Sanatorium- spa treatment Tuberculosis patients plays an important role in the overall range of measures for the treatment of this disease. Its exceptional impact on the psychological state of such patients is not questioned. No less great value It also has the ability to correct impaired functions and metabolic processes. Sanatorium treatment of tuberculosis patients allows achieving positive results in all these directions. Physical methods of treatment with dosed exercise, in combination with favorable meteorological influences, create all the necessary conditions for both medical and labor rehabilitation of tuberculosis patients with the restoration of their ability to work.
Typically, sanatoriums are divided according to a local principle: local and located in resort areas. For most patients, it is sufficient to undergo a course of treatment in local sanatoriums, the location of which coincides with their places of permanent residence. In such cases, there is no need to adapt to new climatic conditions, and the transport costs. As a rule, patients with any form of tuberculosis are sent to local sanatoriums, but only after a stable disappearance of the symptoms of acute intoxication and if there are signs of stabilization of the process. As for the continuation phase of treatment, in local sanatoriums it is most advisable to carry it out for older patients age groups, patients after surgical interventions for tuberculosis and young children.
In cases where the prognosis suggests the most complete involution of lesions in sufficient time short terms, it is advisable to refer patients to resort sanatoriums. If patients with tuberculosis have concomitant diseases, it is also better to send them to the climatic resort in which these diseases occur with the least damage to the patient.
The main principles of treatment of patients with tuberculosis are elimination clinical manifestations tuberculosis, achieving stable healing of tuberculous changes, restoration of working capacity and social status. Based on these principles, the venue is chosen sanatorium treatment.
In general, tuberculosis patients undergo sanatorium-resort treatment in sanatoriums located in different climatic and geographical zones. When choosing such an area, take into account the impact that may be caused by natural factors V different seasons year, and when choosing a sanatorium, the possibilities it provides for using sanatorium treatment methods in complex therapy of both tuberculosis itself and concomitant diseases are taken into account.
To a sanatorium-resort area with gentle climatic and meteorological factors and maximum comfortable conditions, includes resorts on the sea coast of the Caucasus. Patients are sent to this group of resorts for the treatment of patients. in whom the changing continental climate causes exacerbations of tuberculosis, as well as patients with concomitant diseases of the respiratory system of a nonspecific nature.
The climatic conditions of mountain and steppe resorts have mainly an irritating, training and hardening effect on the body. In the sanatoriums of the steppe region, treatment is supplemented with the use of kumiss. These sanatoriums are most suitable for patients with all forms of chronic tuberculosis, who have no signs of disease progression, but have signs of low nutrition, as well as patients with concomitant diseases such as chronic gastritis and chronic bronchitis.
96. Sanatorium-resort treatment of patients with tuberculosis and its role in rehabilitation.
In the complex of measures for the treatment of patients with tuberculosis, the impact on their psychological state is of undoubted importance. Correction of impaired functions and metabolic processes is also important. Sanatoriums are divided into local ones and those located in resort areas. It is advisable to send most patients to local sanatoriums located in the area of their permanent residence. At the same time, there is no need to adapt to new climatic conditions and transportation costs are lower. Patients with all forms of tuberculosis can be sent to local sanatoriums after the symptoms of acute intoxication have been eliminated and with signs of stabilization of the process. The second phase of chemotherapy (the continuation phase of treatment) in local sanatoriums is preferable for patients in older age groups, young children and patients after surgery for tuberculosis. Patients who have
it can be assumed that the lesions will involute more completely in a short time. Another group is patients with concomitant diseases that progress better in the conditions of an appropriate climatic resort. For sanatorium and resort treatment of patients with tuberculosis, sanatoriums of different climatic and geographical zones are used. This takes into account the impact of natural factors in different seasons of the year and the possibility of using sanatorium treatment methods for complex therapy of tuberculosis and related diseases. The zones with gentle climate and meteorological factors in conditions of maximum comfort are the resorts on the warm sea coast of the Caucasus. These resorts are indicated for the treatment of patients who react with exacerbations to the changing continental climate, as well as for patients with concomitant nonspecific respiratory diseases. The climate of mountain and steppe climatic resorts has a predominantly irritating, training and hardening effect on the body. In the sanatoriums of the steppe region, treatment with kumiss is used. They refer patients with all forms of chronic tuberculosis without signs of progression in the presence of chronic gastritis and low nutrition, as well as patients with concomitant chronic bronchitis. Treatment of patients with respiratory tuberculosis with concomitant diseases of the cardiovascular system is advisable in sanatoriums located in favorable climatic conditions. When referring tuberculosis patients to climatic resorts take into account that in some of them, in addition to departments for patients with pulmonary tuberculosis, there are departments for the treatment of extrapulmonary tuberculosis, in particular tuberculosis of the eyes and organs genitourinary system. Vouchers for sanatorium treatment are issued to patients by anti-tuberculosis dispensaries. The duration of sanatorium treatment ranges from 1.5 to 6 months or more.
97. Emergency conditions in phthisiology - pulmonary hemorrhages, spontaneous pneumothorax.
Pulmonary hemorrhage
Pulmonary hemorrhage is understood as the outpouring of a significant amount of blood into the lumen of the bronchi. The patient usually coughs up liquid blood or blood mixed with sputum.
