Method of internal hemorrhage diagnostics

FIELD: medicine.

SUBSTANCE: hematocrit is determined in patient's blood and in drainage content. Ratio of drainage content hematocrit to blood hematocrit is calculated. If its value is less than 0.05 absence of hemorrhage is diagnosed, if the value is from 0.05 to 0.2 capillary hemorrhage is diagnosed, from 0.2 to 0.5, diffusive hemorrhage is diagnosed, over 0.5 vascular hemorrhage is diagnosed.

EFFECT: methods application makes it possible to increase accuracy of internal hemorrhage diagnostics in short terms and at early stages of disease.

2 ex


The invention relates to medicine, surgery, anesthesiology and reanimatology and intensive care, and can be used to diagnose internal bleeding.

Internal bleeding is one of the most common pathologies in patients of intensive care.

While diagnosing internal bleeding is often a very difficult task. The main signs of internal bleeding - functional and Hematology. Functional manifested by pallor of the skin, reduction of arterial and Central venous pressure, reducing the rate of diuresis. The disadvantage of using functional traits is their nespecificnomu. The symptoms included in the number of patients in critical States can have almost any reason (Marino, P. Intensive therapy (Per. s angl.) / Pyrina. - M, GEOTAR - Medicine, 1998).

Hematological manifestations are characterized by a decrease in the dynamics of the number of erythrocytes, haemoglobin concentration, hematocrite value. Hematological manifestations of internal bleeding, confirming functional, have a significant delay in time, appearing after 4-12 h from the beginning that can lead to delayed diagnosis threatening condition (Cashiers, I.A. Klinicheskaya Hematology. / Iascinski, Gaaleries. - M.: Medicine, 1970).

The closest way to diagnose is to evaluate the discharge to drains, catheters and probes located at the alleged source of bleeding (Emelyanov, SR General surgery. / Siemeling, Muddebihal, A.v.fedorov. - M: Medical information Agency, 2003). However, this method has the disadvantage of excessive subjectivity of the method, since the determination of the nature of the discharge occurs solely by it's color.

We first proposed a method for the diagnosis of internal bleeding, which in comparison hematocrit of the patient's blood with a hematocrit separated by drainage (catheter probe), which is in the cavity of the body or the place of operative intervention.

To use this method, you must have a functioning drainage (catheter tube) at the place of intended bleeding. If you suspect internal bleeding blood samples were taken from a vein of the patient. In the blood sample is determined hematocrite value. Is the fence contents of the drainage catheter, probe), which is determined by the same indicator. Methods for the laboratory testing of blood and the contents of the drainage catheter, probe) does not matter; it is used routine method for determination of hematocrit, Rinata in a particular clinic. It is determined by the amount of blood and the contents of the drainage catheter, probe).

After the results are intercomparison of the studied blood parameters and contents of a drainage catheter, probe); calculated index Sadchikov by the formula:


where Hta - hematocrit content of drainage,

Htb - hematocrit of venous blood,

Is - index Sadchikov.

Depending on the size of the index, we identify three quality, which indicates the index:

StateNo bleedingCapillary bleedingDiffuse bleedingVascular bleeding
Index valueLess than 0.05of 0.05-0.20,2-0,50,5-1,0

We studied 52 patients with functional features it was supposed to be internal bleeding. Of these 22 patients with suspected bleeding from ulcers of the gastrointestinal tract, 18 patients with suspected bleeding from the bladder, 12 patients with alleged paleoprecipitation. They have to arm/exclusion diagnosis applied the proposed method, verified by using fibroesofagogastroduodenoscopia (patients with ulcers of the gastrointestinal tract), videocategory (patients with suspected bleeding from the bladder), revisions in the area of operation (patients with presumed postoperative bleeding).

The control group was 27 patients with similar patterns of causes of bleeding; the control group differed from the basic fact that for arming/exclusion diagnosis was used the traditional method (functional performance and character of the discharge from the drainage).

Functional characteristics and nature of the discharge from the drainageThe proposed method
The true resultFalseAverage time diagnosticsThe true resultFalseAverage time diagnostics
Defined bleeding16(80%)4(20%) 4 h40(93,02%)3(5,8%)30 min
Defined no bleeding5(71,42%)2(28,52%)8(88,88%)1(11,12%)

Compared with the traditional way, using the proposed method decreased the number of erroneous diagnosis of bleeding, as well as the obvious advantage that less time is required for diagnosis.

Specificity is 88,88%, which in combination with the sensitivity 93,02% accounts for its high diagnostic value.

The value of the designated index Sadchikov not depend on the indices of Central venous pressure and circulating blood volume. The simplicity of the proposed method accounts for its technical reproducibility.

Example 1. Sick Gonchar SCI, 72 years, the case history No. 7207. Date of receipt of the oar KB them. Sriratana SSMU 24.07.10. Diagnosis: Primary: prostatic Hypertrophy. Complications: Acute urinary retention. Bilateral pyelonephritis. Background: Chronic renal failure.

