Functional preoperative diagnostic technique in postoperative complications in patients underwent replacing hernia repair for postoperative hernias
SUBSTANCE: invention refers to medicine, specifically surgery and functional diagnostics. The supine heart rate is recorded and represents a baseline test, while the standing heart rate measured is an orthostatic test for 30 sec. The regulatory system activity index (RSAI) is described in points 1 to 10. An increase of this value relates to the deteriorating body adaptive possibilities; the RSAI value of 3-10 points enables predicting the postoperative wound complications.
EFFECT: method enables predicting the postoperative complications following the replacing hernia repair for postoperative hernias.
4 dwg, 3 tbl
The method relates to the field of medicine, namely surgery, can find application in the diagnosis of postoperative wound complications in patients with postoperative hernias. The method can be used in everyday practice abdominal surgery to assess the degree of tension of regulatory systems, prediction of postoperative complications.
There are indirect assessment of the risk of postoperative wound complications: comorbidity, the ratio of re-operations and on the analysis of background conditions (Powergen AV Failures grignetti with plastic polypropylene mesh / AV, Powergen, V.L. Halzov // Herniology. - 2007. No. 2. - S-24.; S.A. Langer Prognosis factors in incisional hernia surgery: 25 years of experience. / C.A. Langer, A. Schaper. T. Liersh [et al.] // Hernia. - 2005. - No. 9 - P.16-21).
Selection of methods of prevention as a rule is carried out empirically, on the basis of averaged data on the quantity and quality complications in some diseases (Timoshin A.D. the Results of surgical treatment of postoperative ventral hernias / A.D. Timoshin, A.L. Shestakov, E.A. Galata // Herniology. - 2007. No. 2. - Pp.33-36).
Approximately also formed recommendations on methods of antibiotic prophylaxis and antimicrobial therapy of complications, without a thorough individual assessment of the health status of the patient and evaluation of adaptation the x capabilities of the regulatory systems of the body (Abdominal surgical infection: clinic, diagnosis, antimicrobial therapy: a Practical guide / edited by V.S. Savelyeva, BYR Gelfand. - M.: Littera, 2006. - 168 C.).
There is a need for reliable mathematically calibrated scale is able to predict the risk of postoperative complications on the basis of preoperative health status of the patient and identifying subclinical flowing pathological processes. Method to assess the adaptive capacity of the organism, there is a long, cardiointervalography was developed in the 60-ies of the last century by a group of Soviet scientists working on space medicine under the supervision of Professor R.M. Baevsky (R.M. Baevsky Problem assessment and prediction of functional organism and its development in space medicine / R.M. Baevsky // Advances in physiological Sciences. - 2006. - V.37. No. 3. - P.42-57).
For half a century of existence, the method has gained worldwide recognition and has been successfully applied in various fields of medicine, it is based on the analysis of HRV. (Wayne A.M. Vegetative disorders. / A. M. Wayne): MIA - 2003. - 400 C.).
The proposed method is developed with the use of a known method of learning rate variability (HRV) (V.M. Mikhailov. "Heart rate variability: the experience of practical application of the method", 2002, p.4. http://www.neurosoft.ru/rus/product/book/hrv-2/chapter4.aspx).
Meth is on HRV is the registration parameters sinus cardiac rhythm of the patient, in particular, before and after the performance of various functional tests, such as orthostatic, test with deep controlled breathing, isometric load test, sample the exercise (Bicycle ergometry) and other Sinus node of the heart, as a special unit of the regulation of physiological processes with the universal form of constant response in normal operation makes sure that the particular situation of the values of the heart rhythm. The concept of "the value of rhythm" includes not only the heart rate, the duration of the intervals R-R, but their sequence (R.M. Baevsky Problem assessment and prediction of functional organism and its development in space medicine / R.M. Baevsky // Advances in physiological Sciences. - 2006. - V.37. No. 3. - P.42-57).
Heart rate is an indicator of deviations arising in the regulatory systems of the body, so the study of HRV has important diagnostic value. Since there is practically no such functional States or diseases that would not participated mechanisms of autonomic regulation, the scope of application of the method of HRV analysis is very high. This is due to the fact that the method is relatively simple, relatively cheap, affordable, non-invasive method for assessment of autonomic regulation.
