Ultrasonic method for examining cicatricial anterior abdominal wall muscle sclerosis

FIELD: medicine.

SUBSTANCE: method involves determining transformed abdominal wall region by means of ultrasound. The sclerosis focus being detected, rheopolyglukine solution is introduced into space between direct muscle belly and its posterior sheath plate before applying repeated ultrasonic examination.

EFFECT: high accuracy in measuring area occupied by structural elements and determining transformed tissue region boundary; objective muscle fiber atrophy and cicatricial sclerosis development degree estimation.

2 dwg

 

The invention relates to medicine, namely to methods for diagnosing lesions of the anterior abdominal wall.

Famous visual ways of defining the boundaries of sclerosis of the anterior abdominal wall after operations on the formed scar, the presence of wound infection, eventualy, postoperative ventral hernia (Taskin CD, Zebrowski CC abdominal Hernia. - M.: Medicine, 1983. - 238 S.). Because the definition of level sclerotic processes is of great clinical importance for plastic surgery, the visual method has several disadvantages:

1) the absence of objective (quantitative) criteria for assessing the state of the modified area of the anterior abdominal wall;

2) the difficulty of determining the functional state of the modified area of the anterior abdominal wall during the operation.

Closest to the technical nature of the proposed method ultrasonic diagnostic stromal-muscle relationships in the anterior abdominal wall (Nshombo et al. Atlas of ultrasound structure of the connective tissue of the skeleton of the anterior abdominal wall. -Krasnoyarsk, 2004. - 148 C.), however, has several disadvantages:

1) it is impossible to clearly differentiate muscle-stromal ratio in the zone of sclerosis after laparotomy;

2) difficult quantification of muscle and connective tissue relationship changed in the Oh of the anterior abdominal wall;

3) it is impossible to determine the boundaries sclerosis.

Object of the invention is the objectivity and accuracy sclerotic-modified area of the anterior abdominal wall with the lowest concentration of muscle tissue and a high content of connective tissue.

The task reach due to the fact that after the detection of the hearth sclerosis before re-examination with ultrasound enter solution reopoligliukina in the space between the belly of the rectus abdominis muscle and the posterior plate of her vagina and determine the severity of sclerosis. The pretreatment solution reopoligliukina can improve the differentiation of muscle and connective tissue elements consistently in all upper layers of the anterior abdominal wall and to clearly define the boundaries sclerosis.

The method is as follows:

- in experimental animal (mongrel dogs weighing from 3 to 10 kg) is carried ultrasound of the anterior abdominal wall sensor from 9.0 to 11.5 MHz apparatus Logiq-700" (figure 1), which shows a sonogram of the anterior abdominal wall (multifrequency linear probe 9,0 MHz, the device "Loc 700"): 1 - skin; 2 - subcutaneous tissue; 3 - the front plate of the vagina of the rectus abdominis muscle; 4 - the rectus abdominis muscle; 5 - rear plate of the vagina of the rectus abdominis muscle;

under ultrasonic who control the injection needle carry out puncture formations of the anterior abdominal wall (the first obstacle the skin, the first failure of subcutaneous fatty tissue, the second obstacle - the front plate of the vagina of the rectus abdominis muscle, the second fail - rectus, to the third obstacle, the rear plate of the vagina of the rectus abdominis muscle), attach the syringe and injected the solution reopoligliukina in the space between the rear plate of the vagina straight muscles and abdomen.

- repeated ultrasound examination of the anterior abdominal wall, put the solution reopoligliukina allows you to clearly differentiate between muscle and connective tissue elements of direct muscles, to define the boundaries sclerosis (figure 2), which shows a sonogram of the anterior abdominal wall (multifrequency linear probe 9,0 MHz, the device "Loc 700"): 1 - skin; 2 - subcutaneous tissue; 3 - the front plate of the vagina of the rectus abdominis muscle; 4 - the rectus abdominis muscle; 5 - rear plate of the vagina of the rectus abdominis muscle; RPG-reopoglukin.

An example of a specific application: In experimental animal No. 5 under endotracheal anesthesia after shave hair carried ultrasound of the anterior abdominal wall sensor from 9.0 to 11.5 MHz apparatus Logiq-700". Define the boundaries of the straight muscles and her records. Under control of the ultrasonic device at the boundary between the straight arm, and the rear plate of her vagina enter solution reopoligliukina with other than we the C and aponeurosis of the echo.

The application of this method was carried out on 5 experimental animals. Complications in early and late postoperative periods were observed.

The proposed method allows to:

to quantify the area occupied by structural elements;

- objectively, accurately judge the degree of atrophy of muscle fibers and proliferation of connective tissue elements endo-, peri - and epimysial direct muscle;

- to quantify the degree of scar sclerosis in the anterior abdominal wall.

- to determine the exact boundaries of the affected tissues.

The way ultrasound scar sclerosis muscles of the anterior abdominal wall in experimental animals, including identification of the modified area of the anterior abdominal wall using ultrasound, characterized in that after detection of the hearth sclerosis before re-examination with ultrasound enter solution reopoligliukina in the space between the abdomen direct muscles and the back plate of her vagina.



 

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