In clinical practice, a distinction is made between pulmonary hemorrhage and hemoptysis. The difference between pulmonary hemorrhage and hemoptysis is mainly quantitative. Hemoptysis - This is the presence of streaks of blood in sputum or saliva, the release of individual spits of liquid or partially coagulated blood. At pulmonary hemorrhage blood is coughed up in significant quantities, simultaneously, continuously or intermittently. Depending on the amount of blood released, bleeding is classified into small (up to 100 ml), medium (up to 500 ml) and large or profuse (over 500 ml). It should be borne in mind that patients and those around them tend to exaggerate the amount of blood released. Some blood from the respiratory tract may be aspirated or ingested, so quantification of blood loss from pulmonary hemorrhage is always approximate.
aminophylline (5-10 ml of 2.4%) aminophylline solution is diluted in 10-20 ml of 40% glucose solution and injected into a vein over 4-6 minutes). To enhance blood clotting, a 10% solution of calcium chloride or calcium gluconate (10-15 ml) is administered intravenously. With bronchoscopy, it is sometimes possible to stop bleeding by temporarily occluding the bronchus with foam rubber or collagen sponge. This bronchial occlusion prevents aspiration of blood into other parts of the bronchial system and sometimes completely stops bleeding.
Spontaneous pneumothorax. Spontaneous pneumothorax refers to the entry of air into pleural cavity, which arises spontaneously, as if spontaneously, without damage chest wall or lung. However, in most cases with spontaneous pneumothorax, both a certain form of lung pathology and the factors that contributed to its occurrence can be established. It is difficult to assess the frequency of spontaneous pneumothorax, since it often occurs and is eliminated without an established diagnosis. Among patients with spontaneous pneumothorax, men account for 70-90%, mainly between the ages of 20 and 40 years. On the right pneumothorax there are several
more often than on the left.
Pathogenesis and pathological anatomy. Currently, spontaneous pneumothorax is most often observed not in pulmonary tuberculosis, but in widespread or local bullous emphysema as a result of rupture of air bubbles - bullae. Common bullous emphysema is often a genetically determined disease, which is based on deficiency of the elastase inhibitor α1*antitrypsin. Smoking and inhalation of polluted air are important in the etiology of widespread emphysema. Local bullous emphysema, usually in the area of the apex of the lungs, can develop as a result of tuberculosis and sometimes a nonspecific inflammatory process.
In addition to bullous widespread or local emphysema, the following factors may be important in the etiology of spontaneous pneumothorax:
Perforation into the pleural cavity of the tuberculous cavity;
Rupture of the cavity at the base of the pleural cord during the application of art. pneumothorax;
Damage to lung tissue during transthoracic diagnostic and therapeutic puncture;
Burst of abscess or gangrene of the lung.
In the mechanism of spontaneous pneumothorax in bullous emphysema, the leading place belongs to an increase in intrapulmonary pressure in the area of thin-walled bullae.
Among the causes of increased pressure, the patient’s physical stress, heavy lifting, jolting, and coughing are of primary importance. A complication of pneumothorax is the formation of exudate in the pleural cavity - usually serous, sometimes serous-hemorrhagic or fibrinous. In patients with active tuberculosis, cancer, mycosis, with an abscess or gangrene of the lung, the exudate is often infected with nonspecific microflora and purulent pleurisy is associated with pneumothorax (pyopneumothorax). Rarely, with pneumothorax, penetration of air into the subcutaneous tissue and mediastinal tissue is observed (pneumomediastinum) and air embolism. Clinical picture and diagnosis. Clinical symptoms of spontaneous pneumothorax are caused by the entry of air into the pleural cavity and the occurrence of lung collapse. Sometimes spontaneous pneumothorax is diagnosed
only with x-ray examination. Main complaints: pain in the corresponding half chest, dry cough, shortness of breath, palpitations. The pain may be localized in upper section abdomen, and sometimes concentrate in the heart area. In severe cases of spontaneous pneumothorax, pale skin, cyanosis, cold sweat, tachycardia with increased blood pressure are characteristic. The most informative method for diagnosing all variants of spontaneous pneumothorax is x-ray examination. The amount of air pressure in the pleural cavity and the nature of the opening in the lung can be assessed using manometry, for which a puncture of the pleural cavity is performed and
connect the needle to the water pressure gauge of the pneumothorax apparatus. Usually the pressure is negative, i.e. below atmospheric, or close to zero. By changes in pressure during air suction, one can judge the anatomical features of the pulmonary-pleural communication. A particularly severe and life-threatening form of spontaneous pneumothorax is tension, valve, valvular or progressive pneumothorax. It occurs when a valvular pulmonary/pleural communication is formed in
site of perforation of the visceral pleura. During inhalation, air enters through the perforation into the pleural cavity, and during exhalation, the closing valve prevents it from leaving the pleural cavity. With each breath, the amount of air in the pleural cavity increases, intrapleural pressure increases, and the lung on the side of the pneumothorax completely collapses. Upon palpation, a displacement of the apex beat of the heart is determined in the direction opposite to the pneumothorax; there is no vocal tremor on the side of the pneumothorax. Subcutaneous emphysema may be detected.
Treatment. The puncture is performed under local anesthesia along the midclavicular line in the second intercostal space. If all the air cannot be removed and it continues to flow into the needle “without end,” a silicone catheter must be inserted into the pleural cavity for constant aspiration of air. For hemopneumothorax, a second catheter is inserted along the midaxillary line in the sixth intercostal space. Constant aspiration with a vacuum of 10-30 cm of water. Art. in most cases leads to the cessation of air flow from the pleural cavity. If the lung has expanded according to X-ray examination, aspiration is continued for another 2-3 days, and then the catheter is removed. In case of tension pneumothorax, the patient needs emergency assistance - drainage of the pleural cavity with constant aspiration of air. In 10-15% of patients spontaneous pneumothorax after treatment punctures and drainage recurrence, if preserved. reasons for its occurrence. and free pleural cavity. In case of relapses, it is advisable to perform videothoracoscopy and determine subsequent treatment tactics depending on the identified picture.
