Method for stimulating knee joint lymph circulation in patients suffering from diabetic foot syndrome

FIELD: medicine.

SUBSTANCE: method involves administering triple injections of medicament mixture composed of Lidase 32 units, Anicaine 4ml, Dexamethazon 4 mg, Alflutop 1 ml, into Hoff fat pad.

EFFECT: reduced pain and knee joint edema manifestations; increased joint range of motions.

5 tbl

 

The invention relates to medicine, namely to surgery. The invention can be used in the treatment of patients with diabetic foot syndrome.

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

The method consists in the introduction of complex mixture drugs in fat body Hoffa. The medicinal composition of the mixture: lydasum 32 UNITS, Anikin 4 ml, dexamethasone 4 mg, alflutop 1 ml Ratio manipulation: three times with an interval of 48 hours.

The result is to improve lymph flow of the knee joint - the increased speed and volume of lymphatic drainage, improve blood flow - increase the speed and volume of the venous outflow, which clinically manifests itself in the reduction of swelling of the knee joint, reducing pain, increasing range of motion. Contraindication to perform injections are: intolerance of the drug included in the drug mixture, local purulent processes in the implementation of manipulation.

To assess the effectiveness of the stimulation of the lymph flow of the knee joint in patients with diabetic foot syndrome was the comparative analysis of the medical records of 34 patients. Evaluation of the effectiveness of therapy was carried out by comparative analysis reolymphovasography and metasomatically parameters. In the result, it was proved that the use of injections to stimulate lymph flow (LIS) in the fat body Hoffa in the treatment of patients with diabetic foot syndrome on the background of standard therapy, leads to an increase in speed and volume parameters of the lymphatic and venous outflow, increase the size of the active component of the resistivity of the soft tissues in the knee joint. When conducting the stimulation of the lymph flow at the level of the tibia revealed the increase in the rate of regional lymph 1.8 times, increase lymphatic drainage 1.6 times increase in the rate of venous outflow 1.5 times increase in the volume of the venous outflow 1.3 times. At the level of the knee joint was marked increase in the rate of lymph outflow 2.6 times increase in the volume of regional lymph 2.3 times increase in the rate of venous outflow 2.1 times increase in the volume of peripheral venous outflow 1.8 times. At the hip level was determined increase in the rate of regional lymph 2.0 times, the increase of regional lymph 1.8 times increase in speed peripheral venous outflow 1.7 times increase in the volume of peripheral venous outflow 1.5 times. At the level of the ankle joint increase of impedancometry amounted to 1.5 times, at the level of the middle third of the tibia 1.8 times the level of the knee joint, in the projection nadkarni bags, 2.4 times. Comparative data are given in tables. In the control group patients received conventional treatment (OL) of the diabetic foot syndrome, which included glucose-lowering drugs to achieve optimal blood glucose levels, anticoagulants, drugs improving metabolism in the ischemic area, the drug alpha-lipoic acid, b vitamins, antibiotics, local sorption treatment, unloading of the foot.

Table 1

Dynamics of speed lymphatic drainage in patients with diabetic foot syndrome, Ω/s, M±m
The level of researchThe study periodOL (n=18)OL+LIS (n=16)
TibiaBefore the treatment0,21±0,020,21±0,02
After the treatment0,25±0,030,38±0,04*
The kneeBefore the treatment0,21±0,020,22±0,03
After the treatment 0,23±0,020,57±0,05*
HipBefore the treatment0,22±0,030,21±0,02
After treatment;0,26±0,030,42±0,04*
Note: * - differences in performance before and after treatment reliable, p<0,05
Table 2

Dynamics of volume of lymphatic drainage in patients with diabetic foot syndrome, Ω, M±m
The level of researchThe study periodOL (n=18)OL+LIS (n=16)
TibiaBefore the treatment0,22±0,020,23±0,02
After the treatment0,26±0,030,37±0,04*
The kneeBefore the treatment0,21±0,020,19±0,02
After the treatment 0,24±0,020,44±0,05*
HipBefore the treatment0,22±0,020,21±0,03
After the treatment0,26±0,030,38±0,04*
Note: * - differences in performance before and after treatment reliable, p <0,05
Table 3

The dynamics of the rate of venous outflow in patients with diabetic foot syndrome, Ω/s, M±m
The level of researchThe study periodOL (n=18)OL+LIS (n=16)
TibiaBefore the treatment0,27±0,020,26±0,03
After the treatment0,30±0,030,39±0,04*
The kneeBefore the treatment0,31±0,030,30±0,03
After the treatment0,35±0,040,63±0,05*
HipBefore the treatment0,29±0,030,27±0,03
After the treatment0,34±0,030,46±0,04*
Note: * - differences in performance before and after treatment reliable, p<0,05
Table 4

