Prevention method for infectious complications after cervix uteri cerclage surgery during pregnancy
SUBSTANCE: before and after cervix uteri stiching operating margins are treated with instilagel. Since the second day after operation vagina and vaginal part of cervix uteri are lavaged with epigen twice a day in day and night clinic - 3-4 days. Further treatment with epigen is implemented ambulantly twice a day during 5 more days.
EFFECT: prevention of surgical infection aganst background of progressive pregnancy.
The invention relates to medicine, namely to obstetrics.
The level of technology.
Isthmic-cervical insufficiency (ICN) is a common pathology of the cervix, which is the cause of spontaneous abortions in the second trimester of pregnancy and premature birth; occurs as a result of structural and functional changes isthmic Department of the uterus (2.5), and requires, as a rule, surgical correction during pregnancy.
Similar to this method may be the processing methods of the vagina and the vaginal part of the cervix in pre - and postoperative period disinfectant (furacin), chlorhexidine, yodopiron, hydrogen peroxide) and appliques on the vaginal part of the cervix ointments, promoting regeneration and has anti-inflammatory properties (calendula ointment, levomicol etc.) (6, 7).
The prototype of this method is systemic antibacterial therapy in pre - and postoperative period (1, 8), providing, however, adverse effects on the fetus and lead to the eventual formation of antibiotic-resistant microorganisms.
The essence of the invention. The purpose of the invention is to develop a method of prevention of infectious complications after surgery cerclage cervix with isthmic-cervical enough the tee in the near and long-term postoperative period.
The method is as follows.
stage 1: after appropriate treatment of external genital organs in aseptic conditions for 10 minutes before surgery cervix naked in mirrors, vaginal part of the cervix and the vaginal vaults dry sterile cotton swab, and then make processing of the vaginal part of the cervix, anterior, lateral and posterior vaginal fornix by INSTILLAGEL (farcot-Pharma, Germany), containing (1 g) of lidocaine hydrochloride monohydrate (20 mg), chlorhexidine digluconate 500 mcg, methyl-4-hydroxybenzoate 600 mcg, propyl-4-hydroxybenzoate 250 mcg (4).
After this mirror is removed.
After 10 minutes (exposure time instillagel) under intravenous anesthesia again introduce vaginal mirrors, neck lock pliers, Muso and produce operation cerclage of the cervix according to the modified method of MacDonald with fixation for the Sacro-uterine ligaments Mylar thread or mersilene tape (1).
After blending in a circular seam and tighten the ligature until full closure of the inner throat locking tongs remove, vaginal part of the cervix and the vaginal vaults dry sterile cotton swab and produce re-processing INSTILLAGEL, then the woman on the 1 day prescribe bed rest with holding tokoliticheskoe therapy (intravenous drip introduction what their solution ginipral or magnesium sulfate).
stage 2: one day the cervix is inspected in the mirrors, the vagina and the vaginal part of the cervix dry with a cotton swab and produce irrigation of the vagina and the vaginal part of the cervix EPIGENOME. Processing the epigenome repeat in the hospital twice a day for 3-4 days (in the evening, the patient performs the instillation by yourself under the supervision of medical staff), after which she was discharged home, where she continues processing the epigenome 2 times a day for 5 days.
The drug "Epigenome-sex" (Cheminova Internacional S.A., Spain) is available in spray form, the active substance is activated glycyrrhizin acid that has anti-inflammatory, antiviral, regenerating, anti-itching and immunostimulatory effects (3).
IL No. 769
Kozlovskaya NB, powerseraya woman 35 years of age with recurrent pregnancy loss.
This fifth pregnancy, had the second child. History of rapid and premature births in the period of 33 weeks. girl weight 2050,0 (growing and developing normally), honey. abortion without complications and two regressing the gestation period of 7-8 weeks. and in 14 weeks. respectively. Gynecological anamnesis burdened hemorrhagic form of apoplexy left ovary, about which were crevoshay, suturing of the ovary.
For d is authorized pregnancy was complicated by development of ICN (by ultrasound internal orifice of 5 mm, the cervical canal 24 mm) on the background of traumatic deformity of the cervix. In clinical and laboratory examination revealed a ureaplasmosis (by polymerase chain reaction (PCR) in 10 weeks), colpitis (the analysis of a smear on flora: the urethra is the leukocytes 30-40, cervix - leukocytes 80-100 PSR., flora rich rod), the sowing of the cervical canal Candida 105, were symptomatic therapy. In the period of 15 weeks gestation superimposed circular Mylar seam on the cervix with fixation for the Sacro-uterine ligaments. Before surgery and immediately after surgery has been the treatment of cervical cancer "Instillagel", in the postoperative period was made irrigation seam drug "Epigenome sex" 3 days in the hospital, 5 days on an outpatient basis.