Anti-tuberculosis sanatoriums in Russia
Spa treatment is an important factor medical rehabilitation patients with tuberculosis. The use of natural and medicinal factors, kumiss treatment, therapeutic nutrition and the active motor mode of this continent makes it possible to increase the effectiveness of treatment and speed up the rehabilitation process. The network of sanatoriums of the Federal subordination of the Ministry of Health of Russia includes 13 sanatoriums with 3270 beds for adults (Teberda, Golubaya Bukhta, Ples, Vyborg-7, Vyborg-3, Lesnoye, Krasny Val, Glukhovskaya, named after Aksakov, Shafranovo, Chemal, Zhemchuzhina, Sovetsk) and 3 sanatoriums with 910 beds for children (Pioneer, Kiritsy, Pushkinsky), in the Lipetsk region there is a local sanatorium “Forest Fairy Tale”. Work on sanatorium-resort treatment is carried out in accordance with the order of the Ministry of Health and Social Development of the Russian Federation dated March 27, 2009 No. 138-n “On the procedure for organizing work on the distribution of vouchers and the referral of patients from institutions providing specialized, including high-tech, medical care” and the Order of the Health Administration of the Lipetsk Region dated April 13, 2012 No. 304 “On increasing the availability and quality of sanatorium-resort medical care for patients with tuberculosis and persons with increased risk diseases of local tuberculosis, including children aged 0-17 years inclusive.”
Lipetsk regional anti-tuberculosis sanatorium "Forest Fairy Tale" was opened in 1990 with 130 beds.
The sanatorium is located in a suburban area, on three sides the sanatorium is surrounded by pine and mixed forest, on the fourth side by the floodplain of the Voronezh River.
One of the sanatorium buildings is a dormitory , rooms are designed for 3 and 5 people. In another building - a medical one, there is a treatment room, an aerosol room (inhalations with various mixtures and herbs are carried out), a halacamera (allows for anti-inflammatory, desensitizing treatment of tuberculosis and chronic obstructive nonspecific diseases), a physiotherapy room (ultrasound , electrophoresis, sinusoidal modular currents, magnetic therapy), massage, physical therapy.
The sanatorium employs qualified doctors and paramedics. staff. Beauty surrounding nature, long stay fresh air and sanatorium-hygienic regime are important factors, which have a beneficial effect on the nervous system and general condition sick.
All of the above is the basis of sanatorium treatment and helps to increase its effectiveness.
The efforts of all medical workers at the sanatorium are aimed at consolidating the effect of treatment obtained at earlier stages, as well as restoring respiratory function, blood circulation, nervous system and treatment of concomitant diseases.
Sanatoriums of Federal significance
Sanatorium "Teberda" located in the most picturesque corner of the Karachay-Cherkess Republic at an altitude of 1340 meters above sea level. Operating since 1923. Designed for 250 year-round beds for patients with minor and limited forms of respiratory tuberculosis. Climatic conditions with reduced atmospheric pressure, intense ultraviolet insolation and high air ionization. Coniferous forest, most beautiful places, mountainous landscape, but there are contraindications as for all high-mountain sanatoriums. The sanatorium also receives persons who have professional contact with tuberculosis patients for their recovery.
The sanatorium has 195 rooms. Of these, 30 are single, 150 are double, 15 are triple. Certified specialists of the sanatorium: bacteriologist, gynecologist, nutritionist, clinical laboratory diagnostics doctor, otolaryngologist, ophthalmologist, occupational pathologist, reflexologist, dentist, therapist, ultrasound doctor, physiotherapist, phthisiatrician, functional diagnostics doctor, surgeon. The Teberda River flows 250 meters from the sanatorium.
Used the following types treatments: hardware physiotherapy: galvanization, sinusoidal modulated currents, diadynamic currents, ultrasound, electrosleep, electrophoresis of medicinal substances, microwave therapy, UHF therapy, magnetic therapy, inductothermy, laser therapy, UV irradiation, phototherapy polarized light. Balneotherapy: mineral sodium chloride baths, Charcot shower, circular shower, ascending shower, underwater massage shower. The Teberda sanatorium employs qualified doctors and nursing staff. There is a large arsenal of tools here therapeutic effects, conditions have been created for aero- and heliotherapy, physical therapy and physiotherapy are carried out, and inhalations are functioning. X-ray rooms, clinical laboratories, bacteriological and biochemical laboratories are equipped with modern equipment. In functional diagnostic rooms the condition is determined external respiration and cardiovascular system. Patients with tuberculosis and concomitant nonspecific diseases are admitted to the Teberda sanatorium: bronchial asthma, chronic bronchitis, pneumonia.
Sanatorium "Blue Bay" located on the shore of the sunny city of Gelendzhik, in the valley of the Caucasian foothills - Gelendzhik Bay, which has always been famous for the cleanest air and crystal clear calm water. Founded in 1955, 320 beds for the treatment of patients with minor and limited forms of respiratory tuberculosis.
The large multi-storey building of the Blue Bay sanatorium is located on a cliff, thanks to which the windows and balconies of the sanatorium offer a magnificent view of the Gelendzhik natural landscapes and the huge, sparkling Black Sea with a pebble beach.
On the territory of the Blue Bay sanatorium: a dance floor and a disco, billiards. To maintain fitness: sports and gym s.
Gelendzhik Bay, with its mild climate and magnificent nature, has excellent conditions not only for relaxation, but also for treatment.
Treatment and diagnosis are carried out by doctors of the highest category. The sanatorium is equipped with the latest equipment
Work: clinical, biochemical, bacteriological laboratory; ultrasound, x-ray and functional diagnostic rooms.
