Method of predicting efficiency of local chemical therapy in treatment of patients with malignant tumours of brain
SUBSTANCE: invention relates to medicine, namely to oncology and can be used for predicting efficiency of local chemical therapy of brain in patients with malignant tumours of central nervous system. For this purpose during surgical intervention for ablation of brain tumour from perifocal zone of tumour taken is brain tissue, which is divided into samples, 100 mg each. Number of samples is limited by number of studied chemical preparations. Chemical preparationbs are added to samples in dose 0.2 mg. Incubation at temperature 37°C for 30 minutes is performed. Activity of alpha-2-macroglobulin is determined before and after incubation. If index increases by 40% and more, in comparison with the value before incubation, efficiency of chemical preparations is predicted.
EFFECT: method ensures high specificity, possibility of objective evaluation of efficiency of chemical preparation impact in performing analysis on operation day, which makes it possible to start adequate therapeutic measures, including cancelling or replacement of chemical preparation in each specific case.
The invention relates to medicine, namely to Oncology, and can be used to assess the effectiveness of local chemotherapy of brain in patients with malignant tumors of the Central nervous system.
There is a method of assessing response to treatment with chemotherapy drugs, which are used biochemical indicators, such as
the concentration of TNF-α, IL-1, IL-6 in serum (Orlov V.N., Gusev S.A. Goncharov, AP Influence of chemotherapy on the concentration in the serum of patients with multiple myeloma interleukin-1, interleukin-6 and tumor necrosis factor. RBM. W. hematol. transposal. 2007, N 3, p.17-20.).
However, this analysis was not conducted in malignant tumors of the brain, and the determination of TNF-α and interleukins in serum informative, but is not specific to the operation of the authority and does not allow to predict therapeutic effect for intracranial gliomas.
A known method for determining the expression of P-glycoprotein in normal, okolokrugovykh and cancerous tissues (Chen Chun-Yan, Zhu Zhao-Hua Shiyie huaren xiaohua zazhi=World Chin. J. Dig. - 2003. - 11, N 1. - P.36-38;). The level of P-glycoprotein was different in normal, allopurinol and cancerous tissues in cancer of the stomach: 13, 22, and 43%from the norm and correlated with the number of surviving patients.
The authors use this pokazatel is to confirm the effectiveness of chemotherapy, but the main point of reference become clinical signs of the patient, the duration and quality of their lives.
Playback of the following methods is not used for predicting the efficacy of chemotherapy when choosing chemotherapy drugs during the operation.
There is a method of assessing the efficacy of chemotherapy (Cirak O.V., Lisovskaya POSTGRADUATE performance Criteria endolymphatic chemotherapy in patients with advanced breast cancer and ovarian cancer. RBM. chemotherapist. J., 2000. N 4, P.17-21.), selected as a prototype. The essence of the method lies in the fact that prior to treatment from the peripheral blood of cancer patients produce lymphocytes and leukocytes, register in lymphocytes admonitive DNA fragments in the gel electrophoresis, and then examine the index change in the affinity of cells to antigens of the primary tumor and placenta in LAI-test. Check admonitive DNA fragments in peripheral blood mononuclear prior to treatment and decrease the affinity of cells to the antigen of the primary tumor with simultaneous rising to the antigen of the placenta in the period of treatment was correlated with a marked clinical effect of chemotherapy.
However, the disadvantages of this method are, on the one hand, its duration (2-3 days), associated with the separation of lymphocytes and leukocytes, the implementation of the PE the work with antigens and the need for repeat studies after the introduction of chemotherapy drugs, that slows down the production and analysis of results, on the other hand, the inability of a cancellation or replacement of a chemical in the case of resistance of the investigated tissues to the previously selected before the introduction of the drug to the patient. In addition, this method is not applicable in patients with malignant brain neoplasms.
The aim of the invention is to be able to predict the efficacy of chemotherapy drugs directly to the target organ malignant process.