Dynamics of volumes of venous outflow in patients with diabetic foot syndrome, Ω, M±m
The level of researchThe study periodOL (n=18)OL+LIS (n=16)
TibiaBefore the treatment0,37±0,050,35±0,05
After the treatment0,41±0,040,46±0,04*
The kneeBefore the treatment0,35±0,050,33±0,05
After the treatment0,37±0,040,60±0,05*
HipBefore the treatment0,35±0,050,34±0,05
After the treatment0,40±0,040,51±0,04*
Note: * - differences in performance before and after treatment reliable, p<0,05
Table 5

Dynamics of impedancometry in patients with diabetic foot syndrome, Ω, M±m
The level of researchThe study periodOL (n=18)OL+LIS (n=16)
AnkleBefore the treatment36,74±1,4135,83±1,37
After the treatment38,67±1,4453,74±2,34*
The middle third of tibiaBefore the treatment46,75±1,7245,84±1,62
After the treatment49,54±1,9182,51±3,57*
The kneeBefore the treatment48,06±1,8347,72±1,68
After the treatment50,47±1,98114,53±4,05*
Note: * - differences in performance before and after treatment reliable, p<0,05

The addition of standard therapy of diabetic foot syndrome the use of injections to stimulate the lymph flow of the knee joint leads to a pronounced relief available in this category of patients, severe knee pain, increase range of motion, compared with conventional treatment, by improving lymphovenous relationships.

Clinical example.

Patient K., 62 years. Diagnosis: diabetic foot Syndrome, mixed forms. Ill with diabetes for 15 years, said the appearance of puffiness, pain in the knee joints 1.5 years ago, 8 months ago noted a decrease in range of motion of the knee. Examination - clinical, realestaterama lower extremities, impedancometry lower extremities. Treatment - conventional therapy. Conducted seance injections to stimulate the lymph flow of the knee joint, consisting of lidz (32 UNITS), Anikina (4 ml), dexamethasone (4 mg), alflutop (1 ml), with an interval of 48 hours in the fat body Hoffa both the knee joint. After a course of treatment there has been a decrease swelling in the area of both knee joints, decrease pain, increase range of motion. According to realestateradiousa.com survey indicated the following dynamics: the rate of lymph outflow at the level of the tibia to the treatment of 0.20 Ohms/sec, after a course of injections to 0.39 Ohm/sec, the speed of lymph outflow at the level of the knee joint before treatment - 0,23 Ohm/sec, the rate of injection of 0.56 Ohm/sec, the speed of lymph outflow at the level of the hips to the treatment of 0.21 Ω/s, after a course of injections - 0.43 Ohm/sec, the volume of lymph outflow at the level of the tibia before treatment to 0.21 Ohms, after a course of injections is 0.38 Ohms, the volume of lymph outflow at the level of the knee joint before treatment to 0.18 Ohm, after a course of injections at 0.42 Ohms, the volume of lymph outflow at the hip level before treatment - 0.22 Ohm, after a course of injections - 0.40 Ω, the rate of venous outflow at the level of the tibia before treatment - 0.25 Ohm/sec, after a course of injections at 0.42 Ohms/sec, the speed of the venous outflow at the level of the knee joint before treatment - 0,33 Ohm/sec, after injections - 0.65 Ohm/sec, the speed of the venous outflow at the hip level before treatment to 0.39 Ohm/sec, after injections - 0.48 Ohm/sec, the volume of venous outflow is at the level of the tibia before treatment - of 0.36 Ohm, after a course of injections - 0,49 Ohms, the volume of the venous outflow at the level of the knee joint before treatment - 0,31 Ohms, after a course of injections for 0.62 Ohms, the volume of the venous outflow at the hip level before treatment - 0.35 Ohm, after a course of injections - 0,53 Ohms. According to the results of impedance metric survey indicated the following dynamics: the quantity of the active component of the resistivity of the soft tissues at the level of the ankle joint before treatment - 35,23 Ohms, after a course of injections is to 54.19 Ohms, the value of the active component of the resistivity of the soft tissues at the level of the middle third of the leg before treatment - 44,87 Ohms, after a course of injections - 78,41 Ohms, the value of the active component of the resistivity of the soft tissues at the level of the knee joint before treatment - 48,06 Ohms, after a course of injections - 95,83 Ohms.

Application of the presented method with diabetic foot syndrome leads to a pronounced decrease swelling in the knee joint, reduce pain, increase range of motion compared with conventional treatment, as evidenced by realestateplays.com and impedance metric data.

How infotemplate lymph flow of the knee joint in patients with diabetic foot syndrome on the background of standard therapy, characterized in that the fat body Hoffa administering a mixture comprising lidz 32 UNITS, Anikina ml, dexamethasone 4 mg, alflutop 1 ml, the procedure is performed three times with an interval of 48 hours



 

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