Treatment at the Blue Bay sanatorium is comprehensive: climate therapy and aerosol therapy, therapeutic exercises and massage, physiotherapy, IRT, honey treatment and kumiss treatment, herbal medicine.
Sanatorium "Ples" located in the city of Ples on the banks of the Volga River, near the city of Ivanovo. The sanatorium has a capacity of 460 beds. For the treatment of patients with respiratory tuberculosis, eye tuberculosis, sarcoidosis. The sanatorium also receives persons who have professional contact with tuberculosis patients for their recovery. Natural and climatic conditions are most favorable for patients with tuberculosis, burdened by concomitant diseases of the respiratory organs of a nonspecific nature and the cardiovascular system, for whom treatment in sanatoriums of the Black Sea coast is contraindicated.
Today, as before, the PLES sanatorium remains one of the leading specialized treatment and preventive institutions in our country for patients with pulmonary and eye tuberculosis. Since July 2012, the sanatorium has been included in the St. Petersburg Research Institute of Phthisiopulmonology of the Ministry of Health and Social Development and is its branch.
It's spotless here clean air, silence, tranquility, various walking routes. Plyos is a preserve of 19th-century architecture, a tiny oasis of a measured, sedate lifestyle, perfectly suited for overcoming stress, strengthening the nervous system, normalizing sleep, appetite, vitality. Plyos is also irreplaceable as a cozy, private place for rehabilitation after serious medical interventions.
The sanatorium has all the necessary treatment and diagnostic rooms: X-ray, functional diagnostics, ultrasound, physiotherapeutic, gynecological, otorhinolaryngological, biochemical, clinical, bacteriological laboratories, equipped with domestic and imported equipment. Since 2006, in the complex treatment of respiratory diseases, sessions in salt cave. Treatment in the sanatorium meets all the requirements of modern therapy for patients with pulmonary tuberculosis with various forms and is carried out comprehensively. Specific etiotropic chemotherapy is used against the background of a sanatorium-hygienic regime. All different methods of administering chemotherapy are widely used: intramuscular, intravenous, enteral, foam-oxygen.
Chemotherapy is combined with physical methods of treatment: physical therapy, morning exercises, occupational therapy, air baths, hydrotherapy, diet therapy. Collapse therapy (artificial pneumoperitoneum) is performed according to indications. As a non-drug treatment method, kumiss therapy is prescribed - kumiss based on cow's milk.
An important component of sanatorium treatment is rational meals five times a day, which corresponds to diet No. 11 and meets the objectives of dietary therapy for tuberculosis.
FSBI sanatorium "Lesnoye" created on the basis of the private kumiss clinic “Lesnoye” of the Stavropol merchant V.N. Klimushin, opened in 1910.
The sanatorium has 360 beds for the treatment of patients with tuberculosis of the respiratory, genitourinary, and osteoarticular systems. The sanatorium serves 70 regions of Russia. Occupies 43 hectares of pine forest located in geographical center city of Togliatti.
In 1988, the construction of a seven-story dormitory and medical building with a catering unit, a dining room, a club, a cinema hall and other services was completed. The institution is licensed to carry out medical activities in 2012 for 24 types of activities by Roszdravnadzor.
Sanatorium "Glukhovskaya" is located in the Republic of Bashkortostan. Profiled for the treatment of 250 adult patients with tuberculosis of the urinary and genital organs. The sanatorium also receives persons who have professional contact with tuberculosis patients for their recovery. The climate of the pine forest, air rich in phytoncides, and kumiss treatment have a beneficial, profound and diverse effect on the course of the tuberculosis process. It is also one of the oldest climatic sanatoriums. The unique combination of natural climatic factors made it possible to call this place “Russian Switzerland”. By the way, the village located next to the sanatorium still bears the same name.
The diagnostic and treatment department is equipped with modern domestic and imported equipment, which allows you to apply express diagnostic methods and carry out the necessary examination and clarification of the diagnosis in the first days of your stay in the sanatorium.
A clinical diagnostic laboratory, radiation, functional, ultrasound, and endoscopy rooms make it possible to conduct examinations at the modern level.
Physiotherapy rooms, mud therapy rooms, therapeutic massage, hirudotherapy, dental, exercise therapy, gym. There is a herbal bar, stylized in the form of a national Bashkir yurt, with a wide range of medicinal mixtures.
Sanatorium "Vyborg -7". Located in the Leningrad region, on the shores of the Gulf of Finland, 14 km. from the city of Vyborg, 120 km from St. Petersburg.
The sanatorium is intended for the treatment of adult patients with various forms of pulmonary tuberculosis. The sanatorium is located in three medical buildings, an administrative building, combined with a dining room. The buildings contain clinical, biochemical and bacteriological laboratories, a modern X-ray examination complex, a functional diagnostics room, and an endoscopy room. For the treatment of patients there are rooms: treatment rooms, dental, exercise therapy, physiotherapy, aerosol therapy, herbal medicine and oxygen cocktails, herbal bar, hydropathic clinic, halocomplex. The basis of treatment is complex antibacterial therapy, kumiss treatment, herbal medicine, physical therapy and climate therapy. The sanatorium also receives persons who have professional contact with tuberculosis patients for their recovery. For the leisure of patients there is a cinema and concert hall, a gym, a library, a tennis court, and a volleyball court. Excursions are regularly organized.
Sanatorium "Vyborg-3" located in the Leningrad region. A unique sanatorium for the treatment of patients with eye tuberculosis. Functioning all year round, designed for 210 beds with accommodation in 89 wards, located on the shore of the flowing lake "Krasnokholmskoye" on the Karelian Peninsula, 9 km north-east of the city of Vyborg, remote from settlements. Communication with the city is carried out by buses.
