Method for treatment tactics selection for patients with abdominal incision wounds

FIELD: medicine.

SUBSTANCE: following parameters are determined: time from the moment of injury; hemodynamic parameters; peritoneal symptoms; presence of internal organs eventration; presence of concomitant brain or spinal injuries; presence of free gas in review R-graphy of abdominal organs; rate of free fluid rise in the abdominal cavity; signs of injury to the internal hollow organs or continued bleeding on the abdomen CT. In accordance with the presence or absence of these indicators points are awarded. Then, depending on the aggregate identified changes indicators of their presence or absence, a decision is made on absence of indications for emergency surgery and need for active supervision, or on laparoscopy or laparotomy performance necessity.

EFFECT: method allows to optimize the choice of treatment taking into account individual changes in a diagnostically significant set of indicators; to reduce the number of unjustified surgical interventions in patients with incision wounds of the abdomen; to reduce the length of stay in the hospital by reducing the number of postoperative complications and shortening the terms of rehabilitation.

1 tbl, 2 ex

 



 

Same patents:

FIELD: medicine.

SUBSTANCE: invention relates to means for carrying out visualisation-guided medical procedures. Method of processing X-ray image contains stages, at which: 2D X-ray image of anatomical area, which includes ultrasound probe, is received, ultrasound probe s detected on it, ultrasound probe is superposed with reference coordinate system, with taking into account evaluation of position and orientation of ultrasound probe relative to reference coordinate system. Superposition stage additionally contains stage, at which presented in digital form projection of 3D model of ultrasound probe is correlated with ultrasound probe detected on X-ray image, with obtaining evaluation of ultrasound probe position and orientation from correlated 3D model. Computer-readable carrier contains stored in it sets of instructions for system-processing unit for combination of ultrasound and X-ray images, which contains X-ray system of 2D X-ray image, ultrasound system, including ultrasound probe, processing unit and monitor for combined image presentation.

EFFECT: application of invention makes it possible to increase accuracy of position determination.

9 cl, 4 dwg

FIELD: medicine.

SUBSTANCE: nephrosonography is performed to determine a kidney volume (V pk, mm3). Child's height and age are specified and used to determine a reference kidney volume (V rk, mm3), to calculate a kidney volume coefficient (Kkv) by formula: , wherein Kkv is the kidney volume coefficient; V pk is the patient's kidney volume, mm3, and V rk is the reference kidney volume, mm3. In the unilateral ureteral obstruction, a healthy kidney volume coefficient (Khkv) and a obstruction kidney volume coefficient (Kokv) are calculated. If K hkv is more than 1.0, the absence of compensatory hypertrophy and hyperfunction is diagnosed; the morphofunctional kidney condition from the side of an obstructed ureter occurs to be noninvolved; the conservative treatment of the obstruction is preferred. If K hkv is more than 1.0 and less than 1.8, K okv is more than 1.0, compensatory hypertrophy and hyperfunction of the healthy kidney; the morphofunctional kidney condition from the side of the obstruction is depressed; a preserving surgery is chosen. Khkv between 1.8 or 2.0 and Kokv less than 1.0 enable diagnosing manifested compensatory hypertrophy and hyperfunction of the healthy kidney; kidney downsizing, functional depression are diagnosed from the side of the obstruction, and a nephrectomy is preferred.

EFFECT: method enables choosing the therapeutic approach to the ureteral obstruction in the children by detecting the clinical manifestations of the urinary outflow obstruction.

4 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to ultrasonic diagnostics, neurosurgery, vascular surgery and neurology. Colour duplex scanning in horizontal and vertical position of patient is performed. Pathological tortuosity is diagnosed in case of presence of deformation of main neck arteries with angle of tortuosity less than 60° in horizontal and vertical positions, turbulence of blood flow in area of tortuosity, more than 50% acceleration of systolic blood flow in area of deformation in comparison with proximal part of artery, reduction of blood flow rate more distally than tortuosity in comparison with proximal part of artery to tortuosity more than 20%.

EFFECT: method makes it possible to increase diagnostics accuracy due to change of hemodynamics under impact of change of patient's body position.

4 ex

FIELD: medicine.

