Method for the diagnosis of adhesive disease of the peritoneum
The invention relates to medicine, namely to surgery. The method involves performing infrared spectroscopy of blood plasma, indicators transmittance of infrared radiation, the calculation of the average transmittance. When the value of the average transmittance of less 79,5 in the range 3085-2832 cm-1and more than 40.5 and 71,6 ranges 1710-1610 cm-1and 143 0-1210 cm-1accordingly diagnose adhesive disease of the peritoneum. The normal value of the average transmittance is more in the range of 79.5 3085-2832 cm-1and less 40.5 and 71,6 ranges 1710-1610 cm-1and 1430-1210 cm-1respectively. The method can improve the accuracy of early diagnosis of adhesive disease of the peritoneum.
The invention relates to medicine, namely to surgery.
Diagnosis and treatment of patients with early postoperative adhesive intestinal obstruction is one of the most difficult problems in abdominal surgery.
About adhesive disease annually are treated 1% of all operated patients. These complications occur in 20-50% of patients, and each year the number of such patients uvelichivaya adhesive disease of the peritoneum (PRSP) reaches 30-60%.
Mortality in acute adhesive intestinal obstruction in children remains quite high - 3-10%, and at an early adhesive obstruction is increased to 17-20%.
Currently, the methods for diagnosing SBB (complaints, data of anamnesis, examination, x-ray, ultrasound, laboratory, immunological) insufficiently informative, and sometimes time-consuming. Therefore, the development of objective methods of early diagnostics PRSP has actual value.
A prototype of the proposed method, the authors propose a laboratory method of diagnosis of this disease in the index definition activation rasplastyvanija monocytes (IARM) in blood in the presence of the end product of the breakdown of collagen L-hydroxyproline (L-GP), accounting for 70% of all isomeric total hydroxyproline. The clinical value IARM from 4.5 relative values and above - diagnose the PRSP, with more than 5.5 - common adhesions. (Potovyh N. N., Arkhipov, S. A., Panasenkov N. Y., Shorin, N. Immunological and biochemical aspects of the formation of adhesive disease of the peritoneum in children// Children's surgery. - 2002, No. 3. - S. 29-33.).
In the opinion of the authors, this method has drawbacks - the percentage of the forecast PRSP small (Matematicheskoe disease of the peritoneum in patients on the study of blood plasma using infrared spectroscopy. Infrared spectroscopy was carried out using an infrared analyzer “ICARUS” on 9 channels for 1 min, after 1 sec. In the investigated material was used, the blood plasma of a patient in a volume of 5 ml. currently in the etiology of adhesive disease of the peritoneum of Prime importance given to various pathogens as microbial and viral origin, and in the pathogenesis of chronic inflammation of the peritoneum with the development of autoimmune processes in the body. We examined two groups of children who underwent surgery on the organs of abdominal cavity, one control group of 30 people - without adhesions in the abdominal cavity, the other in the amount of 30 people - with adhesive disease of the peritoneum.
The most informative was 2,4 and 5 channels corresponding to the ranges 3085-2832 cm-1, 1710-1610 cm-1and 1430-1210 cm-1.
Using infrared spectroscopy determined the transmittance of blood plasma, calculated the average transmittance of infrared radiation and found that when the average value of the transmittance on the 2nd channel less 79,5 in the range 3085-2832 cm-1on the 4th channel is more in the range of 40.5 1710-1610 cm-1and 5-th channel more 71,6 in the range 1430-1210 cm-1's the 2nd channel more in the range of 79.5 3085-2832 cm-1on the 4th channel is less 40,5 range 1710-1610 cm-1and 5-th channel is less 71,6 in the range 1430-1210 cm-1.
Based on these data the authors concluded that adhesive disease of the peritoneum in patients correspond to the average transmittance of infrared radiation less 79,5 in the range 3085-2832 cm-1and more than 40.5 and 71,6 ranges 1710-1610 cm-1and 1430 - 1210 cm-1accordingly, that the authors used for the objective diagnosis of adhesive disease of the peritoneum in children.
In addition, the research method is fast and can be performed on an outpatient basis, speeding up the process of examination of the patient.
The proposed method allows the diagnostics of adhesive disease of the peritoneum in children and adults.
Patient C., survey map No. 2, preliminary diagnosis - adhesive disease of the abdominal cavity. Admitted with complaints on a periodic, paroxysmal abdominal pain associated with physical activity and errors of diety. From the anamnesis: was operated 4 months ago about destructive appendicitis performed appendectomy from oblique access. During examination - palpation of the abdomen Besbre the new loop of intestine to postoperative scar. According to history, clinical and radiological methods of examination and ultrasound was diagnosed with adhesive disease of the abdominal cavity. For conducting infrared spectroscopy taken 5 ml of blood. The study by using the apparatus “ICARUS”. In the range 3085-2832 cm-1the average transmittance was 63,0, in the range 1710-1610 cm-1- 67,6 and in the range of 143 0-1210 cm-1- 76,1. Data infrared spectroscopy of blood confirmed the diagnosis of adhesive disease of the peritoneum. Performed laparoscopy of the abdominal cavity, diagnosed viscerovisceral and visceromegaly adhesions, which deformed the terminal ileum, held adhesions.
Method for the diagnosis of adhesive disease of the peritoneum, including the study of blood, characterized in that the hold-infrared spectroscopy of blood plasma, identify indicators transmittance of infrared radiation, calculate the average transmittance and the average transmittance of less 79,5 in the range 3085-2832 cm-1and more than 40.5 and 71,6 ranges 1710-1610 cm-1and 1430-1210 cm-1accordingly diagnose adhesive disease of the peritoneum during normal value of the average transmittance over 79,5 the
SUBSTANCE: invention relates to laboratory methods for blood analysis. Plasma is dropped in copper sulfate solution with density 1.023 g/cm3, not above, and time for drop falling on bottom of graduated cylinder with column height 243 mm is measured. The blood plasma density value is calculated by the formula:
wherein is the unknown blood plasma density (g/cm3); is copper sulfate solution density measured by areometer (g/cm3); t is average falling time of plasma drop in the copper sulfate solution (as seconds); 0.260130126 and 0.00290695 are correction coefficients. Temperature of plasma and copper sulfate solution is 20oC. Method is simple and suitable and allows carrying out analysis of small volumes of blood plasma and to reduce analysis time.
EFFECT: improved assay method.