The way regional infotemplate and analgesia with lymphedema of the lower extremities

 

The invention relates to medicine, surgery and can be used in the treatment of lymphedema of the lower extremities, accompanied by the development of lymphovenous insufficiency, edema, chronic pain syndrome. Enter in column megastate ligaments of the spine at the level of L1-L5 complex drug mixture consisting of 32 UNITS lidz, 4 mg dexamethasone, 100 mg of lidocaine, 2 ml at controlling pain, diluted to 6 ml of 40% glucose solution, the procedure is repeated 5 times with an interval of 48 hours the Invention contributes to a more pronounced reduction of lymph edema by improving lymphovenous relationships in the region of the lower extremities. table 4.

The invention relates to medicine, in particular to surgery. Can be applied in the treatment of lymphedema of the lower extremities, accompanied by the development of lymphovenous insufficiency, edema, chronic pain syndrome.

This method is not unique, is ease of implementation, availability, efficiency and cheapness.

The method consists in the introduction into the thickness megastate ligaments of the spine at the level of L1-L5 complex drug mixtures, consisting of 32 UNITS lidz, 4 mg dexamethasone, 100 mg lidocaine> The technical result consists in prolonged anesthesia due to the action of local anesthetic and lymphotropic the introduction of the Central analgesic, improving lymph flow - the increased speed and volume of peripheral lymph circulation, improving blood flow - increasing volume of peripheral venous blood, which clinically is manifested in the reduction of swelling. Contraindication to perform injections are: hypersensitivity to any drug included in the drug mixture, local purulent processes in the area of the injection.

To assess the effectiveness egotistic lymphotropic infostealers injection was carried out comparative analysis of medical records of 61 patients with lymphedema of the lower extremities (stages 1-4). Evaluation of the effectiveness of therapy was carried out by comparative analysis estimates the level of pain on a visual analogue scale, anthropometric research, realestaterama (RLG). In the result, it was proved that the use of egotistic lymphotropic infostealers injection in the treatment of patients with lymphedema of the lower extremities allows a 1.6-fold increase in volumetric and linear velocity of regional lymph flow, improve peripheral krooo what of the pain syndrome from 3.8 to 0.3 points on the visual analogue scale (VAS).

Listed below are the comparative evaluation of the above indicators in a numeric expression. The control group was patients with the same pathology, the same age group and same severity of the disease who received only traditional conservative therapy. In the tables group designated as "K", the number of observations is 30 patients. The main group, denoted in the tables as "On" (number of observations - 31 patients), consisting of patients who, in addition to traditional treatment were assigned megastate lymphotropic infostealers injection.

Table. 1-4, see end of text.

The use of indirect lymphotropic therapy in complex treatment of patients with lymphedema leads to a more pronounced reduction of lymph edema compared with traditional methods of treatment by improving lymphovenous relationships in the region of the lower extremities.

Clinical example.

Patient W., 64 years old, was admitted 30.03.98, with complaints of swelling of the left lower extremity; also concerned about the feeling of heavy, dragging pain in the limbs in the evening hours. From the anamnesis: edema developed 3 years ago after acute thrombophlebitis of deep veins of left lower leg. Edema platytera. Previously, the patient underwent 2 course complex conservative therapy in the clinic NIIK and E; the last hospitalization in September 1997, the Clinical diagnosis of secondary lymphedema of the left lower extremity 3 stages. Data anthropometry at admission (left/right, see ): stop - 36/32; the lower third of the tibia - 35/33; middle third of the tibia - 44/40, the upper third of the tibia - 49/47. At admission the patient was assessed by the intensity of pain on YOUR in 4.2. According to RLG conducted 31.03.98 year, there were pronounced differences in lymphatic and venous outflow in the left limb in comparison with the healthy limb: the amount of peripheral lymph (left/right) - 0,13/0,26 Ohm; velocity of circulation of lymph - 0,24/0.54 Ω/s; volume of blood in the peripheral veins - 0,11/0,19 Ohms; the speed of the flow of blood in the peripheral veins of 0.47/0.50 in Ohm/sec According to imaging studies from 1.02.98, noted a pronounced asymmetry in the distal lower extremities; the difference of skin temperature in the symmetric sites stop was 1.70 castle, on the level of the lower third of the leg - 2.68 castle, the middle third of the leg - 2,15 hail, the upper third of the leg - 1.11 degrees. The patient was prescribed course of complex conservative therapy (elastic bandaging, e is N 10, irradiation limbs helium-neon laser N 10) in combination with mistissini lymphotropic injections, which were performed three times. The composition of the injection consisted of 32 UNITS lidz, 4 mg dexamethasone, 100 mg of lidocaine, 2 ml at controlling pain, diluted to 6 ml of 40% glucose. Before performing the first injection, the patient rated the pain on YOUR 3.6 points, 1 hour after her run - in 0.9 point; 09.04.98, - 2.1 points. The second injection is made 10.04.98, the level of pain was assessed patient before execution of 1.7 points, after 1 hour - 0.6 points. Third, held 13.04.98, allowed us to reduce the intensity of pain from 1.3 to 0.7 points. During the course of treatment achieved a distinct positive clinical dynamics - the patient said reducing unpleasant subjective sensations (pain level at discharge was estimated it at 0.7 point), edema of the left lower extremity decreased, swelling became more soft. According to the anthropometry reduced the circumference of the limb at the level of the foot to 3.0 cm at the level of the lower third of the tibia 4.0 cm, middle third of the leg of 2.5 cm, the upper third of 2.0 see According to RLUG from 22.04.98, there is an increase in parameters of peripheral venous and lymphatic drainage in the affected limb: is anyone venous blood flow increased to 0.19 Ohms, the speed of the flow of blood in the peripheral veins is to 0.50 Ohm/C. the Patient was discharged for outpatient phase of aftercare, 22.04.98

Claims

The way regional infotemplate and analgesia with lymphedema of the lower extremities, characterized in that the thickness megastate ligaments of the spine at the level of L1-L5 impose comprehensive medicinal mixture consisting of 32 UNITS lidz, 4 mg dexamethasone, 100 mg of lidocaine, 2 ml at controlling pain, diluted to 6 ml of 40% glucose solution, the procedure is repeated 5 times with an interval of 48 hours

 

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