This objective is achieved in that during the surgical intervention, removal of brain tumors from perifocal zone tumor take the tissue of the brain, divided into samples of 100 mg each; the number of samples is limited to the number of chemotherapy plus one sample, which leave intact; other samples add chemotherapy at a dose of 0.2 mg for each sample, incubated for 30 min at 37°C. after incubation, determine the activity of the inhibitor alpha-2-macroglobulin in all samples, including intact (before incubation); increase to 40% and more compared with the value prior to incubation predict the efficacy of chemotherapy.
The invention of "a Method for predicting the effectiveness of regional chemotherapy in the treatment of patients with malignant brain tumors" is but the YM, as it is unknown the level of achievements of medicine in the field of predicting the effectiveness of chemotherapy and resistance to chemotherapy drugs.
The novelty of the invention lies in the fact that in the perifocal tissue determine the activity of the universal inhibitor of proteolysis of alpha-2-macroglobulin before and after incubation with chemotherapy and with its increase by 40% or more after incubation predict a positive clinical effect. If the level of alpha-2-macroglobulin less than 40% predicted resistance fabric perifocal zone of the tumor to the chemotherapy drugs, which gives the possibility of making appropriate decisions about the choice of chemotherapy drugs during the operation. This method of forecasting is new and allows for individual selection of chemotherapy drugs during surgery, as well as the timely adoption of measures to prevent adverse consequences.
In open sources information of Russia, CIS and abroad indications for a similar method for predicting the effectiveness of chemotherapy drugs us not detected.
The invention is industrially applicable as it can be reproduced and re-reproduced in any clinical laboratory medical health care institutions.
The method is as follows. During the op the radio removed the tumor and the required number of perifocal brain tissue, which was used for the determination. Fabric perifocal zone was divided into several samples of 100 mg each (2-3, depending on the number of tested drugs). One of the samples was left intact, others were added to chemotherapy in a dose of 0.2 mg each, and incubated 30 minutes at 37°C. After incubation in each sample were used to define the alpha-2-macroglobulin. The tissue was ground in a homogenizer with 1 ml of physiological solution. Osmotic shock caused by the addition of 1 ml of bidistilled water and after 10 minutes of exposure of the obtained homogenate was centrifuged 15 min at 3000 Rev/min the Precipitate was discarded, and the supernatant was determined by the activity of alpha-2-macroglobulin. The measurement was repeated unified kinetic method for speed cleavage of the synthetic substrate BAEE (Artikova V.F., Pashina T.S., J. The matters. the honey. chemistry, 1979, V.25, no 4). The activity of alpha-2-macroglobulin was calculated as the increase in optical density of the investigated solution in the cuvette of a spectrophotometer for 10 min vs. control for the reagents. Recalculation in Sg tissue was performed using the conversion factor proposed by the authors of the method, adjusted to 1 g of fresh tissue. The duration of definition 2 hours, which allows analysis to be performed on the same day.
An example of the application method can be the issue the ski records.
1. Patient K., 1958 born., Case history No.-726/kg, was admitted to the Department of tumours of the Central nervous system FGU RNII and gynecology 15.10.2007 and was in the hospital on 30.10.2007.
Diagnosis (primary, secondary, complications): glioblastoma left fronto-parietal region of the brain; the spasms.
G/a No. 974384-389 - isomerisation glioblastoma with diffuse infiltrative growth, extensive hemorrhage.
17.10.2007 the patient underwent surgery decompressive craniotomy with removal of the tumor of the left fronto-parietal region of the brain. During the operation, after removal of the tumor was preparing 4 sample perifocal brain tissue 100 mg One sample was left for comparison as the original, others were added 0.2 mg of chemotherapy in each (1 - cyclophosphamide, 2 methotrexate, 3 - carboplatin), and incubated at 37°C for 30 minutes. Alpha-2-macroglobulin was determined in the original sample and in the samples after incubation. The increase in the activity of alpha-2-macroglobulin after incubation with carboplatinum was 62.8% from the original. The drug is considered effective, which was confirmed by the subsequent dynamics of the patient. Currently (within 2 years) the patient is under observation, data in favor of relapse no.