The lake is 400 m wide, the lake shore is flat, the swimming season is from June to August. The forests are coniferous and mixed, rich in berries (raspberries, lingonberries, blueberries) and mushrooms, and there is a lot of fish in the lake.
The sanatorium has been collaborating with research institutions in St. Petersburg for many years. Medical University On the basis of the sanatorium, he conducts advanced training courses for ophthalmologists for the Leningrad region.
Sanatorium "Krasny Val" located in the south of the Leningrad region, in a picturesque area on the banks of the lake and the Bystritsa river. It is surrounded by an ancient park that turns into a mixed forest. 150 year-round beds have been deployed, in 2-, 3- and 4-bed rooms, specializing in the treatment and rehabilitation of patients with eye tuberculosis with determination of the degree of activity of the process, differential diagnosis inflammatory eye diseases.
Patients who have had tuberculosis of other organs, as well as employees of anti-tuberculosis institutions, are admitted for treatment of non-tuberculosis eye diseases. The health resort is equipped with the necessary equipment and tools: laser for therapeutic treatment diabetic retinopathy, primary and secondary glaucoma, wet form of macular degeneration, hemorrhages in the fundus, secondary cataracts, conduction laser coagulation for central macular hole, ruptures and detachments in the periphery, for laser treatment of trichiasis, cosmetic surgeries on the eyelids, to activate the lacrimal opening. There is a fundus camera for fundus photography and an optical coherence tomograph for examining the anterior segment of the eye and retina. Appointments are conducted by highly qualified ophthalmologists, a therapist, a phthisiatrician, a psychotherapist, a functional diagnostics doctor, an ultrasound doctor, a dentist, a gynecologist, and a physiotherapist. Proximity to St. Petersburg makes it possible to refer patients for consultation and surgical treatment to leading clinics in the North-West with subsequent rehabilitation in a sanatorium.
Sanatorium named after S.T. Aksakova located in Bashkortostan. One of the oldest kumis treatment sanatoriums, opened in 1890. It has 160 beds for the treatment of adult patients with minor and limited forms of pulmonary tuberculosis without decay and bacterial excretion. Patients are accommodated in 2-story buildings of 2-3 people. The uniqueness of this sanatorium in healing properties local koumiss. The combination of forest-steppe grasses and local natural factors contribute to its excellent quality.
Sanatorium "Shafranovo"
»
is located in Bashkortostan. Located on the western foothills of the Urals. 300 beds for the treatment of adult patients with tuberculosis, of which 180 are for patients with respiratory tuberculosis, including common forms, and 120 beds for the treatment of patients with genitourinary tuberculosis. Kumis is used in the treatment of tuberculosis, there are all modern methods drug and pathogenetic therapy of tuberculosis.
Sanatorium "Chemal". Republic of Gorny Altai. Profile – 210 places for the treatment of adult patients with respiratory tuberculosis, including common forms with bacterial excretion. The sanatorium is located in a pine forest in the picturesque valley of the Katun and Chemal mountain rivers. Thanks to the richness of the flora, an amazingly beautiful natural landscape is created.
Sanatorium "Sovetsk". Specialized for the treatment of adult patients with osteoarticular tuberculosis and tuberculosis of the genitourinary system. Operating since 1950. Has 120 beds. The institution carries out diagnostics, conservative treatment and rehabilitation of patients. The sanatorium is the clinical base of the St. Petersburg Research Institute of Phthisiopulmonology. Located in a pine forest on the outskirts of Sovetsk, Kaliningrad region.
Sanatorium "Pearl". It has been operating successfully since 1924. It has 115 beds for adult patients with respiratory tuberculosis, observed in 1-2 hospital units, including chronic forms of pulmonary tuberculosis with MDR and XDR. Located in the Leningrad region, in a pine forest, not far from the city of Luga. After a major overhaul, significantly improved living conditions: each room has 2-3 people, comfortable furniture, digital television, hygiene rooms, showers on the floors. Patients have a variety of board games, billiards, tennis.
Children's sanatorium "Pioneer" is located in the city of Sochi on the shores of the Black Sea, the only place in Russia where all climatic and natural opportunities for proper treatment and recreation are concentrated.
Operating since 1956. The climate is characteristic of humid subtropics. 210 beds for children aged 7–14 years with respiratory tuberculosis. The treatment is complex. Against the background of specific therapy, climate therapy is carried out on the seashore, hardening procedures, heliotherapy, and physiotherapy. There is a school, the location of the sanatorium is characterized by a relatively humid subtropical climate of the Mediterranean type, the absence of summer heat, refreshing sea breezes, and warm winters.
The territory of the sanatorium and the surrounding mountain slopes are covered with rich vegetation. There is a park area with centuries-old trees of various species, lawns and flower beds, ornamental trees and shrubs.
You can relax and enjoy communion with nature in the park directly adjacent to the sanatorium buildings. Healthy walks along the paths laid out throughout the territory will give you a boost of energy and good mood. There are gazebos and benches for relaxation in the park.
The sanatorium has its own beach and outdoor sports grounds.
Sanatorium "Kiritsy" » located 55 km from Ryazan and 20 km from the city of Spassk, in a picturesque place, in the village of Kiritsy, Ryazan region, on the former estate of Baron Von Derviz. It is located near a forest area, not far from the lake. There is a rose garden on the territory, the whole system ponds, a huge park, pine trees grow around. The estate itself looks like a fairytale castle with towers and weather vanes. In connection with the departure of Baron Von Derviz in 1934, all buildings and land were transferred first to a rest home, and then a children's tuberculosis sanatorium was located here.
