The method of differential diagnostics of blood circulation in the basins of the external carotid and ophthalmic arteries

 

(57) Abstract:

The invention relates to medicine, ophthalmology. Produce removal plethysmogram with common carotid, supraorbital and temporal arteries. Provide alternate synchronization plethysmogram with electrocardiographic signal. Determine the relative shift plethysmogram common carotid artery in relation to plethysmogram supraorbital and temporal arteries. If the shift between plethysmography common carotid and supraorbital arteries less than 20 or more than 60 MS, it is considered that the circulation in the area of the ophthalmic artery violated. If the shift between plethysmography common carotid and temporal arteries less than 10 or more than 40 MS, it is considered that the circulation in the basin of the external carotid artery violated. The method allows to produce a differential diagnosis of the physiological condition and the rigidity of the walls of arteries in the basins of the ophthalmic and external carotid arteries. 3 Il.

The invention relates to medicine, namely to angiology and ophthalmology.

Known plethysmographically method of diagnosis (Misawa Homes Institute of Research and Development. Technical Report. - 1991. - vol. 22. -p. 1-4). Its disadvantage is that the method does not allow nepoznat artery or carotid artery.

The task of the invention consists in the differential diagnosis of the physiological condition and stiffness of the walls in the basins of the ophthalmic and (or) external carotid arteries.

The specified task according to the method is solved in that, in order to increase the accuracy of diagnostics, perform alternate synchronization plethysmogram with electrocardiographic signal, then determine the relative shift plethysmogram common carotid artery in relation to plethysmogram supraorbital and temporal arteries and, if the relative shift between plethysmography common carotid and supraorbital arteries less than 20 or more than 60 MS, it is considered that the circulation in the area of the ophthalmic artery is impaired, and if the relative shift between plethysmography common carotid and superficial temporal arteries less than 10 or more than 40 MS, it is considered that the circulation in the basin of the external carotid artery violated.

The method is illustrated by drawings, where Fig. 1, Figs. 2 and Fig. 3 shows a block diagram of the device and the sample entries synchronized with the electrocardiogram of plethysmogram.

In Fig. 1 position 1 - body, 2 - power, 3 - unit plethysmograph, 4 - block, ECG, 5 - block bei plethysmogram carotid artery and the ECG is normal, 8 - simultaneous recording plethysmogram supraorbital artery and ECG are normal, 9 - simultaneous recording plethysmogram temporal artery and ECG are normal.

In Fig. 3 positions 10-12 - same as in Fig. 2, but in a state of pathology, vascular sclerosis.

Block plethysmography combined with (3) serves as a sensor for converting voltage of the optical signal from the sensor, which is proportional to the wave of blood vessels in the treated area.

The unit for removal of the electrocardiogram (4) is standard (catalog Siemens-elema, Mingograph 34, page 6-7) and allows measuring of ECG in one of the standard leads with subsequent transfer of the signal at the instantaneous recorder (ibid.).

Instantaneous recorders (6) is designed for simultaneous recording pulsogram and ECG with minimal errors in the estimation of the initial phase of the signals.

It Is Evident From Fig. 2 and Fig. 3 shows that there is a possibility of reliably and repeatedly reproduced to evaluate the phase shift ECG and plethysmogram, and it indirectly evaluate the phase shift between plethysmogram from different parts of the bloodstream, which speaks of the absolute velocity of propagation of pulse wave along identificirebis points adjacent to the carotid artery, to the supraorbital artery, temporal artery is applied consistently over time the sensor plethysmograph (3) signals and plethysmogram recorded synchronously with one of the standard ECG leads, remove the using block for pickup electrocardiogram (4), the instantaneous recorders (6).

The obtained curves, the shape of which may vary markedly, compared, and evaluated only the initial phase of the signals carrying the information about the average propagation speed of the pulse wave in the areas of blood stream, concluded between the points of removal plethysmogram located along the channel.

Based on the analysis of research 248 patients empirically by it was proved that if the relative shift between plethysmography common carotid and supraorbital arteries less than 20 or more than 60 MS, the condition of blood circulation in the area of the ophthalmic artery is impaired, and if the relative shift between plethysmography common carotid and superficial temporal arteries less than 10 or more than 40 MS, the state of circulation in the basin of the external carotid artery violated.

