Method and device for determining the efficiency of muscle venous pump
(57) Abstract:The invention relates to medicine. Measure the volume of the limb after performing dosed physical load and when the transition from the horizontal to the vertical position. The efficiency of muscle venous pump is defined as the result of dividing these values in %. The method allows to take into account individual variation of the initial values of the volume of a limb. The device contains plethysmographic connected through an adjustable current source, and a control circuit to the controller, which also ADC is connected through a signal amplifier of the sensor. Last through the pre-amplifier connected to the sensor directly with the source of the reference voltage. To the output of the controller is also connected keyboard control, and to its input via the bus of the microprocessor device constant memory and the indicator. 2 S. and 1 C.p. f-crystals, 1 Il. The invention relates to medicine, in particular to phlebology, and can be used to determine the functional state of the veins of the lower extremities, in particular the efficiency of muscle venous pump of the leg in the execution of the dosed physical load evaluation sostojatel the capacity of muscle venous pump (P. Alekseev P. Methods of diagnostics of vascular diseases of the extremities. HP: Medicine, 1971, 190 C.), at which the efficiency of muscle venous pump is estimated to reduce the level of the liquid column in the vessel, which is connected with the measuring cuff, using March tests, Delbe-Perthes disease, however, this method has low accuracy.There is also known a method of determining the state of the muscle venous pump of the lower extremities (A. S. N 880406, 1981), which aimed at reducing the morbidity status of the muscle venous pump is determined by the magnitude of the change in muscle volume of the upper third of the leg when walking.As devices used to study the functions of the muscle venous pump of the Shin, known advanced peoplesmart (Ignatiev, I. M. Surgical correction of violations of the outflow of blood through the deep veins in post-illness. Diss. Kida. the honey. of Sciences, Leningrad, 1988, S. 48-52), pneumatic plethysmographic connected by a rubber tube with pressure gauge (Zavialov C. D. Modern approach to diagnosis and definition of tactics of varicose veins of lower extremities based on a quantitative assessment of hemodynamics. Diss. for obtaining the academic step is I indicators of venous hemodynamics, measure the indirect value (impedance of the tissue or the air pressure in the cuff) and require significant post-processing of the received data. The most optimally used in similar studies of A. plethysmometer (M. I. Lytkin, A. N. The Vedeno and other Occlusive plethysmography in the diagnosis of abnormalities of the venous blood flow in the lower extremities. Bulletin of the surgery. I. I. Grekova 1988, No. 6, S. 38-43).As a prototype known method (Zavialov C. D. Modern approach.. ., C. 164-180), in which the patient performs the sustainer of the sample for one minute, with the help of pneumatic plethysmography installed on the upper third of the tibia, plethysmographically recording cuff of plethysmograph "Fluvoscript" is determined by the volume reduction of limbs in the mm, which is then translated into a relative reduction of the volume of a limb, which is the parameter that characterizes the work of the muscle venous pump.However, this method has a high complexity and does not provide sufficient accuracy to determine the effectiveness of muscle venous pump, because the first pneumatic plethysmographic has a low rate is about second this method does not account for individual variation in the initial values of venous volume.The invention is directed to improving the accuracy and reliability of determination of efficiency of muscle venous pump of the leg.For this it is necessary to determine the increase in limb volume (in ml per 100 ml of tissue) at the transition from the horizontal to an upright position (orthostatic volume), and then to determine the decline in the execution result of the dose load of five times rising on his toes (meaning muscle pump), then divide the value of muscle pump on the value of orthostatic volume. This is the result, expressed as a percentage, and is a characteristic of the efficiency of muscle venous pump of the tibia, which takes into account the individual variation of the initial values of the volume of a limb.Device for the automated implementation of this method, shown in the drawing, consists of A. plethysmometer (sensor Witney) 1, is connected through an adjustable current source 2 and the control circuit 3 to the first digital output controller 9, the second digital output through an analog-to-tiiny amplifier 4 is connected to the sensor, and the second with the output of the voltage reference. The third digital output controller 9 is connected to the control keyboard 8, and a digital input connected to the bus of the microprocessor 10, to which is also connected device's permanent memory 11, a RAM 12 and through the indicator 13. The device has an output analog signal for recording on the recorder.The device operates as follows. On the upper third of the tibia of a patient lying in a horizontal position, set A. plethysmometer, and keyboard control the command is given to start work. In accordance with the program stored in the ROM, the CPU via the controller and the control circuit sets the value of the current sensor, in which the voltage at the amplifier output signal is zero. Then at the command of the experimenter, the patient goes into a vertical position. The resulting increase in limb (orthostatic volume) is recorded by the processor in the device memory and is displayed on the indicator as speeds increase and its final value. Then, at the command of the experimenter, the patient performs the exercise nagruzke thus reduce limb muscle venous pump) is recorded by the processor in the device memory, then, the processor calculates the value of the efficiency of muscle venous pump, as expressed as a percentage of the result of dividing the value of muscle venous pump on the value of orthostatic volume. On command from the keyboard to the indicator alternately called all measured parameters: orthostatic volume, the value of the muscle venous pump, the efficiency of muscle venous pump, the speed of growth after the transition to a vertical position in the research process analog curve is recorded on a chart recorder. 1. The way to determine the effectiveness of muscle venous pump of the tibia, including the registration of the volume of a limb with plethysmometer, determination of reducing the volume of a limb after dosed physical load, characterized in that determine the growth of the limb after the transition from horizontal to vertical position, and the value of the efficiency of muscle venous pump tibia is defined as the percentage of the result of dividing the output of the reduce limb after performing dosed physical loading on the growth of the limb when moving in a vertical position.2. done on socks.3. A device for determining the efficiency of muscle venous pump containing plethysmometer, characterized in that it is connected through an adjustable current source and control circuit to the first digital output of the controller, to the second digital output through an analog-to-digital Converter connected to the amplifier output signal, the first input is through a pre-amplifier connected to the sensor, and the second with the output of the voltage reference, the third digital output of the controller is connected to the control keyboard, and a digital input connected to the bus of the microprocessor, to which is also connected device constant memory and the indicator.