SUBSTANCE: invention relates to medical equipment, namely to diagnostic ultrasound systems. Curved converter of high-intensity focused ultrasound (HIFU) contains curved piezoelectric matrix, which has opposite convex and concave surfaces, with concave surface being transmitting surface, and multitude of zones of acoustic transmission. Multitude of electrodes is located on surfaces of curved piezoelectric matrix. Curved adjustment layer, formed in monolithic, continuous way, is formed with required curvature of curves matrix of converters, and is attached to transmitting surface. Printed circuit board and back plate are located on side of matrix, opposite to adjustment layer, with back plate limiting air channel between printed circuit board and plate, and printed circuit board limits air channel between printed circuit board and matrix.

EFFECT: application of invention makes it possible to facilitate giving required shape to converter.

15 cl, 13 dwg

FIELD: medicine.

SUBSTANCE: neurovisualisation examination of brain is carried out, Cirs comorbidity index and Kaplan-Feinstein comorbidity index are determined, cochleovestibular syndrome, eye-moving impairments, type of diabetes mellitus are identified. Value of discriminate function (D) is calculated. If D value is higher than zero, diagnosed are consequences of ischemic brain stroke (IBS) with hyperhomocysteinemia (HH), if D is lower than zero, consequences of IBS without HH are diagnosed.

EFFECT: method makes it possible to increase reliability of diagnostics of IBS consequences, which is achieved due to complex analysis of said parameters.

2 ex

FIELD: medicine.

SUBSTANCE: inner angle (α) between back surfaces of an episternum and a mesosternum is preoperatively ultrasonically measured in a patient. A spiral oesophagomyotomy is performed. Tendons of the sternum legs of sternocleidomastoid muscles are dissected away from the episternum. A retrosternal tunnel is created. If α<165°, the episternum is dissected away at the level of a lower edge of the second rib. If α>165°, the episternum is dissected away at the level of a lower edge of the first rib. A colonic graft is delivered onto the neck through the retrosternal tunnel. An end-to-end anastomosis is applied between a cervical segment of the oesophagus and the colonic graft.

EFFECT: reducing invasiveness and postoperative complications by an individual approach to determining the episternum resection extent.

2 ex

FIELD: medicine.

SUBSTANCE: direct size between the most distant points of a presenting segment of the foetus head at the level of the sagittal plane, large transverse size of the foetus head between the most distant points of the parietal tubers, transverse size of the shoulders between the most distant points of the acromial processes and the anteroposterior size of the foetus chest at the level of VII thoracic vertebra and the base of the xiphoid process are determined. A probability coefficient of the foetus shoulder dystocia is calculated by a mathematic formula. Development of the foetus shoulder dystocia is made on the basis of the obtained coefficient value.

EFFECT: method makes it possible to predict the development of the foetus shoulder dystocia due to the evaluation of the significant ultrasonic indices in the foetus.

1 tbl, 4 ex

FIELD: medicine.

SUBSTANCE: ultrasonic examination of brachial artery is realised. During ultrasound examination lumen of brachial artery in systole and diastole is determined, reactive hyperaemia test and test with nitroglycerinum intake are performed. After that, values of lumen, obtained before performing test and after them, are compared. Presence of endothelial dysfunction is identified on the basis of degree of obtained data change. If value of brachial artery diameter after reactive hyperaemia test is less than 12% in systole and less than 13% in diastole, as well as after intake of nitroglycerinum, if value of brachial artery diameter in systole is less than 20% and less than 21% in diastole, endothelium dysfunction is diagnosed.

EFFECT: method provides detection of affection of vessel wall in said category of patients at the earliest stages.

2 ex

FIELD: medicine.

SUBSTANCE: predicting neonatal hypoglycaemia in an infant born by a woman suffering diabetes mellitus in the stages of at least 36 weeks of pregnancy is ensured by foetal ultrasonic scanning. A pancreatic gland (PG) is visualised in a cross-section of the foetal abdomen. Its maximum anterior-posterior dimension is measured at the body level, and if its dimension is more than 1.55 cm, the neonatal hypoglycaemia is predicted. In a particular case, the PG is visualised better if displaying the cross-section of the foetal abdomen at the level of a stomach and an intra-abdominal segment of an umbilical vein is followed by rocking and rotating an ultrasonic probe.

EFFECT: method enables improving the early postnatal adaptation, preventing the postnatal complications, incidence of disease and death caused by the hypoglycaemic conditions in the newborns born by the women suffering diabetes mellitus by correcting them timely due to the accurate prediction of developing neonatal hypoglycaemia starting from the stage of 36th week of pregnancy.