2. Patient B., 1939 born., Case history No.-8235/C, was dropped at the re with 19.06.2008 on 04.07.2008.
Diagnosis (primary, secondary, complications): glioblastoma right temporal lobe of the brain; the spasms.
G/a No. 36957-962 - glioblastoma with infiltrative growth, foci of necrosis.
10.12.2007 the patient underwent surgery osteoplastic craniotomy with removal of the tumor on the right temporal region of the brain. During the operation, after removal of the tumor was preparing 4 sample perifocal brain tissue 100 mg One sample was left for comparison as the original, others were added 0.2 mg of chemotherapy in each (1 - cyclophosphamide, 2 methotrexate, 3 - carboplatin), and incubated at 37°C for 30 minutes. Alpha-2-macroglobulin was determined in the original sample and in the samples after incubation. The increase in the activity of alpha-2-macroglobulin after incubation with drugs was less than 27% in all samples. Drugs considered ineffective, which was confirmed by the subsequent dynamics of the patient's condition.
In may 2008 (5 months after chemotherapy and determining the activity of the inhibitor), the patient showed a relapse of the tumor, his condition deteriorated; 23.06.08 re - operation-recruitme with Subtotal removal of the tumor. The patient died in August 2008.
Were examined 7 patients with brain tumors who were treated in the Department of tumours of the NS RNII and subjected to operation with local chemotherapy.
Found that 5 patients with a favorable clinical effect after intraoperative injection of chemotherapy drugs value of alpha-2-macroglobulin in the tissue of the perifocal zone tumors, incubated with the cancer, varied 13,65 inhibitory units (S), tissue - 19,11 Sg tissue, which exceeded the original value on 44-76%%. In 2 patients developed a relapse, and died subsequently, the activity of alpha-2-macroglobulin, defined in the same tissue in the same conditions ranged from 10,37 Sg tissue to 13,65 Sg tissue (increased to 27% from the original)that is clearly linked to the resistance of the fabric perifocal zone of the tumor to the chemotherapy. The source believed the value of the activity of alpha-2-macroglobulin in the same perifocal tissue prior to incubation. In all patients, the initial activity of alpha-2-macroglobulin ranged from 8,19 Sg tissue to 13,92 Sg tissue.
Technical and economic efficiency of the method is its high specificity, being able to objectively evaluate the impact of chemotherapy drugs directly to the affected organ, analysis on the same day that allows for timely assign adequate therapeutic measures, cancel or replace the chemo.
A method for predicting the effectiveness of local himit is rapie in the treatment of patients with malignant brain tumors, including operation, spectrophotometric studies, characterized in that during the surgical intervention - remove a brain tumor from perifocal zone tumor take the tissue of the brain, divided into samples of 100 mg each, the number of samples limit the number of investigational drugs, one sample is left intact to other samples add chemotherapy at a dose of 0.2 mg for each sample, incubated for 30 min at 37°C, before and after incubation to determine the activity of the inhibitor alpha-2-macroglobulin, when the increase by 40% or more compared with the value before incubation predict the effectiveness of chemotherapy drugs.
SUBSTANCE: diagnosing of early congenital latent syphilis is enabled by determining the values of acute cell-mediated, humoral components of the immune system and phagocytosis. If the CD19 +-lymphocyte percentage values exceed 12.1 as related to the reference group, the absolute and relative HLA-DR-antigen number values: more than 80.6×103/mcl and 1.5 % respectively, than in the reference group, and also a phagocytic neutrophil index is more than 48.2 %, latent ECS is diagnosed.
EFFECT: use of the method faster and more accurate diagnosing of latent ECS.