SUBSTANCE: method involves recording rheogram from feet and legs lifted and fixed at an angle of 45є. Then, rheogram is recorded on inhaling from legs directed vertically downward. Functional blood circulation reserve index is calculated as product of results of dividing and subtracting rheographic indices recorded under conditions of lifted and lowered extremities that means under conditions of functional venous system relief and venous hypertension, respectively.
EFFECT: enhanced effectiveness in recognizing patient group suffering from severe lower extremities ischemia.
FIELD: medicine; medical engineering.
SUBSTANCE: method involves doing multi-channel recording of electroencephalogram and carrying out functional tests. Recording and storing rheoencephalograms is carried out additionally with multi-channel recording of electroencephalogram synchronously and in real time mode in carotid and vertebral arteries. Electroencephalograms and rheoencephalograms are visualized in single window with single time axis. Functional brain state is evaluated from synchronous changes of electroencephalograms, rheoencephalograms and electrocardiograms in response to functional test. The device has electrode unit 1 for recording bioelectric brain activity signals, electrode unit 2 for recording electric cardiac activity signals, current and potential electrode unit 3 for recording rheosignals, leads commutator 4, current rheosignal oscillator 5, synchronous rheosignal detector 6, multi-channel bioelectric brain activity signals amplifier 7, electrophysiological signal amplifier 8, demultiplexer 9, multi-channel rheosignal amplifier 10, multi-channel analog-to-digital converter 11, micro-computer 12 having galvanically isolated input/output port and personal computer 13 of standard configuration.
EFFECT: enhanced effectiveness of differential diagnosis-making.
11 cl, 6 dwg
FIELD: medicine; medical engineering.
SUBSTANCE: method involves irradiating blood-carrying tissue area under control with luminous flow, receiving scattered luminous flow modulated with blood filling changes in blood vessels and capillaries of blood-carrying tissue and forming electric signal of pulse wave. Deviation signal of light-emitting and light-receiving transducers of optoelectronic converter relative to blood-carrying tissue area under control based on difference between the current and preceding values of impedance signal on the area under control. The signal being observed, prohibition signal is produced on pulse wave electric signal passage for excluding errors caused by motion artifacts from its following processing. The device has optoelectronic converter having light-emitting and light-receiving transducers and unit for producing pulse wave signal, which input is connected to light-receiving transducer output. Unit for forming deviation signal has two measuring electrodes connected to separate comparator inputs which output being deviation signal former output, is connected to control input of key. Information input of the key is connected to pulse wave signal former output.
EFFECT: improved noise immunity.
3 cl, 3 dwg
FIELD: medicine; medical engineering.