Method HRV is used in the diagnosis when blood hyperten the AI, ischemic heart disease, diabetic autonomic neuropathy (Analysis of heart rate variability using different electrocardiographic systems / R.M. Baevsky, Ivanov I.I., Characin L.V., Havrilesky A.P., dovgalevskii PA, Kukushkin Y.A., Mironov TF, Prilutsky D.A., Semenov A.V., Fedorov V.F., Fleishman A.N., Medvedev M. //Bulletin of Arrhythmology, No. 24, 02.03.2002, p.65; V.M. Mikhailov "heart rate Variability: the experience of practical application of the method", 2002).
But still this method is not practically found its application in surgery (Piksin I.N. Neural network prediction of early postoperative complications in abdominal surgery. / I.N. Piksin, A.A. Solomakha. Bulletin of the Mordovian state University. N.P. Ogarev. - 1997. No. 2-3. - S.112-115.).
The purpose of the proposed method is preoperative diagnosis of occurrence of postoperative complications in patients after protesilaus hernioplasty about incisional hernias by measuring the activity of regulatory systems vegetation.
The objective is achieved by recording the cardiointervalography in the supine position (background sample) and in standing position (orthostatic test) for 300 sec, estimated the rate of activity of regulatory systems (PARS) in points from 1 to 10, increase the top is the number corresponds to the deterioration of the adaptive capabilities of the organism, and when you get the value of PASR 3-10 points predict getting wound complications in the postoperative period.
If indicated PARS corresponding to greater than or equal to 3-10 points apply individualised tactics of patients (the choice of antibiotic prophylaxis leukocyte implant, the choice of alloplasty, drainage of the abdominal wall).
(Kuznetsov A.V. Antibacterial activity in vitro prepared leucogastra in vitro/ A.V. Kuznetsov, S. p. Belogortseva, Y. Kuznetsov // international conference "Fundamental problems of lymphology and cell biology, Novosibirsk, October 28-29, 2008 - S-210.
Kuznetsov in Vitro antibiotic-immunotherapy as prevention of infection in the area of surgical intervention when using polypropylene mesh prosthesis in patients with postoperative ventral hernias/ Y. Kuznetsov, BS Dobryakov, E.N. Fedin, A.V. Kuznetsov // Herniology. - 2008. - №3(19). - P.24-25.
Kuznetsov A.V. the Possibility of using leukocyte implant in herniology /A.V. Kuznetsov, S.N. Belogortseva, Y. Kuznetsov. GV Seledtsov //Vestnik of the Irkutsk state University. Series: Biology, clinical medicine - 2009. - volume 7. - Issue 3. - S-106.
Kuznetsov A.V. the Management of patients with siromani after grignetti in the early postoperative lane is ode /AV Kuznetsov, V. Shestakov, B.A. Alekseev// Bulletin of the East-Siberian scientific center of the Siberian branch of the Russian Academy of Sciences, 2011, No. 1, part 2, P.75-80.
Kuznetsov A.V. the Management of patients with seromas after protesilaus hernioplasty "INLAY"/ AV Kuznetsov// Vestnik ngu. Series: Biology, clinical medicine 2011, volume 9, edition 3. - P.1 72-177.
Kuznetsov A.V. choose how alloplasty when the hernia defects of the big sizes/ Y. Kuznetsov // Vestnik ngu. Series: Biology, clinical medicine 2011. - Volume 9. Edition 2. - S-191.
Kuznetsov A.V. a New method of intraoperative antibiotic prophylaxis in herniology/ A.V. Kuznetsov, YU Bravve, BS Dobryakov, B.V. Alexeev, V. Shestakov, S. Belogortseva, Y. Kuznetsov
// Questions of pathogenesis of typical pathological processes (Proceedings of 111 all-Russian scientific-practical conference with international participation, Novosibirsk 2011. - P.143-145.
Kuznetsov A.V. Peculiarities of the early postoperative period when Greenacre with different position of the mesh prosthesis/ A.V. Kuznetsov, Y. Kuznetsov, BS Dobryakov, B.V. Alexeev, VST, ALEXANDER Borodach, E.N. Fedin // Bulletin of experimental and clinical surgery 2011, vol IV, No. 1. - P.17-20.
