смертность от этого состояния является высокой, а его течение осложняется сопутствующими заболеваниями. Кроме того, эффективность лечения гнойного стерномедиастенита варьирует в зависимости от применяемого подхода, а также определяется индивидуальными особенностями пациента.

Представлен клинический случай успешного лечения хронического гнойно-деструктивного стерномедиастенита у пациента 53 лет, развившегося после операции аортокоронарного шунтирования из стернотомного доступа и протекавшего в течение 1 г. Для лечения применяли физиопроцедуры на основе ультрафиолетового облучения (УФО), лазерную терапию и внутривенное лазерное облучение крови (ВЛОК) в комплексе с антибактериальной терапией, поскольку имелось продолжительное нагноение раны в послеоперационном периоде. Подробно описаны характеристики и последовательность применяемых воздействий при проведении процедур.

После проведения 3 курсов комбинированных физиопроцедур у пациента отмечено очищение раны от патогенной микрофлоры, прекратилось нагноение, произошло уменьшение отека и размера раны, произошло заживление раны.

Комбинированное использование ультрафиолетового облучения, лазерной терапии и внутривенного лазерного облучения крови приводит к быстрому заживлению раны грудины при лечении сложных гнойно-деструктивных стерномедиастинитов. Эффективность и преимущества проведения таких комбинированных физиопроцедур перед инвазивными методами лечения необходимо исследовать более подробно

Purulent sternomediastinitis is a severe complication of open cardiac surgery. Although the incidence of postoperative sternomediastinitis is 1-3%, mortality from this condition is high, and its course is complicated by concomitant diseases. In addition, the effectiveness of treatment of purulent sternomediastinitis varies depending on the approach used, and is also determined by the individual characteristics of the patient.

A clinical case of successful treatment of chronic purulent-destructive sternomediastinitis in a 53-year-old patient, which developed after aortocoronary bypass surgery from a sternotomy approach and lasted for one year, is presented. Physiotherapy procedures based on ultraviolet irradiation, laser therapy and intravenous laser blood irradiation in combination with antibacterial therapy were used for treatment, since there was prolonged suppuration of the wound in the postoperative period. The characteristics and sequence of the applied effects during the procedures are described in detail.

After three courses of combined physiotherapy procedures, the patient's wound was cleared of pathogenic microflora, suppuration ceased, swelling and wound size decreased, and the wound healed.

The results obtained in this study show that the combined use of ultraviolet irradiation, laser therapy and intravenous laser blood irradiation leads to rapid healing of the sternum wound in the treatment of complex purulent-destructive sternomediastinitis. The effectiveness and advantages of such combined physiotherapy procedures over invasive treatment methods should be studied in more detail.

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The authors declare that there are no conflicts of interest present.