In the article the term “new medical technologies” is defined, the main directions of medical rehabilitation are observed, the concrete example of rehabilitation during expiratory tracheal stenosis is presented.

The correct treatment in some patients with bronchial and pulmonary diseases having reserves enough for the pathological process compensation have the reparation character and is finished by medical, professional, and social rehabilitation. The latter one is presented by two main directions: “respiratory invalid” rehabilitation for the life quality support and preventive rehabilitation of the “frequent sick” contingent (acute lingering bronchitis, recidiving bronchitis, asthmatic bronchitis, lingering pneumonia, etc.) which have hazard of inflammation process chronisation and progredicnt obstructive pathology. At the last case, rehabilitation is to be considered as a preventive action against chronic disabling pathology formation. The rehabilitation must be step divided with three main stages: outpational, hospital, and sanatorium—health stage with the continuous examinational watching of the rehabilitant. During the correct action, rehabilitation is much successful in the mast of “frequent sick” persons, in patients with chronic bronchitis without severe breath insufficiency, and allows to increase the life quality of “respiratory invalids”.

Cumulating literature data and own studies the authors define the role of physical methods in complex rehabilitation treatment of patients with acute pneumonia. These methods choice is based on the clinical pathogenetical analysis of process course evolution, its syndromologic characterics. Physiotherapeutic methods supplement and potentiate ethyotropic treatment. During the bacterial agression phase, the positive action on the infiltration forming syndrome is provided by aerosol inhalational sanation of bronchi. The antiinflammatory treatment as well UHF, inductoheating, microwaves, peloid therapy, laser radiation are nessesary for the later resolve of the infiltrate. During the morphologic recovery and the reconvalescence stage, the antiinflammatory physiotherapy continues. The bronchial obstruction syndrome persistention is the cause for ultrasonic therapy, euphilline phonophoresis, and ozokerit application use. The astcnic vegetatic impairments syndrome in reconvalescents is the cause for halvanic collar, electric sleep, electric analgesia, and hydrotherapy use. The out-patient’s clinic (the department of rehabilitational therapy) is the main place of rehabilitation of reconvalescents with acute pneumonia. The lingering and complicated course of acute pneumonia causes the necessity of sanatorial rehabilitation both in local and cimatic sanatoriums with later dispanserization during the year.

In the article, aspects of the sanatorial treatment efficacy that is valuable in the rehabilitational measures complex during bronchial asthma (BA) are discussed. According to data of sanatorial physicians based on parameters of the clinical course of the disease, respiratory function, and data of the inflammational process activity in the bronchial tree, the most of patients with BA were discharged with relief. In conditions of the Kislovodsk sanatorium, the relief was observed in 90.8—98.4% of the patients while remission may be durated near 7.6 months. In 60—70% of the patients the vital capacity increased in 380±20.7 ml, the maximal voluntary ventilation increased in 14.6±2 1, and FEV₁ increased in 320±17.5 ml. The normalization of the cholinergic system as the increase of the cholinestherase level 245.8±7. to 254.8±12.1 mkM/hml, p<0.05 promoted to the respiration activation. It was noted, that in 64% of the arriving to the Kislovodsk sanatorium persons the level of IgE and the level of IgG decreased to 217 KI/1 and 1014±25. mg/% respectively.

The obtained data testify about the increase of the natural resistance of the organism that assisted the most of patients with BA in the favorable course of the disease and in successful acclimatization. These data pointed to the availability of direction to the sanatorium of patients with early signs of the disease such as predasthma or non pulmonary allergy forms complicated with the occupational harm and cold.

In the article, the common data cumulated during last 20 years in the institute of pulmonology concerning the use experience of the dosed therapeutic starvation in patients with bronchial asthma were presented. The detailed clinical estimation of the method effectivity based both on immediate and postponed (after 5—7 years) results of treatment was performed. The interaction was shown between microbal infection and the mucus lamina state in the patients during FDT. It was demonstrated that sanogenetic effect is provided by the bronchial pass recovery, regenerating processes in the mucus lamina, and the eliminating clearing action. The fact of the release from granulocytes located in the bronchial mucus lamina is most important that leads to the rupture of the pathogenic link defining the common clinical syndromes as well bronchial obstruction, mucus lamina oedema, and discrinia. The positive asction of FDT on bronchial hyperreactivity and the positive changings occuring in endocrinic systems as well hypophysis, thyroid, epinephros, pancreas, and extraction out from the organism such microelements as copper and zinc defining the dross level in the bronchial asthma patient organism were shown for the first time.

The efficiency of the use of laser puncture in rehabilitation of patients with chronic obstructive bronchitis was investigated. The patients of the main group (60 subjects) received laser treatment. The control group patients (20 subjects) treated with drug therapy. The estimation of results of the treatment was based on changes of the clinical state of the patients, blood analysis, biochemical and immunological examinations, the evaluation of the level of catecholamines, serotonin and histamine in peripheral blood structures (according to histochemical study findings), and changes in reactivity ofbronchi after inhalational bronchial challenge with Obsidan.

Positive changes of all the findings investigated and the late results of the treatment testified to advisability of the use of laser puncture at the out-patient stage of rehabilitation of patients with chronic obstructive bronchitis.