2 cl, 3 ex

FIELD: medicine.

SUBSTANCE: patient's serum asparagine aminotransferase (AST) is measured. That is combined with duplex scanning to measure a splenic vein diameter (SVD) and a body weight. The measured AST, SVD and body weight are used to calculate a fibrosis index by formula: FI=-6.31+0.19*AST-1.02*SVD+0.24*BW, wherein FI is the fibrosis index, -6.31 is a constant, 0.19-1.02 and 0.24 are the coefficients, AST is blood serum asparagine aminotransferase (Unit/l), SVD is the splenic vein diameter (mm), and BW is the patient's body weight (kg). The constant and coefficients in the presented formula are calculated by multiple regression method; a dependent variable is a liver density value according to ultrasonic elastography findings. If the derived fibrosis index is less than 6.3, the absence of fibrosis (stage F0) is stated. If the fibrosis falls within the range of 6.3 to 8.3, the first stage of fibrosis (F1) is diagnosed. The fibrosis index of 8.4 to 10.8 corresponds to the second stage of fibrosis (F2). The fibrosis index of 10.9 to 13.9 corresponds to the third stage of fibrosis (F3). If the fibrosis index is more than 13.9, hepatic cirrhosis (stage F4) is diagnosed.

EFFECT: technique provides the adequate differentiation of the fibrosis stages in the patients with chronic viral hepatitis by the complex assessment of biochemical, ultrasonic and antropometric parameters.

5 ex

FIELD: chemistry.

SUBSTANCE: invention refers to veterinary science and can be used for the prediction of the clinical course of bronchitis in calves. That is ensured by measuring body temperature, heart rate and respiration rate per a minute. That is ensured by calculating a respiratory disturbance index (RDI) as a relation of the respiration rate per a minute following a 30-second expiratory induced breath holding to the rest respiration rate per a minute. A Hildebrandt index is calculated as a relation of the heart rate to respiration rate per a minute. The derived data are analysed. If the body temperature is 37.5÷39.6°C, the heart rate is less than 100 per a minute, the respiration rate is less than 40 per a minute, the RDI is more than 1.4, whereas the Hildebrandt index is more than 1.8, the animal's absolute recovery or the benign clinical course of the disease is predicted (a favourable prognosis, prognosis bona). If the body temperature is more than 39.5°C, the heart rate is 90÷120 per a minute, the respiration rate is 40÷60 per a minute, the RDI is 1.2÷2.5, whereas the Hildebrandt index ranges within 1.7÷3.1, a probability of the unfavourable clinical course of the disease is predicted (a doubtful prognosis, prognosis dubia). If the body temperature is 39.5°C, the heart rate is more than 100 per a minute, the respiration rate is more than 60 per a minutes, the RDI is less than 1.2, whereas the Hildebrandt index is more than 1.8, the animal's partial recovery or the malignant clinical course of the disease is predicted (an unfavourable prognosis, prognosis bona).

EFFECT: method offers the prospect of the objective prediction of the clinical course of bronchitis in calves, including of the potential development of the complications, namely bronchial pneumonia, that in turn enables specifying a therapeutic approach and controlling the clinical effectiveness.

2 tbl, 2 ex

FIELD: chemistry.

SUBSTANCE: invention refers to veterinary science and can be used for the prediction of the clinical course of bronchitis in calves. That is ensured by measuring body temperature, heart rate and respiration rate per a minute. That is ensured by calculating a respiratory disturbance index (RDI) as a relation of the respiration rate per a minute following a 30-second expiratory induced breath holding to the rest respiration rate per a minute. A Hildebrandt index is calculated as a relation of the heart rate to respiration rate per a minute. The derived data are analysed. If the body temperature is 37.5÷39.6°C, the heart rate is less than 100 per a minute, the respiration rate is less than 40 per a minute, the RDI is more than 1.4, whereas the Hildebrandt index is more than 1.8, the animal's absolute recovery or the benign clinical course of the disease is predicted (a favourable prognosis, prognosis bona). If the body temperature is more than 39.5°C, the heart rate is 90÷120 per a minute, the respiration rate is 40÷60 per a minute, the RDI is 1.2÷2.5, whereas the Hildebrandt index ranges within 1.7÷3.1, a probability of the unfavourable clinical course of the disease is predicted (a doubtful prognosis, prognosis dubia). If the body temperature is 39.5°C, the heart rate is more than 100 per a minute, the respiration rate is more than 60 per a minutes, the RDI is less than 1.2, whereas the Hildebrandt index is more than 1.8, the animal's partial recovery or the malignant clinical course of the disease is predicted (an unfavourable prognosis, prognosis bona).