Kuznetsov A.V. assessment of the feasibility of vacuum drainage when protesilaus head sublay" in the treatment of incisional hernias / A.V. Kuznetsov, FL. Bravve, BS Dobryakov, ALEXANDER Borodach, V. Shestakov, B.V. Alexeev, E. Fedin // Science, education, medicine: proceedings of the annual all-Russian scientific-practical conference (2011; Samara). All-Russian scientific-practical conference "Science, education, medicine" Samara: the media "REAVES". - 2011. - S-339.
Kuznetsov A.V. Course the early postoperative period after protesilaus allogenically at different positions of the mesh prosthesis/ A.V. Kuznetsov, YU Bravve, BS Dobryakov, V. Shestakov, A.V. Beaver, B.V. Alexeev, Y. Kuznetsov // Topical issues of urgent and reconstructive surgery (Collection of scientific and practical work, in proc. The 80th anniversary of M.I. Hulman. Krasnoyarsk) - S-205.
Kuznetsov A.V. Preclinical study of leukocyte implant for antibiotic prophylaxis in herniology / A.V. Kuznetsov, BS Dobryakov, V. Shestakov // Vestnik ngu. Series: Biology, clinical medicine 2012, volume 10, issue 1, S-171).
The day before the operation record electrical potentials of the heart rate at rest (lying on the back for 300 seconds), and in translation in a vertical position (orthostatic test standing within 300). Next, a hardware way to analyze the duration of RR-intervals from a prior electrocardiogram both samples. Then create serial number of one hundred and digital Kodo is, the corresponding values of the measured durations of RR-intervals, and subjected to his mathematical analysis, including statistical, pictographically, correlation and spectral processing. Based on the results of the mathematical analysis form codes in the points corresponding to five indicators: the total effect of regulation, functions, automatic, autonomic homeostasis, stability, regulation and activity of subcortical nerve centers. For General characteristics of the activity index of regulatory systems (PARS), combining the scores of these indicators form a code corresponding to the integral indicator of the activity of regulatory systems, the value of which is determined in conventional points from 1 to 10.
PARS allows to differentiate various degrees of tension of regulatory systems and to assess the adaptive capacity of the organism (R.M. Baevsky, 1979, 1984).
Criteria taken into account when calculating PARS:
A. the Cumulative effect of regulation on indices of heart rate (PE).
B. the Total activity of regulatory mechanisms at the average quadratic deviation - SD (or total power of the spectrum - TR).
C. Autonomic balance using a range of indicators: In, RMSSD, HF, IC.
Was the activity of the vasomotor center regulates vascular tone, the power spectrum of the slow waves 1 to adca (LF).
D. the Activity of the cardio-vascular subcortical nervous centre or newsegments levels of regulation of the power spectrum of the slow waves of the 2nd order (VLF).
Values PARS are expressed in points from 1 to 10. Based on the analysis of values PARS can be diagnosed following functional state:
Norm (PARS=1-2)Sostoyanie optimal (working) tension of regulatory systems necessary to maintain an active balance of the organism with the environment.
The state of tension of regulatory systems (PARS=3-4), when for adaptation to environmental conditions, the body requires additional functional reserves. Such conditions arise in the process of adaptation to work, emotional stress or exposure to adverse environmental factors.
State overvoltage (PARS=5-6). regulatory systems, which is associated with the active mobilization of protective mechanisms, including increased activity of the sympathetic-adrenal system and the pituitary-adrenal axis.
State depletion (PARS=7-8) or overvoltage regulatory systems, for which characterize failure 'protective-adaptive mechanisms, their inability to provide adequate reaction of the organism to the influence of environmental factors. Here excessive activation of regulatory item already not supported by functional reserves, there are characteristic signs of pathology. Specific changes clearly prevail over non-specific.
Adaptation failure (PARS=9-10). or the state of Paloma" adaptive mechanisms, when dominated by specificheskie pathological deviations and the ability of adaptive mechanisms for self-regulation partially or completely broken.
Prospective surveyed 200 patients, aged 35-55 years (87 men, 113 women), without severe concomitant pathology and diseases of the nervous system received in the surgical Department routinely operated on for median postoperative hernias MW3-4R0-2 SWR classification (Chevrel I.P., Rath A.M. Classification ofincisional hernias of the abdominal-wall // Ibid. 2000. - Vol.4. Nol. - P.1-7) method of implantation of polypropylene mesh prosthesis.