The suture is removed in pregnancy 37 weeks (the analysis of a smear on flora: the urethra leukocytes 20, cervix 50 in PSR., flora rod reasonable, the planting of the cervical canal - Lactobacter 105). Woman yourself odoratissimus 38 weeks of live full-term boy weighing 3800,0 length of 55 cm with a score on the Apgar 7/8 points. Discharged home on the 4th day.
IL No. 664
Fedotov Anna Vladimirovna, powerseraya 33 years. Somatic diseases: chronic pyelonephritis, myopia II Art.
From the third pregnancy had II childbirth, history 1 mini-abortion, 1 CROC who's birth (boy weighing 3460,0 at birth, healthy).
This pregnancy occurred spontaneously, there were multiple pregnancy: monochorionic limniotisa twins. In the period of 24 weeks for admission in Institute of MME was identified traumatic deformity of the cervix, ICN (by ultrasound internal Zev 5.5 mm; the cervical canal 26 mm), which required, taking into account multiple pregnancy, conducting cerclage cervix. Before cerclage conducted clinical laboratory tests: PCR urogenital infections not detected in the analysis of a smear on flora: the urethra is the leukocytes to 10, the cervix up to 30 in PSR., flora rod; KPI 7%; in the sowing of the cervical canal Candida 103.
In the period of 24-25 weeks. held cerclage cervical fixation for the Sacro-uterine ligaments. Before surgery and immediately after surgery has been the treatment of cervical cancer "Instillagel", in the postoperative period was made irrigation seam drug "Epigenome sex" 3 days in the hospital, 5 days on an outpatient basis.
In pregnancy 34-35 weeks. in connection with monochorionic type of placentation was rodorazresheniye by abdominal routinely. The seam is cleared before the operation - wealthy. The analysis of a smear on flora: the urethra leukocytes 0-1, cervix 0-1, flora rod, the planting of the cervical canal - Lctobacter 10 5. 4 and 5 min extracted girls weight: first 2000,0, the second 2170,0; both length 44 cm with estimates for Apgar 6/7 and 4/7, respectively, transferred to hospital for further stages of nursing, was discharged home on the 26th day. in satisfactory condition.
IL No. 1397
Umnov Anna G., Avtomobilnaya perforada woman 30 years of age with recurrent pregnancy loss (in history 2 spontaneous miscarriage with reabrasio in both cases, about residues of the ovum) on the background of congenital anomalies of the internal genital organs: intrauterine septum is resected during hysteroscopy. Entered the Institute MME in the period 20-21 weeks. to correct ICN.
Before the operation produced clinical laboratory tests: PCR negative (ureaplasmosis sanitized before pregnancy), in the analysis of a smear on flora: the urethra is the leukocytes 0-1, cervix up to 5 in PTR., flora rod; KPI 7%; in the sowing of the cervical canal microflora is not detected. Made cerclage cervical fixation for the Sacro-uterine ligaments were conducted pre - and post-processing instillagel. Postoperative complications was not conducted irrigation cervical cancer epigenome by exposure of the cervix in the mirror three times in the hospital, then out for 5 days. In further observed condition of the seam conditions addednew the second hospital in the period 26, 32 weeks., planned hospitalization in the period of 34 weeks. prevention of placental insufficiency, SDR fruit.
The seam was wealthy, filmed in the period 37-38 weeks.
Odoratissimus per vias naturalis in pregnancy 39 weeks. girl weight 3110,0 length 50 cm, with rating on a scale of Apgar 8/9 points, discharged home on day 7.
Thus, the proposed method of prevention of infectious complications in conducting cerclage cervix can improve perinatal outcomes in pregnant women with isthmic-cervical insufficiency, reduce time finding patients in the hospital, thereby reducing contamination of nosocomial flora.
Sources of information
1. Complex method of perinatal care to premature babies [Text]: Method. REC. - Sverdlovsk, 1986. - 27 S.
2. Ledina AV, Aboud YOU Isthmic-cervical insufficiency // diseases of cervix, vagina and vulva (clinical lectures). - M.: Publishing House "Medpress". - 2000. - S-120.