SUBSTANCE: method involves recording multichannel electroencephalogram, electrocardiogram record and carrying out functional test and computer analysis of electrophysiological signals synchronously with multichannel record of electroencephalogram and electrocardiogram in real time mode. Superslow brain activity is recorded, carotid and spinal artery pools rheoelectroencephalogram is recorded and photopletysmogram of fingers and/or toes is built and subelectrode resistance of electrodes for recording bioelectrical cerebral activity is measured. Physiological values of bioelectrical cerebral activity are calculated and visualized in integrated cardiac cycle time scale as absolute and relative values of alpha-activity, pathological slow wave activity in delta and theta wave bandwidth. Cerebral metabolism activity dynamics level values are calculated and visualized at constant potential level. Heart beat rate is determined from electrocardiogram, pulsating blood-filling of cerebral blood vessels are determined from rheological indices data. Peripheral blood vessel resistance level, peripheral blood vessel tonus are determined as peripheral photoplethysmogram pulsation amplitude, large blood vessel tonus is determined from pulse wave propagation time data beginning from Q-tooth signal of electrocardiogram to the beginning of systolic wave of peripheral photoplethysmogram. Postcapillary venular blood vessels tonus is determined from constant photoplethysmogram component. Functional brain state is determined from dynamic changes of physiological values before during and after the functional test. Device for evaluating functional brain state has in series connected multichannel analog-to-digital converter, microcomputer having galvanically isolated input/output ports and PC of standard configuration and electrode unit for reading bioelectric cerebral activity signals connected to multichannel bioelectric cerebral activity signals amplifier. Current and potential electrode unit for recording rheosignals, multichannel rheosignals amplifier, current rheosignals generator and synchronous rheosignals detector are available. The device additionally has two-frequency high precision current generator, master input of which is connected to microcomputer. The first output group is connected to working electrodes and the second one is connected to reference electrodes of electrode unit for reading bioelectrical cerebral activity signals. Lead switch is available with its first input group being connected to potential electrodes of current and potential electrodes unit for recording rheosignals. The second group of inputs is connected to outputs of current rheosignals oscillator. The first group of outputs is connected to current electrodes of current and potential electrodes unit for recording rheosignals. The second group of outputs is connected to inputs of synchronous detector of rheosignals. Demultiplexer input is connected to output of synchronous detector of rheosignals and its outputs are connected to multichannel rheosignals amplifier inputs. Outputs of multichannel bioelectrical cerebral activity signals amplifier, multichannel rheosignals amplifier and electrophysiological signal amplifier are connected to corresponding inputs of multichannel analog-to-digital converter. Microcomputer outputs are connected to control input of lead switch, control input of multichannel demultiplexer, control input of multichannel analog-to-digital converter and synchronization inputs of current rheosignals oscillator and synchronous detector of rheosignals. To measure subelectrode resistance, a signal from narrow bandwidth current generator of frequency f1 exceeding the upper frequency fup of signals under recording is supplied. A signal from narrow bandwidth current generator of frequency f2≠ f1>fup is supplied to reference electrode. Voltages are selected and measured at output of each amplifier with frequencies of f1, f2 - Uf1 and Uf2 using narrow bandwidth filtering. Subelectrode resistance of each working electrode is determined from formula Zj=Ujf1 :(Jf1xKj), where Zj is the subelectrode resistance of j-th electrode, Ujf1 is the voltage at output from j-th amplifier with frequency of f1, Kj is the amplification coefficient of the j-th amplifier. Subelectrode resistance of reference electrode is determined from formula ZA=Ujf2 :(Jf2xKj), where ZA is the subelectrode resistance of reference electrode, Ujf2 is the voltage at output from j-th amplifier with frequency of f2, Jf2 is the voltage of narrow bandwidth current oscillator with frequency of f2.
EFFECT: wide range of functional applications.
15 cl, 10 dwg
FIELD: medicine, surgery.
SUBSTANCE: one should evaluate clinical state of a patient and as objective parameters one should calculate rheological and brachio-malleolar indices, detect fractional tension of oxygen in capillary blood. At observing clinical improvement accompanied by increased rheological and brachio-malleolar indices by more than 0.1, increased blood saturation with oxygen by more than 10 mm mercury column one should state upon a "good" therapeutic effect. At detecting clinical improvement accompanied by the increase of either one or several objective parameters, or if dynamics of these values is not available - effect should be considered as a "satisfactory" one. At kept ischemic pain at rest without decrease of its intensity, impossibility to keep a limb in horizontal position for a long period of time, the absence of positive dynamics of trophic disorders, at kept ischemic edema and at no alterations in objective parameters - should be determined as "no dynamics". In case of enhanced ischemic pain and edema of foot, at progressing necrotic alterations in foot - one should detect "deterioration" of patient's state. The method increases the number of diagnostic means.
EFFECT: higher accuracy of evaluation.
1 ex, 1 tbl
SUBSTANCE: method involves recording peripheral differential upper extremity blood vessel rheogram and phonocardiogram in synchronous way. The second phonocardiogram beginning and the deepest rheogram points are detected. Pulse way propagation time reduction being found, arterial bloodstream tone growth conclusions are drawn.
EFFECT: high reliability of the results.
18 dwg, 3 tbl
FIELD: medicine, neurology.