Using a computer apparatus for the study of heart rate variability ("Neurosoft", Russia) to conduct all transactions account in the supine position (background sample) and standing (orthostatic test) within 300 C. Analysis was performed using the standard program "Polyspectra" (LLC "Neurosoft", Russia). Hardware method was evaluated indicators of activity of regulatory systems (PARS) method R.M. Baevsky. The results of this indicator were grouped (table 1).
|A breakdown by groups according to the value of PARS before surgery|
|Group by value PARS||The number of patients|
|(1-2 points) - group # 1||49|
|Voltage (3-4 points) - group # 2||63|
|Overvoltage (5-6 points) - group # 3||46|
|Depletion (7-8 points) - group # 4||25|
|Adaptation failure (9-below) - group # 5||17|
The results are shown as median values, indicating the standard deviation. Statistical processing was performed using a criterion of Mann-Whitney for non-parametric distribution.
Out of 200 patients operated on with a diagnosis of postoperative ventral hernia, we observed 22 cases of infection in the area of surgical intervention (iahv). Also identified 20 cases of wound complications, which were not sown any microflora and directly relate them to iohw not, but the elimination of these effects exceeded 30 days, which is always accompanied by a secondary with the eat, and we included them in the research group.
|The resulting complications in the groups with different value PARS|
|Complication||Group 1||Group 2||Group 3||Group 4||Group 5|
|Infiltration of scar||-||-||1||1||2|
|Marginal skin necrosis||-||-||2||2||-|
|Total (% of all patients)||2(1%)||5(2,5%)||10(5%)||12(6%)||13(6,5%)|
|% of complications in the group||4,1%||7,9%||21,7%||48%||76,5%|
The largest number of patients (112 patients 56%) before surgery were in the normal or subnormal (voltage) condition adaptive capabilities of the organism. For this category of patients accounted for only 3.5% of cases of wound complications.
The remaining 96.5% of cases, complications occurred in the patients with established dysfunction of varying severity - stress, exhaustion, adaptation failure.
Revealed a clear increase in the total number of complications is directly proportional to the deterioration of hell the operating capabilities of the regulatory systems of the organism of the patient according to PARS. According to a number of complications in a particular group, the difference between the group with normal values PARS (4.1%) and the breakdown of adaptation (76,5%) is to 72.4%.
When apparent homogeneity and integrity of the health status of patients based on the standard scheme pre-operative examination (General blood and urine tests, standard General clinical research), using kardiointervalografii can not be detected clinically differentiable different state of the adaptive abilities of the patient, giving a clear correlation with the frequency of potential wound complications in the postoperative period. The resulting study the adaptive capacities of the regulatory systems of the organism data allow to predict the occurrence of postoperative complications and accordingly to determine individualized tactics of the patient to choose the tactics of preoperative preparation, tactics operations (antibiotic prophylaxis, the choice of plastic, drainage etc) and treatment in the early postoperative period.
Thus, on the basis of obtained data we can conclude about the influence of pre-operative condition of the autonomic nervous system of the patient at risk of developing postoperative complications. The study data PARS before surgery allows siragetdinova the incidence is complicated by the rd after the operation.
An example implementation of the method
Patient N. 46 years old was admitted to the hospital 03.01.10 was diagnosed with
postoperative ventral hernia MW3R0 (Chavrel 1999).
Assessment ramagrama and type of regulation sinus rhythm:
Sample: Ortostatichecka test
The recording of heart rhythm 5 min (300 sec). Registered complexes ORS: 582.
The current functional state very poor (-10).
Adaptive reserves of the body is significantly reduced (9).
The final result PARS - 9 (computer issues).
Figure 1 is generated by the computer visual final result values PARS.
The position of the patient during recording: lying. The recording of heart rhythm 5 min (300 sec). Registered QRS complexes: 629.
The rhythm. Average heart rate: 126 beats./min - acceleration of heart rate (tachycardia).
Figure 2 is generated by the computer, the visual result of ramagrama.
Figure 3 is generated by the computer, a visual result of the spectrogram.
|Table of figures temporal spectral analysis|
|Performance analysis over time||Indicators of spectralanalysis|
|R-R min, MS||461||TR, MC^2||133|
|R-R max, MS||492||VLF, MC^2||117|
|RRNN, MS||476||LF, MC^2||15|
|SDNN, MS||8||HF, MC^2||0,58|
|RMSSD, MS||2||LF norm, n.u.||96,3|
|pNN50, %||0||HF norm, n.u.||to 3.73|
|The structure of the spectrum|
Figure 4 - summary chart visualization ratios of LF and HF.