3. Drugs in Russia [Text]: a Handbook. - M.: Estrofem Service, 2005. - S
4. Drugs in Russia [Text]: a Handbook. - M.: Estrofem Service, 2003. - S
5. Lipman A.D., A. A. Ultrasound criteria isthmic-cervical insufficiency // Obstetrics and gynecology. - 1996. No. 4, Pp.5 - 7.
6. Lyubimova A.I., Mammadaliyev NN. The results of the treatment of IP is Miko-cervical insufficiency of the imposition of double U-shaped Mylar seam on the cervix // Obstetrics and gynecology. - 1981. No. 9. - P.40-43.
7. Hirsch HA, Kezer, O., Icle FA Operative gynecology: satin. TRANS. from English. / Ed. by V.I. Kulakov, Yevpatoria. - M.: GEOTAR Medicine, 1999. - 1200 C., Il.
8. Sidelnikov V.M. Miscarriage. - M.: Medicine, 1986.
The way to prevent infectious complications operations cerclage cervix during pregnancy, characterized in that before and after cerclage make processing of the surgical field by instillagel, and on the second day spend irrigation of the vagina and the vaginal part of the cervix epigenome twice a day for 3-4 days in the hospital, then out for 5 days.
SUBSTANCE: method of antimicrobial skin preparation implies use of geothermal, humid or dry gas of Mount Jangan-Tau applied as local vapour or dry air baths at temperature 36-38°C within 6-8 minutes. Then temperature is increased up to 40-42°C and duration up to 10-12 minutes, while total course of skin preparation makes 10-18 procedures.
EFFECT: skin is effectively cleaned from microorganisms.
2 ex, 1 tbl
FIELD: medicine, pharmacology.
SUBSTANCE: method for obtaining composition for preparation of antiseptic compounds includes drying sapropel with definite content of organic substance, thermal procession, condencation, collecting and fractioning liquid organic products under definite conditions.
EFFECT: enhanced antiseptic properties.
1 tbl, 13 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to medicine and pharmaceutical industry, in particular to production of new treatment-and-preventive agent of antibacterial and spermicidal action which can be used in gynaecology. Offered treatment-and- preventive agent characterised by antibacterial and spermicidal action, is made as tablet for intravaginal introduction and contains chlorhexidine or its salt and base which as a main component contains lactose and other pharmaceutically acceptable adjuvant. Besides, specified agent can contain regenerant, in particular dexpanthenol or methyluracil or sea-buckthorn oil. Agent in the form of vaginal tablets is characterised by more effective antibacterial and spermicidal action and is more easy-to-use.
EFFECT: production of agent in the form of vaginal tablets characterised by antibacterial and spermicidal action.
40 ex, 10 tbl, 2 dwg, 2 cl
SUBSTANCE: invention refers to medicine, specifically to urology and concerns prevention of urethra iatrogenic infection caused by transurethral manipulations. For this purpose 5 minutes prior to urinary tracts manipulation gel is introduced to urethra that contains 2 g of 10 % lydocaine solution per 100 g of glycerine. Before introduction gel is ozonised to ozone concentration 1200 mkg/l. Method provides effective prevention of urethra iatrogenic infection at absence of lydocaine by-effects.
EFFECT: provided effective prevention of urethra iatrogenic infection at absence of lydocaine by-effects.
FIELD: medicine; pharmacology.
SUBSTANCE: invention concerns medicinal agent applied for various dermal diseases, injuries, stab, cut and septic wounds, burns and frostbites. Stated medicinal agent is antiseptic ointment containing iodophor as reactant, and polyethylene glycol as ointment base. As iodophor stated ointment contains pharmaiodine, and as ointment base - mixed polyethylene oxide-1500, polyethylene oxide-400 and glycerine taken in proportions as follows, (mass.%): pharmaiodine 5.0-20.0 (0.5-2.0 by active iodine); polyethylene oxide -1500 35-40; glycerine 15-17; polyethylene oxide-400 and other components to 100.
EFFECT: ointment is characterised by antiseptic, anti-inflammatory and wound healing action.
FIELD: medicine, surgery.
SUBSTANCE: invention relates to a method for prophylaxis of arising complications in period of post-operation treatment of patients. Method involves carrying out cannulation of umbilical vein in patients. During post-operation period intraportal infusions of ozonized sodium chloride physiological solution is carried out in the dose 200 ml, 2 times per 24 h. The ozone concentration in solution is 3-5 mg/l at the rate of administration 10 ml/min. Immediately before infusion 10 ml of 0.25% novocain solution is administrated by intraportal route. Method provides rapid administration of ozonized solution into the portal system and without development of pain syndrome and adverse responses of body as dyspeptic disorders.
