Method of assessment of circulatory disorders of the prostate gland

 

(57) Abstract:

The invention relates to medicine, urology, functional diagnostics. In the rectum enter bipolar electrode. Register background rogramme. Through the same electrode exercise pulse fluctuosa stimulation (FIS) within 15 minutes After 5, 10 and 15 min after the beginning and after 5 minutes after re-register rogramme. Allocate phase of the reaction flow: "initial", "compensatory", "maximum effect" and "decline effect". Calculate iograficheskii indicators. When expressed and mohradiant increasing improvement eographically performance in all 3 phases of the impact of IFC determine the absence of circulatory failure prostate cancer. When expressed improve eographically indicators 1 and 3 phase, their deterioration in phase 2 define 1 degree of circulatory disorders - the hidden deficiency of blood flow in the prostate. When a moderate improvement eographically indicators 1 and more pronounced in 3 phase and their deterioration in the 2 phase - 2 the degree of circulatory disorders - severe deficiency of blood flow in the prostate. When the deterioration eographically performance in all 3 phases - 3 the degree of violation of cu is disruption of blood circulation in the prostate.

The invention relates to medicine, specifically urology and functional diagnostics, and is intended for determining the stage of violations of organ blood flow, choice of therapy and predicting the course of diseases of the prostate.

Known way to assess disorders of the circulatory organ of the urogenital system (kidneys) by conducting rheography - background and dynamics - every 5 minutes after "load" tests (injection drugs), analysis of reogram on iographica.com indicators: iographica.com index (RI), the index of peripheral resistance vessels (IPS), the ratio of venous outflow (QUO); selection phase reactions of organ blood flow - "primary", "compensatory", "maximum effect" and "decline effect". According to a characteristic constellation of changes eographically indicators in each phase appreciate one of the three stages of the disorders studied organ circulatory system (A. C. 1531994 the USSR. Method of assessment of circulatory disorders in the kidney / Y. M. Uzilevsky, M. A. Fingers. B 48, 1989).

The disadvantage of this method is its applicability to the study of prostate cancer, as this organ is not genotype in relation to the introduction of data which changes under the influence of these drugs.

There is a method of assessing blood circulation of prostate cancer by endorectal rheography, registration eographically curves, obtaining eographically indicators and their subsequent analysis with the conclusion about the extent of their changes in relation to the conventional "normal" (I. C. Karpukhin. Phonophoresis of antibiotics in chronic prostatitis. Abstract. dis. K. M. N., 1981).

The disadvantage of this method is the lack of information about the extent of reversibility of changes.

The last method is most similar to the claimed object on the technical methods and the achieved result and therefore elected by the applicant as a prototype of the proposed method.

The tasks of the proposed method are more accurate assessment of circulatory disorders of the prostate gland through the analysis of reserve possibilities of organ blood flow, which is detected by physiotherapy load the bloodstream and muscle tissue of the examined organ.

The solution of these tasks is achieved in that in a method for evaluating disorders of the prostate, including endorectal introduction bipolar electrode, conducting rheography and analysis eographically display the full sample on the same electrode session FIS-impact (impulse fluctuosa stimulation - rectangular pulses with an amplitude of 9 V and a duration of 2 MS, the frequency of which change randomly near the Central frequency, adjustable in the range from 9 to 30 Hz) and record rogramme in the process (after 5, 10, 15 min) and after exposure (after 5 min), there are the phase changes of the local circulation, "primary", "compensatory", "maximum effect" and "drop action" and the constellation of changes eographically indicators in each of the phases set one of the three stages of violations of the organ of circulation of the prostate. When expressed and progredient increasing improvement eographically performance in all 3 phases of the impact of IFC determine the absence of circulatory failure prostate cancer. When expressed improve eographically indicators in the 1st and the 3rd phase, the deterioration in the 2nd phase determine 1 the degree of disturbance of blood circulation, which occurs when a hidden deficiency of blood flow to the prostate with a moderate improvement eographically indicators in the 1st and more pronounced in the 3rd phase, and their deterioration in the 2nd phase - 2, the disturbance of blood circulation, which meet the threat - 3, the disturbance of blood circulation, which occurs when the irreversible failure of blood flow in the prostate.

The method is as follows.

Injected into the rectum of the bipolar electrode, prove the correctness of its location behind the prostate and register background rogramme, then after switching electrodes (distal, tail parts) to receive electrotherapy effect serves pulsed electric medical signals (pulse fluctuosa stimulation - rectangular pulses with an amplitude of 9 V and a duration of 2 MS, the frequency of which change randomly near the Central frequency, adjustable in the range from 9 to 30 Hz) in General for 15 min, every 5 min (i.e. after 5, 10, 15 min) and after 5 min after exposure to re-register rogramme, then get iograficheskii indices (RI - eographically index, IPS - index peripheral resistance, QUO - factor for venous), allocate phase of the reaction flow: "initial", "compensatory", "maximum effect" and "downturn actions and their constellations establish one of the three stages of violations of organ blood flow. the Oia FIS determine the absence of circulatory failure prostate cancer. When expressed improve eographically indicators in the 1st and the 3rd phase, the deterioration in the 2nd phase determine 1 the degree of disturbance of blood circulation, which occurs when a hidden deficiency of blood flow to the prostate with a moderate improvement eographically indicators in the 1st and more pronounced in the 3rd phase, and their deterioration in the 2nd phase - 2, the disturbance of blood circulation, which occurs in severe deficiency of blood flow to the prostate with a deterioration eographically performance in all 3 phases - 3 the degree of disturbance of blood circulation, which occurs when the irreversible failure of blood flow in the prostate.