The patient was performed percutaneous needle nephrostomy, then for several days in the urine of nephrostomes observed what up blood, evaluated by different experts from moderate to severe. Discussed the question about the necessity of surgical intervention for the purpose of hemostasis. Was made on the determination of hematocrit in the blood and urine of nephrostomes. In urine hematocrit of 2%in the blood - 33%, the calculated index Sadchikov is 0.06, indicating that capillary bleeding. The need for surgical intervention was rejected. Hematocrit urine in the patient consistently declined over the two days, the third day blood in the urine was not significantly detected.

Example 2. Sick of Darina A.I., 82 years. Case history No. 7608. Date: 9.08.10. Diagnosis: Primary: Cancer of the antrum. Condition after antral resection of the stomach. The failure of the gastrojejunostomy. Arrozivnym bleeding.

In the postoperative period lasted Department scant serous-hemorrhagic content from drains. For 8 days the patient's condition deteriorated: there are hypotension, tachycardia, paleness of the skin. Sample collection blood and the contents of the drainage. Blood hematocrit was 32%, in the discharge of drainage 30%, the index Sadchikov 0,94%, indicating a vascular bleeding.

Was relaparotomy identified and eliminated the source of bleeding: the vessel in the area of the anastomosis.

As can be seen from the description of the deposits, in the following examples, the proposed method allows to diagnose internal bleeding in the early stages, requires significantly less time, is more objective and accurate than the traditionally used methods.

The way to diagnose internal bleeding, including determination of hematocrit in the blood of the patient, characterized in that it further determine the hematocrit content of drainage, calculate the ratio of hematocrit drainage of the content to the hematocrit of the blood and when it is less than 0.05 diagnose the absence of bleeding, a value of from 0.05 to 0.2 diagnose capillary bleeding, from 0.2 to 0.5 diagnosed diffuse bleeding, above 0.5 diagnose vascular bleeding.


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FIELD: medicine.

SUBSTANCE: invention relates to field of medicine. For laboratory diagnostics of early disorders of liver functional state activity of ALT, AST, LDH, GGT, ALP, total bilirubin are measured. Additionally carried out is 3-minute long occlusion of shoulder vessels - "cuff test" (CT) to create short-timer hypoxia. Indices of liver functional activity are determined by the following formulas: ALT index=((ALT after CT - ALT before CT)/ALT before CT)*100%; AST index=((AST after CT - AST before CT/AST before CT)*100%; LDH tot = ((LDH after CT - LDH before CT)/LDH before CT)*100%; ALP index=((ALP after CT - ALP before CT)/ALP before CT)*100%; GGT index=((GGT after CT - GGT before CT)GGT before CT)*100%; Bilirubin index=((Bilirubin after CT - Bilirubin before CT)/Bilirubin before CT)*100%. If said indices increase by more than 10%, early disorder of liver functional state is diagnosed.

EFFECT: method increases diagnostics efficiency due to early detection of liver functional state disorders, preceding registered by laboratory methods changes in its functioning.

2 ex, 4 tbl

FIELD: medicine.

SUBSTANCE: pregnant woman suffering hypotheriosis and obesity on their 2-12 weeks of gestation are examined for a fT4 level. If the fT4 values are less than 10 pmol/l, macrosomic delivery is predicted.

EFFECT: use of the method enables high-accuracy prediction of macrosomic delivery.

2 ex

FIELD: medicine.

SUBSTANCE: multiple urine samples are taken during external exposure on a body for one day. Each sample is examined for the concentrations of thiols and urochrome that is followed by calculation of a thiol-urochrome coefficient (TUC) as a relation of the concentrations of thiols and urochrome. If the TUC value is 1.46±0.2, the body status is stated to be satisfactory. The TUC value more than 1.66 or less than 1.26 enables to state the status beyond the satisfactory limits.

EFFECT: use of the method allows analysing dynamics of the antioxidant body status, response to the external exposure, including to cosmophysical.

3 tbl, 3 ex, 3 dwg

FIELD: medicine.

SUBSTANCE: pH of thrombocyte-poor plasma, and a diagnostic coefficient D is calculated by formula: D=const1xPPP-const2, where D is a diagnostically significant coefficient, PPP is a pH value of thrombocyte-poor plasma of an examined patient, const1=18.877, const2=139.381. If D is less than 0.25, thrombocyte hyperaggregation is stated reliably, and the value of D exceeding 0.25 makes to state reliably the absence of thrombocyte hyperaggregation signs.

EFFECT: use of the declared technique allows high-accurate and sensitive evaluation of thrombocyte hyperaggregation.

3 ex

FIELD: medicine.

SUBSTANCE: invention describes a method for determining antibacterial resistance of a human body in diseases caused by a staphylococcus infection, based on blood neutrophil analysis; functional activity of neutrophilic granulocytes of patient's peripheral blood is determined by chemoluminescence with calculating a bacterial activation index (the BAI-index) of neutrophils representing the relation of an area under a curve of neutrophilic granulocyte chemoluminescence induced by Staphylococcus epidermidis bacteria to an area under a curve of spontaneous neutrophilic granulocyte chemoluminescence, and if the derived value is less than 1.47, a high level of antibacterial resistance is stated, while the derived values 1.47 and more shows a low level of antibacterial body resistance.