EFFECT: method offers the prospect of the objective prediction of the clinical course of bronchitis in calves, including of the potential development of the complications, namely bronchial pneumonia, that in turn enables specifying a therapeutic approach and controlling the clinical effectiveness.

2 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to vascular and endovascular surgery, and can be used to assess the state of an isolated aneurismal sac after a stent graft implantation by measuring a pressure inside the sac, as well as for introducing drugs into the blood vessel aneurism as it may be required. The device for pressure measurement in the isolated cavity of the aneurismal sac and for drug introduction into the blood vessel aneurism is configured as a hollow tube. The tube has side holes and is configured to reshape when inserted into the aneurism, to fill its inner space circumferentially, to attach by a two-piece hollow tube to a pressure sensor to measure a pressure between the vascular wall and the wall of the stent graft implanted into the blood vessel, as well as to introduce drugs by means of the above two-piece hollow tube. The tube is made of a viscoelastic absorbable material and spiral-shaped.

EFFECT: invention enables solving a set of challenges: saving the manufacturing expenses, simplifying the course of the surgical intervention, measuring the pressure, introducing the drugs, improving the immediate and remote results by ensured thrombosing of the aneurismal sac.

5 cl, 3 dwg

FIELD: chemistry.

SUBSTANCE: invention refers to medicine, namely surgery, and can be used for treating aseptic pancreonecrosis. Intra-organic pulseless pancreatic segments are localised and removed. To cover the pancreas, a greater omentum is incised into two portions - 1/3 from the left and 2/3 from the right up to a base of the greater omentum. Segments with pulse oscillation amplitude not less than 3.0 mm in the left 1/3 of the greater omentum and not less than 2.0 mm in the right 2/3 of the greater omentum are localised. The left portion in the distal segment is anchored with U-sutures to peripancreatic subcutaneous fat, whereas the right portion in the distal segment is anchored to a right hepatic lobe.

EFFECT: method enables arresting the disease progression and preventing infected pancreatic necrosis, improving pancreatic tissue blood supply by detecting the intra-organic pulse, removing all necrotic portions of the pancreas and using the greater omentum to cover the pancreas.

3 dwg, 2 ex

FIELD: physics, computer engineering.

SUBSTANCE: group of inventions relates to ergatic systems and can be used to correct the functional status of a human operator. The method includes evaluating the status of a human operator. The status indicator used is the heart rate. Limiting values of the range of a good status ChSSmin and ChSSmax are set for each human operator. When the heart rate exceeds the limiting values, the energy stimuli used are light pulses and binaural action, the frequency f of which is set in accordance with a given expression. An apparatus for correcting the functional status of a human operator is used. The apparatus comprises a central control unit connected to a storage unit, a stimulus generating unit and an analysis unit. The stimulus generating unit is connected to a stimulation unit. The output of the analysis unit is connected to the central control unit. The apparatus additionally includes a unit for measuring and processing an electrical cardio signal and a heart rate determining unit. The output of the unit for measuring and processing an electrical cardio signal is connected to the input of the heart rate determining unit, the output of which is connected to the analysis unit.

EFFECT: group of inventions improves the efficiency of correcting the status of a human operator, prevents excessive fatigue of the human operator quickly and in advance, reduces emotional and psychological stress, raises the level of activity of the body owing to a method of determining the status of the human operator, using the heart rate ChSS as an indicator of the status, the effect of light stimuli and binaural action.

2 cl, 2 dwg, 1 tbl

FIELD: medicine.

