The method of determining the effectiveness of treatment of pain syndrome in patients after combined treatment of breast cancer

 

The invention relates to medicine, namely to Oncology, and can be used in neurology, traumatology, surgery, forensic medical examination to determine pain syndrome. The method includes determining a maximum threshold of pain sensitivity through exposure blunt needle stiletto regarding him with a fixed graduated scale, which is fixed indicators. The impact of exercise on the symmetric point zones of the branches of the brachial plexus in healthy and diseased parts of the body. To reduce differentials between healthy and diseased parts of the body are judged on the effectiveness of treatment. The method allows to increase the accuracy and objectivity of determining the effectiveness of the treatment of pain. 1 Il., 4 table.

The invention relates to medicine, namely to Oncology, and can be used in neurology, traumatology, surgery, forensic and sports medicine to determine pain syndrome.

In patients with breast cancer during surgery and subsequent radiation damage all elements of the peripheral nervous system: placage pain syndrome, difficult to treat. There is a method of definition of pain by the visual analogue scale (VAS) or verbal scale assessments (SVA) (N. A. Losev. Modern methods of assessment of cancer patients with chronic pain. Paliativa medicine and rehabilitation, No. 1, 1998, 28-32). However, the known method shows the subjective attitude of a person to pain, reflecting the total complex of his suffering and cannot assess the effectiveness of the treatment.

The closest achieved a positive result is a method of determining pain sensitivity using a sharp needle (Century, the Archangel. A guide to practical training in neuropathology. - M.: Medicine, 1971, S. 14-19). However, the known method only determines the subjective feeling of pain.

The authors proposed a simple and affordable way with high accuracy objective to determine the effectiveness of treatment and adjust it over time. To date there is no objective way to accurately determine the change in local pain sensitivity and to judge the effectiveness of the treatment over time.

A positive result saleemul the presumed fact, what does the impact on the symmetric parts of healthy and diseased parts of the body subject with blunt end and to reduce the difference of the indices determined on a graduated scale, judged on the effectiveness of treatment.

The method is as follows. Patients with chronic pain syndrome after combined treatment of breast cancer to determine the maximum threshold of pain sensitivity on the symmetric parts of healthy and diseased parts of the body, identifying the zone change pain sensitivity and the degree of change in pain sensitivity, so that in the course of treatment to determine its effectiveness. The method consists in pressing on the skin in symmetrical areas of healthy and diseased parts of the body fixture (drawing). The device consists of a spring-loaded stiletto 1 3 mm in diameter with blunt (not damaging the skin) bullet-shaped end 2 and fixed with respect to the stiletto 1 graduated scale 3. Each division on the scale 3 corresponds to 50 grams compressed stiletto spring. The measure of the displacement of the stylet is fixed at the limit of patience of the patient. The difference in performance when pressed on symmetrical parts healthy and diseased parts of the body ukazi sensitivity. Reducing differentials or alignment indicators on healthy and diseased parts of the body, as well as reducing the damage zone indicates the effectiveness of the treatment.

Clinical examples.

Example 1. Patient K., 1948 birth, the mammary gland T3N0M0The state after the combined treatment in 1999 brachioplasty left. Chronic pain in the past 2 years. Lymphostasis left upper extremity 1 tbsp. Received complex treatment in the form of magnetic therapy, acupuncture, pneumomassage, drug therapy simultaneously with a duration of 15 sessions. The indicators of maximum pain threshold (the point selected freely) Fig.1, scale 1.

The approximation of maximum pain threshold with the patient body part to the indicators of a healthy testifies to the effectiveness of treatment.

Example 2. Patient D. B. 1951. Diagnosis: cancer of the left breast, T3N0M0. Received combined treatment (surgery and radiation therapy) 2.5 years ago. 8 months ago I had a strong pain syndrome on the background of significant fibrosis what about the pain threshold showed: (points selected freely, their number is not limited) Fig. 2, 3, 4.

Before treatment (table. 2)

After 8 sessions: the pain has not decreased and the difference of the indices has not changed (table. 3).

Received treatment (magnetic therapy, acupuncture, troksevazina ointment and pills) was replaced by a magneto-therapy, iontophoresis with Dimexidum, ultrasound with Hidrocortizonum, Fraxiparine, sedative therapy. Held 10 sessions, after which the pain has decreased significantly. Research the maximum pain threshold showed that the difference in performance between healthy and diseased parts of the body decreased (table. 4).

The approximation of maximum pain threshold with the patient side to the indicators of a healthy hand testifies to the effectiveness of the treatment.

A total of 86 studies.

The claimed method is simple, affordable and has a high accuracy of determining the effectiveness of treating patients with lesions of the peripheral nervous system and chronic pain syndrome.

In addition Tom;">Claims

The method of determining the effectiveness of treatment of pain syndrome in patients after combined treatment of breast cancer, comprising determining the maximum pain threshold using impact blunt needle stiletto regarding him with a fixed graduated scale, which record the performance, and the impact of exercise on the symmetric point zones of the branches of the brachial plexus in healthy and diseased parts of the body and to reduce differentials between healthy and diseased parts of the body are judged on the effectiveness of treatment.



 

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