SUBSTANCE: a patient should be in initial position when his/her sight is directed towards the ceiling and in 3-5 min it is necessary to register a background rheoencephalogram, then a patient should fix the sight at a pointer's tip being at the distance of about 30 cm against the bridge of nose along the middle line, then the sight should be directed into marginal position due to shifting pointer to the left. Then the sight should be returned into initial position and 3 min later it is necessary to register rheoencephalogram of vertebro-basilar circulation, calculate rheographic index (RI), coefficient for RI ratio on returning the sight from left-hand marginal position into initial one (k2) and at k2>1.098 from the left and (or) k2>1.085 from the right one should detect alteration in vertebro-basilar circulation by reflector mechanism. The method excludes biomechanical impact in stimulating proprioceptive receptors of muscular-ligamentous system under stretching.
EFFECT: higher accuracy and reliability of detection.
2 ex, 2 tbl
FIELD: medicine, resuscitation.
SUBSTANCE: one should detect cerebral perfusion pressure (CPP), intracranial pressure (ICP), values for blood saturation with oxygen in radial artery and jugular vein bulb (SaO2, SjO2), additionally one should study lactate level in jugular vein bulb and radial artery, calculate venous-arterial difference according to lactate (▵lactate), cardiac ejection (CE) due to thermodilution and hemoglobin level. Values for cerebral oxygen transport function should be calculated by the following formulas: mĎO2 = 0.15 x CE x CaO2 x 10; mVO2 = 015 x CE x (CaO2 - CjO2) x 10; CaO2 = 1.3 x Hb x SaO2; CjO2 = 1.3 x Hb x SjO2. In case of noninvasive detection - due to pulsoxymetry one should measure peripheral saturation (SpO2), due to parainfrared spectroscopy - cerebral oxygenation (rSO2) and cardiac ejection due to tetrapolar rheovasography (CEr), detect and calculate the values of cerebral oxygen transport system according to the following formulas: mĎO2 = 0.15 x CEr x CaO2 x 10; mVO2 = 0.15 x CEr x (CaO2 - CjO2) x 10; CaO2 = 1.3 x Hb x SpO2; CjO2 = 1.3 x Hb x rSO2. At the value of mĎO2 86-186 ml/min and more, MVO2 33 - 73 ml/min, ▵lactate below 0.4 mM/l one should evaluate cerebral oxygen transport system to be normal and the absence of cerebral metabolic disorders. At mĎO2 values below 86 ml/min, mVO2 being 33-73 ml/minO2, ▵lactate below 0.4 mM/l one should state upon compensated cerebral oxygen transport system and the absence of metabolic disorders. At mĎO2 being below 86 ml/min, mVO2 below 33 mM/l, ▵lactate below 0.4 mM/l one should conclude upon cerebral oxygen transport system to be subcompensated at decreased metabolism. At the values of mĎO2 being 86-186 ml/min and more, MVO2 below 33 ml/min, ▵lactate below 0.4 mM/l one should establish subcompensated cerebral oxygen transport system at decreased metabolism. At values of lactate being above 0.4 mM/l and any values of mĎO2 and mVO2 one should point out the state of decompensation in cerebral oxygen transport system and its metabolism. The innovation enables to diagnose disorders and decrease the risk for the development of secondary complications.
EFFECT: higher efficiency and accuracy of evaluation.
1 cl, 3 ex, 1 tbl
SUBSTANCE: method involves setting a patient in vertical posture with stabilogram and rheoencephalogram being concurrently recorded with frontomastoid and accipitomastoid leads being used retaining head position with stressed neck extensor muscles state and head position with relaxed neck extensor muscles state. Stabilogram parameters characterizing vertical posture stability and rheographic index of each of four brain basins. When combining better filling of cerebral basins with blood and higher standing stability, training is carried out in keeping head positions allowing better filling of cerebral basins. If better filling of cerebral basins with blood follows with no increased standing stability, the trainings are carried out in keeping head position with stressed neck extensor muscles state. The training sessions are given twice a day for 15 min during two weeks.
EFFECT: enhanced effectiveness of treatment.
2 cl, 3 tbl
SUBSTANCE: method involves determining pulsating arterial blood flow parameters. To do it, measuring electrodes are applied in main liver body mass location zone. Electrode-to-electrode distance is additionally measured and hepatic index is calculated from formula HI=ρ*L2*Ad*ET*HBR/Z2*1000*S, where HI is the hepatic index (l/min/m2), ρ is the constant reflecting volume blood resistance (150 Ohm cm), L is electrode-to-electrode distance (cm), Z is the base impedance (Ohm), Ad is the differential rheogram amplitude (Ohm/s), ET is blood expulsion time (s), HBR is heart beat rate per 1 min, S is the body surface (m2), 1000 is the coefficient for converting to liters. HI value being greater than 0.225 l/min/m2, porto-portal and/or porto-central hepatic fibrosis is diagnosed.
EFFECT: wide range of functional applications.