The sanatorium specializes in tuberculosis of the organs of vision, tuberculosis of the genitourinary system, tuberculosis lymph nodes, tuberculosis of bones and joints. People only talk about the sanatorium positive reviews. He is considered one of the best sanatoriums countries. Children live here for more than one year, but many of them are finally cured of a serious illness. Entrance to the sanatorium is free. Quite a few tourists visit it every day. The stay of children in a sanatorium is not limited only to medical procedures. Schoolchildren continue their studies in secondary school, and in free time Children can choose an activity based on their interests: the health resort has a library, music, choreography and other clubs. Artist performances, meeting evenings interesting people, film screenings, classes in the gym - with such a rich program you won’t be bored.
Sanatorium "Pushkinsky". located in the suburbs of St. Petersburg in the city of Pushkin. For children 11 – 17 years old, patients with respiratory tuberculosis. The climate is typical for the western regions of Russia. The sanatorium operates a school (grades 5-11) according to the general education program. All types available modern treatment tuberculosis.
Take advantage of treatment and relaxation in anti-tuberculosis sanatoriums. This will give you a boost of strength, vigor, health for the whole year and will leave wonderful memories for a long time.
Head of the dispensary department No. 1 of the State Healthcare Institution "LOPTD" Voropaeva O.A.
Even ancient doctors knew about the beneficial effect of treating patients tuberculosis in a healthy climate with correct use natural healing factors, nutritious nutrition, rationally set motor mode.
The first sanatoriums in Europe appeared in mountainous area, then in coastal areas. In 1858, the Russian doctor N.V. Postnikov organized a kumiss clinic near Samara and scientifically proved the possibility of treating tuberculosis patients in middle lane Russia.
The sanatoriums were owned by private individuals, had an extremely limited number of places, and, most importantly, staying in them was very expensive. Therefore, wealthy people were treated at the resorts, but the bulk of the patients were doomed to death and barely reached the age of thirty.
Only after the Great October Revolution In our country, an extensive network of sanatoriums is emerging in various climatic zones. Long-term residence in sanatorium conditions often made it possible to achieve stabilization of the process or clinical cure, and prolonged the life of many patients.
Sanatorium type of treatment for tuberculosis indicated for patients with focal, disseminated, infiltrative tuberculosis in the phase of resorption and compaction of focal and infiltrative changes, scarring of lung tissue, with tuberculoma, cavernous and fibrous-cavernous tuberculosis in the absence of acute symptoms of intoxication, tuberculous pleurisy in the scarring phase, after surgical interventions.
There is a large network of local sanatoriums and climatic resorts (seaside, mountain, steppe, forest-steppe zones), where complex treatment tuberculosis - specific chemotherapy in combination with climatic and physical factors.
An important therapeutic factor in the climatic resorts of the steppe zone is kumiss – fermented milk drink from mare's milk.
Diets enriched with koumiss restore the architecture of the gastric mucosa and enhance the synthesis of intestinal histohormones, parietal digestion and absorption nutrients. After kumiss treatment, the patient’s body weight increases by 2-7 kg. The combined effect of the steppe climate and kumiss leads to the resorption of tuberculosis infiltrates and the compaction of foci.
Patients with tuberculosis are referred to climatic resorts of the mountains and steppe th (Shafranovo, South Bank Crimea, Black Sea coast of the Caucasus, Medvezhyegorsk, Teberda, Vorokhta, Lebyazhye, Yumatovo, Chimgan, Borovoye, Sortavala, Shovi, Olentui, Acapulco, Assi).
Spa therapy is used for final stages course of chemotherapy, after surgical interventions on the lungs for medical rehabilitation. The duration of sanatorium-resort treatment is 2-4 months, repeated courses are carried out during the first 2 years after the end of the main course of treatment.
Contraindications for referring patients with pulmonary tuberculosis to sanatorium treatment:
- Acute forms of pulmonary tuberculosis with a tendency to rapid progression.
- Frequently recurring hemoptysis.
- Exudative pleurisy in the acute phase.
- Massive cirrhotic changes in the lungs, bronchiectasis, encysted empyema.
- Cavernous and fibrous-cavernous forms of pulmonary tuberculosis with symptoms of pulmonary-heart failure.
- Pulmonary tuberculosis, complicated active forms extrapulmonary tuberculosis.
- Pulmonary tuberculosis complicated by nonspecific diseases: cardiovascular system organs with symptoms of decompensation, respiratory organs in acute stage, bronchial asthma with severe attacks, lung abscess, abscess pneumonia, diffuse pneumosclerosis, stomach and intestines in the acute stage, liver and biliary tract in the acute stage, nephroso-nephritis with symptoms of renal failure
- By general contraindications to refer patients for sanatorium treatment
- Age after 60 years
- Clinical cure for tuberculosis according to 3 “B” and 7 groups of dispensary registration.
Sanatorium Chemal
Sanatorium “Chemal” is located in an urban village 420 km southeast of Barnaul and 180 km southeast of Biysk. Located at the confluence of the Katun and Chemal mountain rivers, on the southern slopes of Mount Bishpek, at an altitude of 620 m above sea level. In the surrounding area there are pine forests.
Address:
659735, Altai Republic, Chemalsky district, village. Chemal, Chemal resort.
Directions:
By public transport: to the Biysk railway station, and then by bus to the Chemal resort.
Medical profile:
Basic medical profile sanatorium - treatment of respiratory diseases (chronic bronchitis, chronic pneumonia, asthmatic bronchitis, bronchial asthma, pleurisy, bronchiectasis, pulmonary tuberculosis), diseases of the digestive system ( chronic gastritis With increased acidity, peptic ulcer stomach, hepatitis, cholelithiasis, hepatitis), metabolic disorders (diabetes).
