Question №1. Pyotr Pavlovich, what problems now concern pulmonologists and thoracic surgeons?
Already in 1975, when it was createdpulmonology center (at its source was a world-renowned thoracic surgeon, Professor Olga Matveevna Avilova), it was clear: the need for specialists of this profile will grow. Currently in our country respiratory disease, alas, are leaders in their prevalence. The only consolation is that with timely diagnosis they are well treatable. Our department, which is headed by Professor Anatoly Makarov, preparing children's and adult pulmonologists and thoracic surgeons for the whole Ukraine. This branch of medicine, particularly surgery on the lungs, interested me as a student. Since then I have been doing things you love.
Question №2. Your patients can not be called easy ...
For us to get children with severe congenitalrespiratory diseases, esophagus and diaphragm, are in need of qualified inspection. Not all areas have the necessary conditions and experts. If you have a lung disease need to spend fibrobronchoscopy, X-ray, CT scan and Bronchography. A comprehensive survey of the child, as a rule, lasts for a week. It is important that this takes place in a hospital, under the supervision of medical staff. If you want to immediately carry out the operation. However, only 40 left in place in the department of 60 beds, which significantly complicated our work, because patients do not become smaller - quite the contrary. And complex patients from all over Ukraine is still sent to us.
Question №3. What caused these diseases and how often they occur in our country?
First of all, their appearance hasliving in the contaminated area, in areas where the operating companies in the chemicals, coal industry. It plays a role, and a genetic predisposition. Among the recurrent repeated chronic diseases lung diseases account for 10-15%. Unlike heart disease, which occur 3-5 times less, but almost immediately diagnosed, they are offset by the healthy parts of the lungs and therefore detected relatively late. There diaphragmatic hernia, which cause gastrointestinal disturbances features light compression, etc.
Question №4. What forecasts in these patients?
As a rule, favorable. For example, we remove the festering hotbed of congenital cyst, and then gradually restored damaged tissue and the patient is recovering. We must remember that birth defects are not amenable to conservative treatment - they always require surgery!
In this regard, I want to give you an example. More recently, we received a patient from Uman. The girl is constantly sick, but parents asked doctors not to do x-rays, to avoid exposure. As a result, the child for eight years has formed a gigantic tumor, which was pressing on the heart, lung, diaphragm and pushed even start to move in the neck. The girl literally gasped. When doctors finally made x-rays, they were shocked.
The operation was very difficult. When I opened the chest, part of the tumor literally vyskolz-Nool out. For eight years, congenital tumor has reached the size of the children's heads. Fortunately, the tumor was dobrokachest-vennoy, and the child was saved. Discharged little patient home in satisfactory condition. But she could have been killed!
Question №5. How can I prevent lung malformations in newborns?
I do not say anything fundamentally new: Pregnant woman in no event should not smoke (this also applies to the so-called passive smoking when smoking husband or other family members). It is necessary to completely eliminate alcohol, work in hazardous work (even a painter on a construction site). Make sure that in the home of the future mother was no dust or moisture. All these factors are crucial in the weeks when the embryo respiration organs are formed.
Question №6. In some cases, it can be assumed that the child has a congenital abnormality of the chest cavity?
When we are training childrenpulmonologists, pediatricians, we teach them to recognize such pathology. First of all we should guard frequent pneumonia, exacerbation of chronic respiratory diseases. If your child complains of pain, chest discomfort, parents should not delay the visit to the doctor and the X-ray examination, regardless of age baby. Here the two evils (exposure or progression of the disease) need to choose the lesser. At a later detection of pathology and surgery, and rehabilitation period are much more difficult.
Question №7. Is there a cure pneumonia without antibiotics?
No. In mild inflammation in the early stages, tablets, and in more complex cases, do intramuscular or intravenous injection. It is important to not only correct and timely diagnosis of the disease, but also to undertake a full course of treatment. Otherwise, the disease progresses rapidly: abscessed develop severe pneumonia, the lungs begin irreversible processes, and the patient may die. It is important not only in time to see a doctor, but also clearly fulfill all of its purposes.
Question №8. How often do you retrieve foreign bodies from the airway and esophagus?
Only in Kiev, it is from 80 to 100 such casesin year. And to bring us children from the Kiev region and from all over Ukraine. The airways get nuts, seeds, beans, beads, buttons, bones, buttons, caps ... In my collection there is even a rusty nail curve - it "breathed" concluded specially in order to get to the hospital. We have removed the "souvenir" under anesthesia, and the patient was taken into custody. Private collection - items retrieved from the esophagus: more coins, badges, fishing shaybochki, brooches, mosaic elements key to the alarm. But this loop with sharp splayed wires I pulled out of the esophagus-year-old child, whose parents have a few minutes left unattended. Very often children (and sometimes adults) are hiding coins in his cheek, and then inadvertently ingest them. Many take the needles in his mouth, pins, safety pins. I want to warn adult men and women: this is not as harmless as it seems at first sight!
Question №9. Can you help yourself to the victim - shake it, knock on the back?
If it is a small round thing, say,bead, pea, it is possible to turn the victim to make cough. Although, unfortunately, it rarely helps. In the first few minutes later it becomes clear that not do without the help of a doctor, so you can not procrastinate! When a foreign object gets into the respiratory tract and the patient does not receive timely assistance, it is fraught with the development of very serious complications, including death. In the esophagus due to the presence of a foreign object in a few days can develop pressure sores and cause a perforation that is life-threatening. Of course, there is a chance that a small object passing through the esophagus, come naturally. But if such trouble occurred with a young child, or wait to start experimenting criminal!
Question №10. What is your hospital staff feels today the most urgent need?
Urgent problem for us - overpopulation. Six years ago we began to assist adult patients with multiple injuries, which is why it was necessary to seal the children's department, and now in the same room side by side 5-6 critically ill children. In general intensive care unit are at the same time every day 8-10 people (it's adults and children), not including the planned patients.
We have repeatedly asked the local authorities to give usneighboring two-storey building, vacated after the relocation of the 7th Children's Hospital to accommodate the children's intensive care unit there and "unload" station. We like not directly deny, but a formal agreement is also not allowed. In addition, there are persistent rumors that this place is planned to build a house. If this happens, it suffers not only the staff who have to work in a very busy schedule. In the first place it will affect our patients. If we have met on this issue, we could help many more people from all over Ukraine.
At home, in the Luhansk region, the three-year long Alena treated pneumonia, followed by 1.5 months - tuberculosis, which was not! In Kiev, the girl successfully removed congenital lung cyst festering.
In my collection - items retrieved from the esophagus: more coins, badges, fishing shaybochki, buttons, mosaic elements key to the alarm, ornaments, pins and pins ...