2 tbl, 2 ex
SUBSTANCE: test device has two surface impermeable layers, a layer of absorbing matrix material on which the reagent is applied and which is placed between the impermeable layers. One of the impermeable layers has multiple openings superimposed with the matrix material and capable of absorbing the sample into the matrix material from the surface. The device is laminated and is fitted with apparatus for separating the sample from the surface when rubbed. Disclosed is an alternative version of the test device, versions of the method of extracting the sample from the surface of test devices and a method of making the test device. The invention increases adhesion strength between layers of the test devices and ensures separation of the sample from the surface of the devices when rubbed.
EFFECT: high-speed and large-scale manufacturing of test devices.
58 cl, 6 dwg
SUBSTANCE: reagent for testing total α-amylase activity in serum, blood plasma and urine contains as a substratum 2-chlorine-4-nitrophenl-4-O -β-D-galactopyranosylmaltoside (GalG2CNP), sodium chloride, potassium sulphocyanate, sodium azide, EDTA, calcium acetate, Triton X-100, 2-morpholinoethanesulfonic acid (MES) and water. The pH value of said reagent is 5.5-6.5.
EFFECT: use of the reagent enables high precision and results reproducibility α-amylase test.
1 tbl, 4 ex
SUBSTANCE: invention concerns a kit of reagents for pancreatic α-amylase activity test including a reagent 1 containing sodium chloride, potassium sulphocyanate, sodium azide, water-soluble calcium salt, monoclonal salivary α-amylase antibodies (MAB), 2-morpholinoethanesulfonic acid (MES) and water, and a reagent 2 containing 2-chloring-4-nitrophenyl-4-O-β-D-galactopyranosylmaltoside (GalG2CNP), MES and water, differing by the fact that the reagent 1 in addition contains EDTA and bovine serum albumin (BSA), and as calcium salt, it contains calcium acetate, and the reagent 2 in addition contains EDTA and sodium azide in the proportions specified in the patent claim.
EFFECT: enhanced stability of the set of reagents with maintaining high accuracy and result reproducibility of the analysis.
1 tbl, 4 ex
SUBSTANCE: invention relates to field of medicine, namely to methods of predicting post-operational complications, namely to methods of predicting development of scars after previous acne. In order to predict scar development content of receptor antagonist of interleukin-1 (RAIL) is determined during 15 days after resolution of inflammatory process. Scarless development of process is diagnosed at level RAIL in peripheral blood serum after disease being within physiological norm (300-800 pg/ml). If level of RAIL is lower than said norm prediction of acne complication in form of skin scars is diagnosed. Possibility of development of hypertrophic scars is predicted if RAIL concentration is lower than 200 pg/ml.
EFFECT: method makes it possible to predict type of complications after previous acne, therefore correcting therapy carried out in due time can prevent risk of skin scar formation and improve patient's life quality.
2 cl, 1 tbl, 4 ex
SUBSTANCE: developing hypoxia in a pregnant woman of the third trimester of gestation is predicted by evaluating peripheral blood oxyhemoglobin (HbO2) and 2,3 diphosphoglycerate phosphatase (2,3DPG) concentrations. A discriminator (D) is calculated by formula D=+17.072·2.3DPG + (-0.041·HbO2), 2,3DPG - concentration, mol/l, HbO2 - amount, %. The D value within 97.09-112.37 enables to predict threatened hypoxia in a pregnant woman had an acute condition of herpes virus infection.
EFFECT: use of the method allows well-timed detection of a risk group and correct prediction of developing hypoxia.
SUBSTANCE: threatened reduced erythrocyte oxygenation in a pregnant woman suffering an acute attack of bronchial asthma in the first trimester of gestation is predicted by evaluating oxyhemoglobin (HbO2) and 2,3 DPG (2,3 diphosphoglycerate phosphatase). This is followed by calculating a D discriminator value by formula D=18.05·2,3DPG + (-0.075·HbO2), and observing the D value within 88.66 to 102.42, threatened reduced erythrocyte oxygenation that leads to hypoxia is predicted.