A specific example of the method.

Example 1. Palen s, 45 years. Diagnosis: Asthenic neurosis, functional prostatute. Complaints about uncomfortable sensations in the urethra and erectile dysfunction in the last month. Disease associates with the physical and mental strain. Objective: external genitals are formed and developed correctly. When rectal finger examination: prostate is slightly enlarged, thick, painful, increase share symmetric. Secret after prostate massage last leukocyte count to 10 in view, the LEC is the cue seals in both lobes. The seminal vesicle is not extended.

When endorectal bipolar rheography of the prostate obtained following iograficheskii indicators. Background rogramme decrease in pulse blood in normal peripheral resistance and the lack of difficulty of venous outflow. On rogramme 1-u "initial" and 2nd is "compensatory" "phase reactions of blood flow in the prostate pulse volume increases progressively (eographically index, reflecting the pulse volume, 1.5 times the background level), peripheral resistance is reduced, on the background of what appears transient obstruction of the venous outflow. In the 3rd phase "maximum effect" eographically index rises more than 3 times compared with the background rate, peripheral resistance decreases, however, the venous drainage is not impeded. Thus, by a pronounced and mohradiant increasing improvement eographically performance in all 3 phases of the impact IFC has identified the absence of circulatory failure prostate cancer and favorable treatment that has been proven as a result of therapy.

Example 2. Patient Genus s, 30 years. Diagnosis: Chronic pathlength after suffering a chlamydial infection of the urethra. Conservative therapy without effect. Objectively: the outer opening of the urethra neperekodirovano, discharge no. The scrotal organs without pathological changes. When rectal finger study, the prostate is not enlarged, elastic consistency, symmetric, the median groove is expressed, the study of disease. When ultrasound suprapubic region: the prostate is small, rounded, not expanded. The seminal vesicle is not extended. In a laboratory study: scraping urethral chlamydia, ureaplasmas, mycoplasmas - no, the secret of the prostate up to 20 cells per field of view, lecithin grains a lot. The results of endorectal bipolar rheography of the prostate. Background rogramme pulse volume decreased peripheral vascular resistance is increased, venous outflow is obstructed. After 5 min physiotherapy FIS-impact (1-I "initial" phase of hemodynamic changes) pulse volume increases peripheral resistance decreases venous return is facilitated. After 10 min of exposure (2-I "compensatory" phase of hemodynamic changes) pulse volume, peripheral vascular resistance and coefficient of venous outflow italsofa volume increases, peripheral vascular resistance and venous return is normalized. Thus, there is a constellation eographically changes, showing 1-th degree of circulatory disorders in the prostate (pronounced improvement eographically indicators in the 1st and the 3rd phase, the deterioration in the 2nd phase), which occurs when a hidden deficiency of blood flow in the prostate gland with a large reserve capacity for its improvement. The forecast impact NIF favorable. The complex therapy with the inclusion of FSI for training reserve capacity prostatic blood flow. The result of the treatment is the cure.

Example 3. Patient, 58 years of age. Diagnosis: chronic congestive prostatitis. Benign prostatic hyperplasia 1 article. Complaints about frequent urination during the day, night pollakiuria 1 times, the weakening of the jet in the morning urination, lower abdominal pain with irradiation to the testicles, erection and orgasm of wear, decrease the amount of ejaculate. The dysrhythmia sex life. Considers himself ill for several years. Rectal examination:

Prostate moderately enlarged, dense-elastic consistency, median groove SG is, for example, sexually transmitted diseases are absent. Ultrasound prostate size 4.H.4 cm, in the center of its host adenoma size 3.5x2.9 cm from the sealed capsule. The contours of the gland fuzzy, there is a small seal in the parenchyma. Seminal vesicles expanded to 1.6 see Vienna prostatic plexus extended to 0.5, see To improve the accuracy of evaluation of circulatory disorders of the prostate and identify indications, optimization physiotherapy, patients received eographically study of the prostate by the claimed method.