List of medical services:
Aeroheliotherapy, climatic and physiotherapy, physical therapy, herbal medicine, kumis treatment. (The effect of kumiss treatment is especially beneficial on patients in whom tuberculosis of the lungs or peripheral lymph nodes is combined with gastritis, insufficiency of gastric secretion, low acidity gastric juice, as well as with insufficiency of vitamin C in the body).
Characteristics of natural healing factor:
The main natural healing factors are the mountain climate (aeroheliotherapy) and kumis (fermented milk drink made from mare's milk (kumis treatment).
An important climatic boundary that determines the climate of Chemal is the mountains surrounding the resort area. The climate is characterized by a small amplitude of temperature fluctuations, thin air, high intensity of solar radiation, and almost complete calmness.
Rooms:
Vacationers are accommodated in double rooms.
Nutrition:
Five or six meals a day, including a custom menu, dietary meals.
Infrastructure characteristics:
Two-story buildings. In accordance with the applied methods of climatotherapy and health-improving procedures, the sanatorium is equipped with special structures: climatic pavilions, verandas, galleries for daytime and round-the-clock stay in the fresh air, aerariums (aerotherapy), aerosolariums, and an inhalation room.
There are special routes for measured walks (health paths), a boat station on the shore of the pond, sports grounds, a club, and a library.
Blue Bay
Address:
Krasnodar region, Gelendzhik, Blue Bay sanatorium.
How to get there:
By plane - to Gelendzhik, Anapa or Krasnodar, then by bus. By train - to Novorossiysk, then by bus to the Golubaya Bukhta sanatorium.
Location:
Sanatorium “Blue Bay” is located on the shore of Gelendzhik Bay. An excellent diagnostic and treatment base for patients with chronic nonspecific lung diseases, as well as those cured of pulmonary tuberculosis.
Nutrition:
3 meals a day in the dining room of the Blue Bay sanatorium. Those staying in luxury rooms at the Golubaya Bukhta sanatorium eat in a separate room.
Terms of accommodation:
Standard room in the Blue Bay sanatorium - one room, bathroom, TV, refrigerator.
Suite in the building of the Golubaya Bukhta sanatorium - 2 rooms, bathroom, TV, refrigerator.
Suite in a cottage in the Golubaya Bukhta sanatorium - a detached cottage, the room has a European-quality renovation, two rooms, a double bed, TV, refrigerator.
At the service of vacationers:
dance floor, disco, billiards, sports hall, gym, rental of sports equipment, banquet hall, summer cinema with a stage, swimming pool with sea water, sauna with plunge pool, library, video salon, hairdresser, excursion programs, long-distance telephone and telegraph, medical. point, ordering and purchasing air and railway tickets, paid guarded parking.
Beach:
Own equipped beach with a pebble strip 250 meters long with rental of beach equipment.
Main medical profile:
Respiratory diseases.
Well-equipped clinical, biochemical, bacteriological laboratories, functional diagnostics room, X-ray, ultrasound.
The complex of sanatorium treatment includes climate therapy, physiotherapy, therapeutic exercises, an equipped gym, aerosol therapy, massage, IRT, kumiss therapy, herbal medicine and honey treatment.
Teberda
Profile:
Respiratory diseases of specific etiology; nonspecific respiratory diseases; diseases of the gastrointestinal tract; diabetes mellitus; Treatment is carried out at the health resort medical workers who are in contact with tuberculosis patients.
Treatment:
Chemotherapy, administration of chemotherapy drugs intramuscularly, intravenously; inhalations, physiotherapy, mud therapy, climate therapy, air baths, heliotherapy, treatment of concomitant diseases.
Sanatorium-resort treatment of tuberculosis
Currently used for tuberculosis the whole complex therapeutic measures, including antibacterial therapy, various anti-inflammatory, hormonal drugs and biostimulants, simple and complex surgical interventions, spa treatment using natural and artificial physical factors against the backdrop of a sanatorium-hygienic regime. Now tuberculosis is cured much more often, the course of the disease is alleviated, life is extended and the ability to work is ensured for thousands of patients.
But only a few decades separate us from the time when healing from tuberculosis was a rare happiness for the patient. Most patients with active tuberculosis died. The appearance and suffering of these people are described in the works of I. S. Turgenev, A. Daudet, D. London, E. M. Remarque and many other writers. Here are lines from Maupassant’s novel “On the Water”: “...from time to time you come across unfortunate, withered creatures that are barely trudged along, leaning on the hand of their mother, brother or sister. The poor fellows cough, choke, wrap themselves in shawls, despite the heat, and their sunken eyes look at you with despair and anger... A terrible, merciless illness, now called tuberculosis, an illness that undermines, burns and destroys thousands of human lives, as if on purpose chose this shore to finish off his victims here. How they should curse him in all corners globe, where so many families, humble and crowned, noble and not noble, buried someone close to them, most often a child, the hope and joy of the whole family!”
Since 1882, when the German scientist Robert Koch discovered the causative agent of tuberculosis, doctors from all countries have been continuously searching for drugs that are active against this serious disease. Have been tested folk remedies, herbal infusions, quinine, preparations of gold, mercury, sulfur and other chemical elements.
Since 1884, at the suggestion of the Italian doctor Forlanini, inflation began to be used - that is, the introduction of nitrogen or air into the pleural cavity after puncture of the chest wall, which reduced the volume of the lung and led to a gradual decrease in the activity of the tuberculosis process in some patients. Inflating was carried out for years and even decades every seven to fifteen days.