EFFECT: use of the method enables predicting threatened reduced erythrocyte oxygenation in a pregnant woman with the acute attack of bronchial asthma.
SUBSTANCE: differentiated detection large and small circulating immune complexes in blood serum is ensured by a follow-on examination of blood serum clarified by short centrifugation with a method of circulating immune complexes precipitation PEG -6000 of the end concentration 4 % and 6 %. Thereafter, the results are recorded by a turbidimetric method with using a microplate spectrophotometer in a two-wave mode: basic - 340 nm, reference filter - 620 nm. Duration of an incubation step at temperature +18-25°C is 15 minutes. Using the method enables higher effectiveness and reliability of determining the level of large circulating immune complexes, results reproducibility, as well as differential measurement of the level of small CIC which are a diagnostically significant indicator of human body immune responsiveness in many types of a pathology, decreased volume of analysed serums to 0.06 ml, and incubation duration to 15 minutes.
EFFECT: method is suitable for clinical screenings.
1 dwg, 1 tbl, 1 ex
FIELD: measurement equipment.
SUBSTANCE: invention refers to biophysics. In order to determine calcium concentration on the basis of discharged photoproteins, bioluminescent reaction of photoproteins and calcium ions is performed, intensity of the solution fluorescence is measured, calibration dependence of fluorescence intensity on calcium concentration in double logarithmic coordinates is built and logarithm value of calcium concentration is determined as per the logarithm of the measured fluorescence intensity. Fluorescence is initiated with the light source after bioluminescent reaction is completed. Fluorescence intensity is measured at the specified length of excitation and recording wave.
EFFECT: method allows determining calcium concentration in various media as per fluorescence intensity of discharged photoproteins, which allows performing continuous measurements of calcium concentration in "in vivo" system.
2 dwg, 6 ex
SUBSTANCE: when admitted, an acuity patient is analysed for total protein concentration and creatine phosphokinase activity in blood serum. If the analysed values are within normal limits, the absence of skeletal muscles injures is diagnosed; total protein concentration being within normal limits and creatine phosphokinase hyperactivity indicate the presence of an accompanying injury of the skeletal muscles, while lowered total protein concentration with underlying creatine phosphokinase hyperactivity shows progressing hypoproteinemia.
EFFECT: method provides pre-clinical detection of the presence of the accompanying injures of the muscles and progressing hypoproteinemia.
SUBSTANCE: invention relates to field of medicine, namely to obstetrics, neurology and neonatology and can be used for early diagnostics of hypoxic-ischemic injuries of CNS in newborn children from mothers with gestosis. In umbilical blood concentration of atrial natriuretic peptide is determined and if its value is 0.15 nmole/ml or higher, hypoxic-ischemic injuries of CNS in newborn children is diagnosed. Claimed method makes it possible to extend arsenal of diagnostic means, increase diagnostic value of truly positive result - confirmation of hypoxic-ischemic injuries of CNS in full-term newborn children from mothers with gestosis.
EFFECT: application of method will make it possible to start efficient therapy of said pathology in newborn baby and avoid complications.
3 ex, 1 tbl
SUBSTANCE: invention relates to medicine, namely to forensic medicine and pathological anatomy. Maximal thickness of subdural hematoma capsule is measured and by means of nomogram for determination of remotedness of incapsulated subdural hematomas, given in description, point and interval estimations of remotedness of subdural hematoma with confidence level from 60 to 95% are determined.
EFFECT: method makes it possible to increase accuracy of determination of incapsulated subdural hematomas.