Laid the patient on his side pressed against the abdomen knees and bend back. Was introduced into the rectum electrode connected cables through the switch input rheography and output apparatus for IFS therapy. Oversaw the proper placement of the electrode directly below the prostate gland after the filing of a "trial" FIS signal through the sensation in a patient characterized by irradiation of the signal at the head of the penis. Set the switch to the input of rheography, recorded rogramme and recorded the "background" indicators. Set the switch to the output device for the FIS-therapy currents of low frequency and perform the procedure IFS "sputum switch toggle on eographically channel, determined iograficheskii indicators, comparing them with the "background" values. It was proven a modest improvement eographically indicators in the 1st and more pronounced in the 3rd phase, and the deterioration in the 2nd phase, i.e. with 2 degree of impaired circulation, which occurs in severe deficiency of blood flow in the prostate. Based on this thought shows the use of the patient IFS therapy in the "noise" mode for 10 minutes each day an estimated number of 20 procedures.

Example 4. Sick Article-Ko, 45 years. Diagnosis: chronic congestive prostatovezikulit, prostatodynia, cyst of the left spermatic cord. Complaints about pain in the left inguinal region. Suffer from chronic prostatitis for several years. Objective: to palpation of the scrotum in the left spermatic cord found testopodobnaja education. When rectal finger examination: prostate medium sized, condensed, share symmetric, the median groove is expressed, the study of disease. When ultrasound suprapubic region of the prostate 3.3x3.6 cm, condensed, outline fuzzy. The seminal vesicle is not extended, but the left seminal vesicle is deformed. The testes and epididymis in normal cyst of the left Nowych grains - a little. Antarctilyne rheography prostate showed the following: the pulse volume of the prostate is decreased and peripheral resistance is increased, venous drainage is not impeded. When conducting physiotherapy samples (IFS procedure 10 Hz, 9 mV, 2 MS ) after 5 min of exposure (1-I "initial" phase changes) - pulse volume decreased peripheral resistance is increased, however, the venous drainage is not impeded. That is, in the 1st phase, there is a very modest improvement eographically indicators. After 10 min of exposure (2-I "compensatory" phase changes) pulse volume decreases peripheral resistance increases, venous return is impeded. That is the 2nd phase of deterioration eographically indicators. After 15 min of exposure pulse volume increases peripheral resistance decreases venous return is facilitated. That is, in the 3rd phase is observed again more pronounced than in the 1st phase, the improvement eographically indicators. Thus, when a moderate improvement eographically indicators in the 1st and more pronounced in the 3rd phase, and their deterioration in the 2nd phase revealed the 2nd degree of circulatory disorders, which vstrechaemosti, however, its effectiveness would be limited due to severe circulatory failure prostate cancer with limited backup capabilities to decrease it.

Example 5. Sick Shi s, 73. Diagnosis: benign prostatic hyperplasia. Condition after hyperthermic therapy. Chronic postperformance prostatitis. Sclerosis prostate cancer. Circulatory failure prostate 3rd stage. Before thermotherapy - (22.02.99. ) - implemented rheography prostate cancer, demonstrated changes in the blood flow characteristic of BPH Through the days after thermotherapy of the prostate (25.02.99.) observed a sharp change in its circulatory venous congestion and arterio-venous shunting, characteristic of acute inflammation. After 1 and 2 weeks (02.03.99. and 10.03.99.) blood flow to the prostate decreased significantly, reflecting the process of sclerosing prostate cancer. 1-2 months after the holding of thermotherapy values of arterial inflow into the prostate restored, re-appear symptoms of arterio-venous shunting, bearing, apparently, not functional (acute inflammation), and organic (SK the valuation of circulatory disorders of the prostate gland by the claimed method.

After 5, 10 and 15 min rectal exposure FIS, i.e. in "primary", "compensatory" and "phase maximum effect any positive changes in blood flow sclerotioides prostate cancer does not occur, therefore, there is a 3rd degree impaired blood flow to the prostate, put forward in the proposed method criteria, which is characteristic of irreversible stage of circulatory failure prostate cancer, and suggests practical futility of vascular therapy identified local changes.

The advantage of the proposed method compared to known is that the reveal back the possibility of changes in blood flow in the prostate by putting a strain on the vascular bed of the prostate using session NIF.

The technical result of the claimed method is to increase the accuracy of evaluation by selection stages of circulatory disorders in the prostate by determining the phase response of the vascular bed and the characteristic constellation of changes eographically indicators in each of the phases.

The way to evaluate the circulation of the prostate by endorectal the introduction of the bipolar electrode, registration rogramme, raspisyvayutsya load test on the same electrode session fluctuating pulse stimulation register rogramme during and after the intervention, there are the phase changes of the local circulation, "primary", "compensatory", "maximum effect" and "recession" and when expressed and mohradiant increasing improvement eographically performance in all 3 phases of the impact of IFC determine the absence of circulatory failure prostate cancer, when expressed improve eographically indicators 1 and 3 phase, their deterioration in phase 2 define 1 degree of circulatory disorders - the hidden deficiency of blood flow to the prostate; when a moderate improvement eographically indicators 1 and more pronounced in 3 phase and their deterioration in the 2 phase - 2 the degree of circulatory disorders - severe deficiency of blood flow to the prostate with a deterioration eographically performance in all 3 phases - 3 the degree of circulatory disorders - irreversible failure of blood flow in the prostate.

 

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