The proposed drugs turned out to be either insufficiently effective or too toxic for humans, which did not allow success in the drug fight against tuberculosis. Therefore, the sanatorium remained the main method of treatment for a long time. Even doctors of antiquity knew about the beneficial effect of treating tuberculosis patients in a healthy climate with the correct use of natural healing factors, good nutrition, and a rationally designed motor regimen.
The first sanatoriums in Europe appeared in mountainous areas, then in coastal areas. In 1858, the Russian doctor N.V. Postnikov organized a kumiss clinic near Samara and scientifically proved the possibility of treating tuberculosis patients in central Russia. The sanatoriums were owned by private individuals, had an extremely limited number of places, and, most importantly, staying in them was very expensive. Therefore, wealthy people were treated at the resorts, but the bulk of the patients were doomed to death and barely reached the age of thirty.
Only after the Great October Revolution did an extensive network of sanatoriums appear in our country in various climatic zones. Long-term residence in sanatorium conditions often made it possible to achieve stabilization of the process or clinical cure, and prolonged the life of many patients. However, without medications that act detrimentally on the causative agent of the disease, the problem of tuberculosis could not be solved. Therefore, the search for drugs continued constantly. Hundreds and thousands of chemicals were synthesized before the first major success was achieved. It came after the antibiotic streptomycin was synthesized in 1944, which turned out to be active against mycobacterium tuberculosis.
In 1946, paraminosalicylic acid (PAS) was recommended for medical practice as an effective anti-tuberculosis agent. In the early fifties, tubazid and ftivazid were synthesized and introduced into the arsenal of anti-tuberculosis drugs. The time of major discoveries has begun. To date, a significant number of highly active anti-tuberculosis drugs have been obtained, the wide range of which allows the doctor to select the optimal combination, taking into account the individual tolerance of the patients.
Basic conditions for successful treatment- duration and continuity of the course. Its usual duration is 12 months or more. Treatment is carried out simultaneously with two or three drugs with by various mechanisms actions, since this allows you to influence various aspects of the metabolism of the pathogen and prevent the development of resistance of mycobacteria to certain drugs. Irregular, indiscriminate use of antibacterial drugs does not reduce the activity of the disease. In such cases, the causative agents of tuberculosis get used to the drugs, become insensitive to them, and as a result, a cure does not occur, the process in the lungs becomes chronic.
Taking medications can be divided, several times a day, but more often once. In some cases, an intermittent course is prescribed - taking medications 2-3 times a week.
Qualified doctors and paramedical personnel work in Teberda sanatoriums. There is a large arsenal of therapeutic agents, conditions have been created for aero- and heliotherapy, physical therapy and physiotherapy are carried out, and inhalations operate. X-ray rooms, clinical laboratories, bacteriological and biochemical laboratories are equipped with modern equipment. In functional diagnostic rooms, the state of external respiration and the cardiovascular system is determined.
A complete X-ray examination using tomography and other special methods allows you to clarify the diagnosis, make the necessary adjustments to treatment, and clearly determine its effectiveness at the resort. Bacteriological research methods help to identify the causative agent of tuberculosis - Koch's Mycobacterium and determine some of its properties, in particular sensitivity to anti-tuberculosis drugs, and, depending on this, prescribe them. If necessary, the type of secondary flora of the respiratory tract is determined, as well as its sensitivity to various drugs. Secondary flora is microorganisms that can cause nonspecific respiratory diseases.
The resort's biochemical laboratory makes it possible to monitor the activity of treatment, the reaction of the patient's body when taking anti-tuberculosis drugs, and determine the concentration medicinal drugs in the blood. This allows you to most accurately select their individual dose.
Pulmonary tuberculosis is often accompanied by diseases of other organs and systems. Therefore, sanatoriums at the resort have different profiles. Thus, the Dombay sanatorium is intended for the treatment of patients with tuberculosis with concomitant diseases of the gastrointestinal tract. The staff of the health resort specialize in the treatment of these diseases and are proficient in special methods diagnostics and therapeutic effects. The sanatorium has a mud bath, and various new techniques are being introduced that make it possible to make fuller use of the resort’s balneological resources. The Jamagat sanatorium is designed for patients with tuberculosis and diabetes mellitus. The Teberda sanatorium admits patients with tuberculosis and concomitant nonspecific diseases: bronchial asthma, chronic bronchitis, pneumonia. The Klukhori sanatorium is specialized for the treatment of patients who have undergone surgery for pulmonary tuberculosis and patients with tuberculosis damage to the kidneys and urinary tract. Patients with concomitant diseases of the heart and blood vessels are sent to the “Mountain Gorge”. The Alibek sanatorium accepts patients in need of intensive therapy for tuberculosis, for which the sanatorium has special rooms, appropriate techniques have been introduced, and experienced staff works.
In the outpatient department, in addition to phthisiatricians, specialists of other profiles are received - a gynecologist, an ophthalmologist, a surgeon, a neurologist, a therapist, a dentist, etc. All this makes it possible to provide a variety of qualified assistance to those who come to the resort.
As a result of all types of treatment and sanatorium-resort treatment, inflammatory phenomena, lesions resolve or scar, decay cavities heal, signs of tuberculosis intoxication disappear, blood counts improve: the leukocyte formula and qualitative composition of leukocytes are normalized, anemia disappears - the amount of hemoglobin and red blood cells increases; biochemical parameters improve, the composition of protein fractions in the blood is normalized, functional indicators breathing.
Very good results obtained from patients who underwent lung surgery. After sanatorium treatment, they return to duty stronger and more efficient. The improvement in health achieved in the sanatorium allows one to do without sick leave, provides them with stable performance for several years.
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