Aspects of clinical examination of patients endured acute pneumonia (AP) with impairments of bronchial reception function were discussed. During the formation of examinational groups of AP reconvalesccnts, the sensitivity and reactivity state of bronchi was taken into account. The special program, dates of examination, and the complex of treaty sanitary measures of AP reconvalescents with the impaired bronchial sensitivity and reactivity were elaborated, that at least improves the distant outcome of AP.

The once-only and course use of transcutaneous diaphragm electric stimulation (ESD) caused the significant improvement of breath perception without intra pulmonary resistance changes in patients with chronic obstructive bronchitis (COB), bronchial asthma (BA), and in healthy persons. Berodual inhalations after ESD caused the further improvement of breath perception in patients with COB, BA, and in healthy persons due to its broncholitic effect. Using the original method, the breath effect of ESD was evaluated which was more durating in the cxaminated subjects during both the once-only and course use of ESD. Due to psychologic restrictions noted in patients with COB and BA, it is more preferably for dispnoe level evaluation to use the visual analog scale than the Borg one.

Authors has proposed an original diagnostic program of examining the respiratory biomechanics and capillary circulation in pulmonary circuit which included pulmonary roentgenopneumopolygraphy and scintigraphy. It was demonstrated that in patients with asthma having not clinical manifestations of chronic respiratory failure during even the moderate course of the disease there was the decrease of diaphragm respiratory function (the diaphragmatic index DI 39±8 mm; the normal value of the one is 98±5 mm) and hyperfunction of the crural component of the respiration (amplitude of the rib cage displacement ARD was 21+4 mm, the normal one is 14+3 mm). While progressing of the disease, the decrease of diaphragm function (DI = 39±8 mm) and the respiratory muscle performance (ARD = 12±5 mm) were demonstrated, that was considered to be the fatigue state. The respiratory muscle training was carried out with Ambu-RMT system during three months and longer. In patients with mild and moderate impairments of respiratory muscles the fisiological fatigue elimination was achieved.

The treatment-rehabilitational measures complex used systematically in patients with chronic bronchitis in 2—9 times decreases the frequency and the degree of progressing of the negative dynamics of pulmonary arterial pressure, the total pulmonary resistance, and the right ventricle work. During a year in average, pulmonary hypertension manifestis in 5 times rarely in rest. Treatment-rehabilitational measures are more efficient as primary profilacxis of pulmonary hypertension during normal values of pulmonary arterial pressure and resistance in rest than in the cases when the hypertension is already presented.

The tissue and blood oxygenation estimation with taking into consideration the hemoglobin affinity for oxygen with new parameter pO₂-effective use was studied. The calculation algorithm and its program realization for paeO₂ and estimation of the dissociation oxyhemoglobin curve (ODC) were produced.

28 patients were examined with the measurement of next parameters of arterial blood: pH, gas composition (paO₂ and paCO₂), and blood oxygenation (SO₂, ctO₂). The calculation of paeO₂ value and the shift of ODC was carried out. The estimation of oxygen consumption (VO₂) was carried out in 11 patients.

The analysis of the obtained data allowed to conclude that paeO₂ reflects changes of the hemoglobin affinity for oxygen in such a way, that when affinity is decreased then ODC shift is greater than zero and when the affinity is increased then ODC shift is less than zero. The parameter paeO₂ allows to estimate more correctly the blood oxygenation than paO₂ in mmHG terms. The correlation with the coefficient 0.8 was found between the value of the DOC shift and oxygen consumption. In the case of the negative ODC shift, the oxygen consumption is decreased, in the case of the positive ODC shift oxygen consumption is increased.

Thus, on the basis of ODC, it is possible to estimate the blood and tissue oxygenation with taking into consideration the hemoglobin affinity for oxygen and, therefore, the respiration of organism in general.

38 children aged 4 to 14 years old with monolateral and bilateral chronic pneumonia during exacerbation, incomplete remission, and remission phases were examined. All the patients were studied with complex examination including diagnostic bronchoalveolar lavage among rcontgenologic and bronchologic methods. The disease duration was 1.5 to 8 years; inflammation process exaceibation appeared near 3—6 times per one year. The cytologic study of the broncho-alveolar fluid in the case when the pulmonary pathology signs were absent in children (the control group) and in sick children showed that during both monolateral and bilateral chronic pneumonia the relative number of neutrofils increased and the number of macrophags decreased significantly in the BAL fluid during exacerbation and incomplete remission. During monolateral chronic pneumonia, there arc no significant differences between the inflicted and intact lung of the relative number in neutrofils in the BAL fluid. The character of endopulmonar cytogramm (EPC) as well the relative number of neutrofils depends on the course phase of the disease, the bronchiectasis presence, and in less extend the area of inflicted lung. There were not significant correlation between the EPC parameters and the periferal blood count; FPC more correctly displies the course phase of the local inflammatory process than hemogramm and clinical sympthoms. The obtained data testifies about the presence of inflammatory changes not only in large bronchi but in distal acinus segments of lung during exacerbation of chronic bronchial pulmonary diseases.

To evaluate the clinical efficiency of the air-cleaning devices (ACD) “Air-O-med” use during complex therapy of atopic bronchial asthma patients 14 women and 6 men were examined which were treated during exacerbation with ACD placed in wardrooms. After reaching clinical remission, the apparatus was distributed among the patients for use at home during 3 to 4 months with the authorised method. The results of the study testifies that ACD allow to achieve clinical remission more faster with less quantity of used drugs, to prolong the remission, and to decrease the frequency of hospitalisation when using ACD at home.