The method is illustrated by two clinical examples.

the disease: hypertension II And, ischemic heart disease.

Was admitted to the hospital with complaints of sudden loss of vision in his right eye, which occurred suddenly 4 hours later. From the anamnesis: in the past two days have worked hard, have enough sleep, work was stressful situation.

Admission: Vis OD= 0.09, OS=1.0; linear velocity of blood flow in the carotid artery - 28 cm/s (normal 22-24 cm/s), in the area of the ophthalmic artery - 12 cm/s (normal 8 - 11 cm/s), blood pressure 165 and 100 mm RT.article When the fundus examination revealed marked spasm of the Central artery of the retina, moderate edema macular area.

The patient underwent a diagnostic study on the proposed way to anatomically identifiable points adjacent to the carotid and supraorbital arteries, was sequentially in time attached sensor plethysmograph and its signals were simultaneously recorded ECG signals instantaneous recorder. Were then evaluated the initial phase of the signals carrying the information about the average propagation speed of the pulse wave in the areas of blood stream, concluded between the points of removal plethysmogram located along the riverbed. In this case, the relative shift between plethysmography obsessional artery.

Emergency procedure the patient underwent intensive therapy, including anti-hypertensive, sedative, vasodilator and rheological tools.

A day later the patient was re-examined: the linear velocity of blood flow in the carotid artery - 23 cm/s, in the area of the ophthalmic artery - 9 cm/s, blood pressure 130 and 85 mm RT.article When the fundus examination: remains moderate swelling of the macular region, the Central artery of the retina of normal diameter.

The relative shift between plethysmography common carotid and supraorbital arteries was 28 MS, which indicates the normalization of blood circulation in the area of the ophthalmic artery.

When you are discharged after 7 days: Vis OD=0.6, OS=1.0; linear velocity of blood flow in the carotid artery - 23 cm/s, in the area of the ophthalmic artery - 10, blood pressure 135 85 mm RT.article When examining the fundus of the normal diameter of the Central artery of the retina, macular edema is practically absent.

The relative shift between plethysmography common carotid and supraorbital arteries was 26 MS.

Example 2. Patient N., 23 years.

The diagnosis of myopia of an average degree.

Special diagnostic methods is not the speed of blood flow in the carotid artery 25 cm/s, in the area of the ophthalmic - 9 cm/s and the superficial temporal 16 cm/sec. At ophthalmoscopy vessels of the ocular fundus normal diameter.

The patient underwent a diagnostic study on the proposed way to anatomically identifiable points adjacent to the carotid and supraorbital arteries, and then to the carotid and superficial temporal arteries, was sequentially in time attached sensor plethysmograph and its signals were simultaneously recorded ECG signals instantaneous recorder. Were then evaluated the initial phase of the signals carrying the information about the average propagation speed of the pulse wave in the areas of blood stream, concluded between the points of removal plethysmogram located along the riverbed. In this case, the relative shift between plethysmography common carotid and supraorbital arteries was 42 MS, and the relative shift between plethysmography common carotid and superficial temporal arteries was 28 MS, which indicates a normal condition of blood circulation in the basins of the ophthalmic and external carotid arteries.

The method is easily reproducible, vasocontraction, repeatable and cheap.

Thus, the apparatus and method diagnosticmode bed.

The method of differential diagnostics of blood circulation in the basins of the external carotid and ophthalmic arteries, including removal of plethysmogram with common carotid artery, with supraorbital artery, temporal artery, characterized in that the implement alternate synchronization plethysmogram with electrocardiographic signal, then determine the relative shift plethysmogram common carotid artery in relation to plethysmogram supraorbital and temporal arteries and if the relative shift between plethysmography common carotid and supraorbital arteries less than 20 or more than 60 MS, it is considered that the circulation in the area of the ophthalmic artery is impaired, and if the relative shift between plethysmography common carotid and superficial temporal arteries less than 10 or more than 40 MS, it is considered that the circulation in the basin of the external carotid artery violated.

 

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