EFFECT: improved method of prophylaxis.
FIELD: veterinary medicine.
SUBSTANCE: the present innovation deals with treating inspecific inflammation of mammary gland in cows due to introducing complex preparation that contains 2%-novocain solution, Dorogov's antiseptic-stimulant fraction 2, dimexid and 40%-glucose solution at the following ratio of the components mentioned, weight%: 2%-novocain solution 20-40; Dorogov's antiseptic-stimulant fraction 2 - 1-3; dimexid 13-15 and 40%-glucose solution - the rest. The preparation should be heated up to 37-38°C and injected intraperitoneally from the side of right epigastric ("hunger") fossa at the dosage of about 100-150 ml once daily. A 2-3-fold injection of this complex preparation leads to healing in cows. The innovation enables to treat mastitis in cows without applying antibiotics, sulfanyl amide preparations, nitrofurans and other inhibiting agents, avoid, thus, hypo- and agalactia, atrophy of the affected portion of the udder, narrowing of teat canal, its imperforation with connective tissue and reconstruct milk performance in cows being 16% quicker against conventional method of therapy.
EFFECT: higher efficiency of therapy.
1 ex, 1 tbl
SUBSTANCE: invention describes a film-forming aerosol comprising the following components: (1) block-copolymer of polysiloxane-polycarbonate (PS-PC) in the ratio of blocks PS:PC = (35-55):(45-65) as a base for formation of film-cover, 3-10; (2) chloroform as a solvent of block-copolymer and anesthetic agent, 90-97; (3) antiseptic preparation in alcoholic solution, 0.1-0.2, and (4) halogenhydrocarbon or their mixture as a propellant, 100-120. Also, invention describes a method for using aerosol. Represented aerosol solves problems associated with the dense fixation of protective cover, it doesn't require any disinfection of spray-coated aerosol films, provides high rate and convenience in applying curative-protective polymeric layers.
EFFECT: improved and valuable properties of aerosol.
2 cl, 4 ex
SUBSTANCE: the present innovation deals with carrying out cryo-impact upon hemangioma followed by treating the wound with concentrated KMnO4 solution. After that, one should additionally affect the wound simultaneously with impulse laser radiation and magnetic field. It is necessary to apply laser radiation at impulse sequence frequency being 1000 Hz at radiation power of about 4-8 W and magnetic field at induction being about 35-40 mTl. The innovation enables to accelerate the processes of epithelization in the wound and provides high cosmetic effect.
EFFECT: higher efficiency of therapy.
FIELD: medicine, stomatology.
SUBSTANCE: it is necessary to treat inflammatory focus with 0.05-0.1%-aqueous solution of polyhexamethylene guanidine hydrochloride. The innovation excludes undesirable resorptive and local reactions due to applying new antiseptic preparation.
EFFECT: higher efficiency of therapy.
1 dwg, 1 ex, 7 tbl
FIELD: organic chemistry, medicine, biochemistry pharmacy.
SUBSTANCE: invention relates to using the known 2-phenyl-substituted imidazotriazinone of the formula (I): (vardenafil) possessing improved properties as compared with other known inhibitors of phosphodiesterase-5 (PDE-5), such as sildenafil and tadalafil. Proposed compound is used for preparing drugs used in treatment of cardiac insufficiency.
EFFECT: valuable medicinal and biochemical properties of compound.
FIELD: organic chemistry, medicine, pharmacy.
SUBSTANCE: invention relates to substituted diketopiperazines of the general formula (I) or their physiologically acceptable salts wherein R1 means 5-membered cycloalkyl group optionally substituted with one or some hydroxyl groups that is condensed with optionally substituted benzene ring; R2 means (C1-C6)-alkyl; R3 means optionally substituted phenyl, 5- or 6-membered heteroaryl group, or condensed bicyclic ring system comprising 9-10 ring members; R4 means -OH, -O-(C1-C4)-alkyl or -NR5R6. Compounds possess antagonistic effect with respect to oxytocin in oxytocin receptors. Also, invention describes a pharmaceutical composition based on compound of the formula (I), using compounds of the formula (I) for preparing a medicinal agent and methods for synthesis of compounds of the formula (I).