EFFECT: method is informative, precise, complies with the modern requirements for laboratory diagnostic techniques and allows predicting a nature, a clinical course period and bacterial complications in the patients of various groups.

1 ex, 2 tbl

FIELD: medicine.

SUBSTANCE: method for prediction of rate of acute infectious diseases in infants with determining the immune status values on the first and fifth postnatal day: absolute lymphocyte count, differentiation marker carriers CD3, CD4, CD8, CD 19, CD56, CD95, a spontaneous nitroblue tetrazolium test value (NBTsp), a level of a phagocytic coefficient (PC), blood serum immunoglobulin A, M, G (IgA, IgM, IgG) concentrations, and further calculating a forecasting index (Ifor) with using a certain equation of multiple linear regression if Ifor does not exceed 3.2, a probability of no more than one acute infectious disease in an infant is concluded; if Ifor is within 3.2-3.7, 2 to 5 probable acute infectious diseases in an infant is stated; if Ifor exceeds 3.7, probability of more than 5 acute infectious diseases in an infant is concluded.

EFFECT: higher prediction accuracy.

2 ex

FIELD: medicine.

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EFFECT: use of the declared method allows higher objectivity of determining severity level of acute pancreatitis.

4 ex, 2 tbl

FIELD: medicine.

SUBSTANCE: method of early solid malignant disease staging (at the stage of provisional clinical diagnosis) by cell number with stable ontogenetic disorders detected in patient's peripheral blood lymphocytes by quantitative and qualitative analysis of stable chromosomal and genomic disorders in metaphase plates from patient's peripheral blood lymphocytes.

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5 ex, 1 tbl

FIELD: medicine.

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2 ex, 1 tbl

FIELD: medicine.

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FIELD: medicine.

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2 ex

FIELD: medicine.

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4 dwg

FIELD: medicine, obstetrics, gynecology.

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EFFECT: higher accuracy of prediction.

3 ex, 1 tbl

FIELD: medicine.

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EFFECT: higher accuracy of detection.

FIELD: medicine, diagnostics.

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EFFECT: increased diagnostic value of obtained results.

3 ex, 1 tbl

FIELD: medicine, laboratory diagnosis.

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EFFECT: improved method for express-diagnosis.

2 tbl, 4 ex

FIELD: medicine.

SUBSTANCE: method involves determining absolute value of ratio between lymphocyte number and absolute value of monocyte number in peripheral blood at the end of combine radiation therapy. The ratio is divided by 4.05. The result value being greater than 1, no disease relapse occurrence is predicted during the first observation year. The value being less than 1, tumor growth progress is stated and carcinoma relapse is predicted at the first year after treatment.

EFFECT: enhanced accuracy in detecting pathological process progress before observing clinical manifestations.

1 tbl

FIELD: medicine.

SUBSTANCE: method involves determining infrared radiation absorption coefficient in blood plasma in bandwidth of 1543-1396 cm-1. The infrared radiation absorption coefficient is determined in %. The value being equal to 29.7±1.1%, catarrhal cholecystitis is diagnosed. The value being 26.4±1.4%, phlegmonous cholecystitis is diagnosed. The value being 21.2±1.8%, gangrenous cholecystitis is diagnosed. The value being equal to 18.6±0.5%, gangrenous perforated cholecystitis case is diagnosed. The value in norm is equal to 32.4±0.8%.

EFFECT: high accuracy and specificity of diagnosis.

FIELD: biomedicine.

SUBSTANCE: the present innovation deals with biomedical measuring technologies, in particular, to those to detect bactericide activity of blood serum according to the level of its inhibiting impact upon luminescence intensity of sulfur-sensitive luminescent bacteria (ΣimpO) against control - luminescence intensity the same sulfur-sensitive luminescent bacteria that had no contact with blood serum (ΣimpK), then one should calculate the value of bactericide activity of blood serum by the following formula:

As sulfur-sensitive luminescent bacteria one should apply either natural or recombinant microorganisms being characterized by direct proportionality between intensity of decreased spontaneous bioluminescence level and degree of bactericide effect. For example, it is possible to apply Escherichia coli strain with genes of Photobacterium leiognathi luminescent system. The suggested method enables to shorten the duration for detecting bactericide activity of blood serum and decrease its labor intensity.

EFFECT: higher efficiency of detection.

1 cl, 1 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: method involves determining blood insulin I and thyroxin T content and phagocytic leukocyte activity (PLA). Activity coefficient is calculated on the basis of formula KA=IxPLA/T. KA value being found greater than 2.8 units, considerable amelioration treatment effect is predicted. The value being from 1.4 to 2.8 units, amelioration is predicted. KA being less than 1.4 units, lower treatment efficiency is predicted.

EFFECT: high reliability of prognosis.