Medico-physiological interpretation of HRV indices
Assessment ramagrama and type of regulation sinus rhythm
Rhythmogram of HRV corresponds to the 3rd class. This option ramagrama and structure of heart rate variability indicate pathological stabilization modulation of heart rhythm with the transition of its regulation with reflex, autonomic management level at lower - humoral - metabolic, who are not able to quickly provide homeostasis.
Evaluation of the spectrogram and indicators spectral analysis
Total spectral power neurohumoral modulation drastically reduced.
The state of neurohumoral regulation is characterized by a low level of vagal, sympathetic and humoral-metabolic (cerebr is selected ergotropic) effects in the modulation of heart rate. The balance of the nervous system characterized by the predominance of the activity of the sympathetic division of the autonomic nervous system. Cardiorespiratory synchronization is maintained. The current functional state drastically reduced (-10). Adaptation reserves of regulatory systems 9 points.
Conclusion: the likelihood of wound complications 75%. It is necessary to conduct antibiotic prophylaxis, preoperative preparation. Intraoperatively, you must use a deep ways protesilaus hernioplasty ("sublay" or "underlay"). Without drainage maintenance operative wound. Dynamic observation of the wound after the operation.
Way functional preoperative diagnosis postoperative complications in patients after protesilaus hernioplasty about incisional hernias, including registration cardiotocogram and the measurement of heart rate variability, characterized in that the recording kardiointervalogrammy in the supine position - background sample - and standing - orthostatic test - for 300 s, estimated the rate of activity of regulatory systems (PARS) in points from 1 to 10, increase this number corresponds to the deterioration of adaptive capacity and receiving values PARS 3-10 points predict receipt of wound complications in the postoperative period.
SUBSTANCE: invention relates to medicine, particularly endocrinology and diabetology. There are involved examining heart rate variability (HRV) followed by spectroscopic analysis and functional testing. Those are added with determining non-linear values: deterrent fluctuation analysis (DFA) and approximated entropy (ApEn). If observing the initial amplitude decay of the HRV spectral components - VLF less than 30 points, LF less than 15 points, HF less than 15 points, DFA more than 0.7, ApEn less than 180, lack of functional response - autonomic cardiac sympathovagal neuropathy is diagnosed. If observing the normal amplitude of the HRV spectral component -VLF more than 30 points, low LF values less than 15 points, HF less than 15 points, DFA more than 0.7, ApEn less than 180, lack of functional response LF, HF - autonomic cardiac vagal neuropathy is diagnosed. If observing the initially normal amplitudes of the HRV spectral component -VLF more than 30 points, LF more than 15 points, HF more than 15 points, DFA more than 0.7, ApEn more than 180, lack of functional response LF, HF - autonomic cardiac subclinical neuropathy is diagnosed.
EFFECT: method enables early diagnosing and typing of autonomic cardiac neuropathy for the purpose of specifying a therapeutic approach.
3 tbl, 3 ex
SUBSTANCE: invention relates to medicine, namely to neurology, therapy, family medicine, and can be used for selection of tactics for treatment of tension headache. For this purpose level of peripheral heart vegetative balance is determined in patient by analysis of index of sympathetic-parasympathetic relationship (LF/HF) in spectral analysis of cardiac rhythm. If LF/HF index increases higher than 2.0 conv. units, psychotropic drugs are introduced into therapy for relief of anxiety and/or depression.
EFFECT: method ensures possibility to stratify patients, requiring introduction of psychotropic drugs, thus making it possible to optimise treatment and increase its efficiency due to account of individual peculiarities of heart vegetative balance.
3 tbl, 2 ex
SUBSTANCE: invention relates to field of medicine, namely to neurology and hepatology. Multi-level neurodynamic analysis of cardiorhythmograms is registered and realised by means of rhythmocardiograph and hardware and software complex "Omega-C". Determined are indices, reflecting: "A" - association of all, but mainly peripheral rhythmic processes, "B1" - degree of equilibration of sympathetic and parasympathetic effects on sinus node of heart, "C1" - state of central subcortical regulation, "D1" - state of central cortical regulation. Diagnostics index (YHE-L) is calculated in patients with chronic liver diseases by formula: YHE-L= -1.5 + 0.003*A + 0.013*B1 + 0.006*C1 + 0.053*D1. If YHE-L value is from -0.47 to 0.49, hepatic encephalopathy of latent stage in patients with chronic liver diseases is determined.