EFFECT: valuable medicinal properties of compounds and pharmaceutical composition.
16 cl, 227 ex
FIELD: medicine, obstetrics.
SUBSTANCE: at detecting discoordination of uterine contractile activity during the first period of parturition it is necessary to introduce grandaxin at the dosage of 100 mg - 2 tablets once daily till normalization of uterine contractile activity. The innovation provides normalization of parturition process in combination with soft psychostimulating effect in parturient women in case of no side impact upon fetal body.
EFFECT: higher efficiency of therapy.
FIELD: medicine, surgery, surgical gynecology.
SUBSTANCE: one should perorally introduce xymedon at the dosage of 0.5 g to be repeated in 30 min. Then, intravenously one should inject 30 ml provocation-diagnostic curative composition, not more, that consists of aqueous solution of nicotinic acid and polyglucin taken at the following ratio of components, weight%: nicotinic acid 0.05-0.1, polyglucin 0.1-1.8, water - the rest. In case of pain one should diagnose appendicitis. The innovation provides the decrease of incorrect diagnostics in case of acute appendicitis in pregnant women at earlier stages of development along with normalizing action upon gravid uterus.
EFFECT: higher accuracy and efficiency of diagnostics.
1 ex, 1 tbl
SUBSTANCE: method involves intravenously introducing 7.5 mg of Verapamyl dissolved in 100 ml of 0.9% sodium chloride solution as infusion therapy at 2 ml/min rate.
EFFECT: enhanced effectiveness of treatment.
SUBSTANCE: method involves intravenously dropping 5 mg of Ginipral dissolved in 100 ml of 0.9% sodium chloride solution. 5 mg of Verapamyl dissolved in 100 ml of 0.9% sodium chloride solution is intravenously dropped second frequency corresponding to wavelength of 292 nm; photons of the third frequency corresponding to wavelength from 700 to 1400 nm. Photons of the first frequency are produced with one or more continuous radiation laser. Photons of the second and third frequency are produced with one or more pulsating radiation laser. The first, second and third frequency photons are applied to atomic vapor containing several Thallium isotopes. Photons of the first frequency pump Thallium isotope assembly in base state and transfer them to metastable state with energy level of 7793 cm-1 over the first excited state distinguished by energy level of 26477.6 cm-1 relative to zero level of the basic state. The second state photons excite Thallium atoms set in metastable state to intermediate state being the second exited state having energy of 42040.0 cm-1 or 42049.9 cm-1 relative to zero energy of the basic state. Photons of the third frequency ionize the set of atoms belonging to intermediate state. Mentioned isotopic ions are accumulated by applying electric field to the vapor.
EFFECT: enhanced effectiveness in separating thallium isotopes.
10 CL, 7 dwg
SUBSTANCE: method involves determining lymphocyte CD 56+ in peripheral blood before planned pregnancy. The content exceeding norm, lymphocytoimmunotherapy courses are applied with donor lymphocytes. The courses are applied at the fifth-eighth day of fertility cycle until normal lymphocyte CD 56+ values become restored. Pregnancy being proved, lymphocytoimmunotherapy courses are applied with ultrasonic examination results having in view. Choriohypoplasia being available, the courses are applied every 2 weeks. Chorion thickness being in conformity with gestation age, the courses are applied every 3-4 weeks to 12-14 pregnancy weeks.
EFFECT: adequate chorion and placenta development.
FIELD: medicine, veterinary medicine.
SUBSTANCE: method consists in application of medication made of vegetable raw materials onto the surface of a wound. The vegetable raw material can be represented by mixture of milled dry leaves, stems and flowers of brandy mint, dry flowers of horse gowan, dry leaves of waybread and dry flower heads of costmary, that is mixed with sea-buckthorn oil, sterile 0.9% solution of cooking salt and formalin in the following proportion of components in g (wt %): dry leaves, stems and flowers of brandy mint - 20.0 (5.29), dry flowers of horse gowan - 20.0 (5.29), dry leaves of waybread - 20.0 (5.29), dry flower heads of costmary - 15.0 (3.97), sea-buckthorn oil - 150.0 (39.68), sterile 0.9% solution of cooking salt -150.0 (39.68), formalin - 3.0 (0.8). After that the mixture is sealed, kept with mixing at the room temperature during 10-15 days and the liquid part is separated. The remaining mass is mixed with shape-generating substance of the equal volume for ointment preparation.
EFFECT: creation of highly effective method of wound treatment.