SUBSTANCE: clinical, X-ray and echocardiographic examinations are performed in a premature infant on the third day of life. Gestation age, Apgar score, infant's reflexes, states of the muscular system, skin, oedemas, moist rale, increased pulmonary vascularity on the X-ray pattern, as well as echocardiographic values of final diastolic size, left atrium and right ventricle per one kilogram of infant's body weight are assessed, and a prognostic coefficient is determined by mathematical formula. If the prognostic coefficient is 10 points and more, the high risk of long persistence of a haemodynamically significant form of the open arterial duct in the premature infants is predicted; the prognostic coefficient falling within the range of 0 to 9 points shows the low risk of long persistence of the haemodynamically significant form of the open arterial duct.

EFFECT: method enables predicting the non-invasive prediction of the high risk of long persistence of the haemodynamically significant form of the open arterial duct in the premature infants on the third day of life, and specifying the further therapeutic approach to the infant and the absolute indications for persistent foetal communication correction.

2 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to cardiosurgery. The bypass blood flow is assessed with assisting artificial circulation and clamped aorta. After a distal anastomosis is created, the bypass is connected to a heart and lung apparatus by means of an intravenous infusion system. Each anastomosis is assessed successively.

EFFECT: method enables the intraoperative assessment of the blood flow in the bypasses and the inspection of the dysfunctional anastomosis before unclamping the aorta and applying cardioplegic solution additionally.

3 dwg

FIELD: medicine.

SUBSTANCE: group of inventions relates to medical diagnostics. Method of determining degree of vessel narrowing contains stages at which obtained are: sequence of first pressure measurements P1 and sequence of respective first rate measurements U1 in first location inside vessel, sequence of second pressure measurements P2 and sequence of respective second rate measurements U2 in second location inside vessel. Wave rate c in fluid medium is determined for each location depending on square of pressure change divided by square of respective rate change. For first location change of direct pressure is determined depending on the sum of pressure change and rate change. For second location change of direct pressure is determined depending on the sum of pressure change and rate change. Reserve of separated direct flow, representing drop of pressure through target area is determined, with said drop of pressure indicating degree of local narrowing or compression of vessel between said first location and second location. Device for determining degree of vessel narrowing is described.

EFFECT: inventions provide measurement of localised flow restriction.

14 cl, 6 dwg

FIELD: medicine.

SUBSTANCE: patient with premature atrial contraction (PAC) undergoes ECG study. A signal-averaged ECG is recorded. The method involves measuring the length of a filtered push-pull (FiP-P) wave of the signal-averaged ECG (ms), P wave dispersion determined as a difference of maximum and minimum P wave lengths while recording 12 leads of the standard ECG (Pd) (ms), a linear deviation (A), B that is the number of premature atrial contractions per hour, a risk index of developing atrial fibrillations (RIDAF) by an original formula. If the RIDAF is less than 0.5, the high risk of atrial fibrillation is predicted for 1-3 months; the RIDAF from 0.5 to 1.5 stands for the moderate risk during 3 months to 1 year, whereas the RIDAF of more than 1.5 shows the low risk for more than 1 year from the first examination of the patient suffering from premature atrial contraction.

EFFECT: method enables increasing the determination accuracy of the risk of atrial fibrillation following the first examination and correcting the therapy.

3 tbl, 4 ex

FIELD: medicine.

SUBSTANCE: method involves determining a period of time from the onset of symptoms to establishing a diagnosis (t); a functional class is rated at the time of establishing the diagnosis (FCinit); a cardiac output is calculated at the time of establishing the diagnosis (CO); an acute pharmacological test (APT) coefficient (X) is calculated as follows: (APT-)=0, (APT+)=1, (APT++)=2. A risk of the unfavourable clinical outcome in the patients suffering from idiopathic pulmonary hypertension (H) is calculated by an original formula. If the value H ≤0.35, a low risk is stated; H=0.36-0.55 shows a moderate risk, whereas H≥0.56 is a sign of a high risk of the unfavourable clinical outcome.

EFFECT: method enables the high-reliability detection of the unfavourable clinical outcome in the patients with idiopathic pulmonary hypertension, the determination of rates of the disease progression for the purpose of prescribing an adequate therapy.

2 ex

FIELD: medicine.

SUBSTANCE: method involves recording heart beat rate and systolic arterial blood pressure before and after two-stage exercise stress. The first stage is of 50 W within 3 min and the second one is of 75 W during 2 min. Patient rest pause is available between loading stages to recover initial heart beat rate. Prognostic estimation of cardiopulmonary complications is carried out with mathematical formula applied.

EFFECT: reduced risk of complications in performing tests.

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