1 dwg, 2 ex
SUBSTANCE: invention relates to field of medicine and can be applied in anesthesiology and resuscitation science. Events that have taken place and risk factors are estimated. To events that took place, which have risk probability not less than 50%, referred is artificial blood circulation for more than 150 min or repeated artificial blood circulation, extension of operation volume, presence of multifocal vascular injury, presence of organ or system dysfunction with severity of state at the time of arrival from operating room by APACHE-II more than 18 points. To factors with 30% risk probability referred are blood loss in tissue injury, presence of shock, expression of system inflammatory response by accepted criteria, transfusion, exceeding two doses of erythrocyte mass or donor plasma, restenotomy and initial severity of state by EuroSCORE more than 2.5%. Probability of risk of developing syndrome of polyorgan insufficiency more than 50% is predicted in case if combination of events and risk factors takes place.
EFFECT: method makes it possible to predict risk of developing polyorgan insufficiency in cardiosurgical patients at early stage.
3 tbl, 2 ex
SUBSTANCE: invention refers to medicine, namely to anesthesiology, and can be used in sevoflurane inhalation anaesthesia. For this purpose, the general anaesthesia is induced by inhalation of an anaesthetic gas of the anaesthetic sevoflurane concentration 8%. Then, in 2 minutes the anaesthetic concentration is reduced to 4%. Thereafter, in 2 minutes, the supporting concentration 1.5 % is adjusted.
EFFECT: method allows reducing narcosis induction time and thereby reducing the adverse actions of the anaesthetic due to staged two-level decrease of the inhalation anaesthetic concentration.
SUBSTANCE: invention relates to medicine, namely, to anesthesiology, and can be used in carrying out inhalation anesthesia. For this purpose carried out is estimation of patient's sedation level by dynamics of pericortical saturation of brain tissues with oxygen, which is registered bimationral oximetry - optic spectroscopy in range 700-1500 nm. If index of regional saturation (rSat) is more than 2% of initial values, adequacy of sedation level is registered.
EFFECT: method makes it possible to ensure adequate anesthesia due to non-invasive and objective control of sedation level when carrying out inhalation anesthesia.
2 dwg, 2 ex
SUBSTANCE: invention relates to medicine, namely to gastroenterology, and can be applied in differential diagnostics of pancreatic cancer and chronic pancreatitis (CP) during initial visit to doctor with suspected pathology of pancreas. Activity of blood serum enzymes and the following parameters are determined: age, presence or absence of: yellowing of the skin, stones in Wirsung duct lumen, its tortuosity, pancreatoliths and cysts in parenchyma of pancreas, formations in liver, regional lymphadenopathy and involvement in pathological process of vessels in projection of pancreatoduodenal zone by USE data; erosions and lymphangiectasias in duodenum by FEGDS data. Biochemical indices are determined: levels of total bilirubin, triglicerides, C-peptide, tumour marker CA-19-9; ultrasonic indices: pancreas dimensions, its echogenicity, thickness of choledoch walls, its length, character of its content, gall bladder dimensions. After that, each sign is given corresponding point from table No 1, presented in description, obtained points are summed up. If point sum is +20 and more, chronic pancreatitis is diagnosed, if point sum is -13 and lower, pancreatic cancer is diagnosed, intermediate value of point sum "-12 - +19" is estimated as uncertain diagnosis.
EFFECT: method makes it possible to increase accuracy of differential diagnostics and possibility of application in clinical practice.
7 tbl, 6 ex
SUBSTANCE: invention relates to field of medicine, namely to forensic medicine and pathology anatomy. In order to determine prescription of subdural hematomas histological testing of their capsules is performed. Presence of histological criteria of prescription of subdural hematomas, given in table "Terms of existence of various histological criteria of prescription of subdural hematomas", presented in description, is registered. By totality of registered histological criteria by means of table formed is set of minimal and set of maximal terms of subdural hematoma prescription. Minimal term of subdural hematoma prescription is determined, as such, the largest element of formed set of minimal terms is taken. Maximal term of subdural hematoma prescription is determined, as such, the smallest element of formed set of maximal terms is taken.
EFFECT: method increases accuracy of determining prescription of subdural hematomas.
SUBSTANCE: invention relates to preventive medicine and occupational diseases. Type of person's body building (somatotype) is determined by their morpho-constitutional parameters and blood group is determined by MN system or by P system. Obtained data make it possible to predict length of service in conditions of vibration-hazardous production not only before determination of diagnosis of vibration disease (VD), but before first complaints characteristic of VD (FCVD), as well as duration of transition period between FCVD and VD diagnosing.
EFFECT: method makes it possible to increase quality of medical selection of people-candidates for vibration-hazardous specialties, workers for vibration-hazardous production, and to carry out rehabilitative-health improving procedures for strengthening occupational health of employees in due time.
1 ex, 7 tbl
SUBSTANCE: invention relates to medicine, namely to dentistry and neurology. Oral cavity is examined, colour of mucosa is estimated in comparison with colour scale by CMYK, consisting of 10 values, namely: 1 - C - 1-2%, M - 6-11%, Y - 1-2%, K - 0%, 2 - C - 3-5%, M - 11-17%, Y - 3-9%, K - 0%, 3-C - 7-9%, M - 18-27%, Y - 10-12%, K - 0%, 4 - C - 10-11%, M - 27-34%, Y - 14-19%, K - 0%, 5 - C - 12-15%, M - 38-45%, Y - 21-24%, K -0%, 6 - C - 18-21%, M - 47-57%, Y - 26-30%, K - 0%, 7 - C - 21-25%, M - 57-67%, Y - 31-42%, K - 0-2%, 8 - C -24-25%, M - 70-76%, Y - 42-47%, K - 2-5%, 9 - C - 25-27%, M - 79-84%, Y - 48-53%, K - 5-9%, 10 - C - 26-26%, M - 84-89%, Y - 58-63%, K - 11-14% from vestibular side in region of alveolar gum at the level of space between teeth 13-14, 23-24, 33-34, 43-44; in region of hard palate on the right and on the left. Index of intensity of oral cavity mucosa colour (J) is calculated as arithmetic mean of obtained indices sum. If J value is from 1 to 3, hemodynamically significant stenosis in extracranial part of carotid arteries is diagnosed.
EFFECT: method extends arsenal of means for express-diagnostics of hemodynamically significant stenosis in extracranial part of carotid arteries during clinical examination of oral cavity.
4 dwg, 1 tbl, 6 ex
SUBSTANCE: invention relates to medicine, namely to surgery, endoscopy, gastroenterology, and is intendeds for predicting risk of development of digestive tract bleeding in case of polypectomy with application of high-frequency current. Laser Doppler flowmetry is carried out. By means of skin sensor on finger average initial value of blood microcirculation index - Im0 is determined. After that, standard occlusion test with three-minute occlusion of brachial artery is performed. Maximal value of blood microcirculation index is determined during maximum of reactive post-occlusion hyperemia- Immax. Increase of blood microcirculation index Kii is calculated by formula Kii=Im max/Im0×100%. If said index achieves value 100-115%, risk of bleeding development in case of polypectomy is predicted.
EFFECT: method makes it possible to ensure non-invasive and reliable prediction of possibility of post-operational bleeding development in case of polypectomy individually for each patient due to examination of blood microcirculation.
FIELD: medicine, clinical toxicology.
SUBSTANCE: at patient's hospitalization one should gather the data of clinical and laboratory values: on the type of chemical substance, patient's age, data of clinical survey and laboratory values: body temperature, the presence or absence of dysphonia, oliguria being below 30 ml/h, hemoglobinuria, erythrocytic hemolysis, exotoxic shock, glucose level in blood, fibrinogen and creatinine concentration in blood serum, general bilirubin, prothrombin index (PTI), Ph-plasma, the state of blood clotting system. The state of every sign should be evaluated in points to be then summed up and at exceeding the sum of points being above "+20" one should predict unfavorable result. At the sum of "-13" prediction should be stated upon as favorable and at "-13" up to "+20" - prediction is considered to be doubtful.
EFFECT: higher accuracy of prediction.
2 ex, 3 tbl