EFFECT: method makes it possible to increase reliability of diagnostics of hepatic encephalopathy of latent stage.
8 tbl, 2 ex
SUBSTANCE: invention refers to occupational medicine. Individual state and performance values are estimated by four-score scale. Zero points if no symptoms observed, 1 point - the symptom is slightly manifested, 2 - moderately, 3 - significantly. A fatigue index (FI) is calculated as an arithmetic mean value. Electrocardiography is recorded to estimate cardiac rhythm variability, to calculate Am, Si, LF, heart rate. A modification coefficient (M) is calculated for each value by formula: wherein Ai is a value of one of the following signs, Amax and Amin are change ranges; : Am min 3.5, Am max - 98; Si min - 2, Si max - 950; LF min - 5, LF max - 90; heart rate min - 40, heart rate max -120; a vegetative regulation index (VRI) is calculated by formula: If the FI value is 0.6 points or less, and the VRI value is 10 or less, the state is considered to be optimal; the FI value 0.6 points or less and the VRI value more than 10 show the borderline state; the FI value more than 0.6 points and the VRI value is 10 or less means the satisfactory state; while the FI value exceeding 0.6 points and the VRI value exceeding 10 providing stating defatigation.
EFFECT: method extends the range of products for detecting defatigation in operators.
7 tbl, 2 ex
SUBSTANCE: invention refers to medicine, namely cardiology, normal physiotherapy, pathological physiotherapy. A daily curve of blood pressure is recorded. It is followed by spectral analysis by the method of continuous wavelet transformation. A frequency power of the blood pressure curve a is determined in the moment b by mathematical formula. Scalograms are drawn on the basis of the wavelet coefficient on the segment [bj, bj] by mathematical formula. Physiologically relevant frequency ranges are selected at the scalograms on the basis of distances between adjacent local minimums on the scalogram curve by formula.
EFFECT: method provides weak influence of vegetative nervous system and humoral effects on the blood pressure curve at the various stages of ontogenesis, in health and disease, both in rest, and in transition processes.
1 ex, 2 dwg
SUBSTANCE: invention refers to rehabilitation and preventive medicine, cardiology, therapy. It involves drug-induced therapy and a course of cardiorespiratory training with biological feedback (BF) presenting a cardiorhythmography (CRG) and a reference cyclic curve (RCC) to the patient to be matched under continuous visual control. It is followed by active (BF-assisted) and non-active (BF-unassisted) 2-minute tests with the first and last test of each session are non-active (NT). The first NT involves recording reference data of patient's cardiorespiratory system with evaluating the parameters as follows: RCC amplitude, period and continuous component matched with average heart rate on the following active test (AT). The test are automatic, individual for the patient as for the moment of testing with the use of an apparatus for functional psychophysiological correction comprising units described in the patent claim. Each following AT requires forming RCC with the use of average heart rate, amplitude and period on the basis of spectral analysis of CRG and CC of the previous AT. In the beginning of the procedure, the patient is set up to successful completion of the task, 5 s after the beginning of each AT, an audio signal (1 kHz, 300 ms, 30 dB above a threshold of audibility) is supplied. Before the beginning of the course and after each session and the whole course, the patient is tested to determine a level of reactive and personal anxiety and depression by stating the required number of sessions for recovery of cardiorespiratory synchronisation and normal heart rate and blood pressure. Before the first NT and after each AT, capnometry is used to determine the concentration of CO2 in expired air. If observing decrease, respiratory depth is corrected. If maintaining CO2 in expired air after each following AT less than 95% from reference, respiratory depth is corrected during the following AT under control of capnometry to achieve the concentration of not less than 95% from reference. The therapeutic course includes at least 5 sessions, 1 session daily or every second day to recover the respiratory pattern lost due to the disease and the biorhythmological structure of heart rate.
EFFECT: method eliminates subjectivity of the respiratory parameters specified by a searcher, and hyperventilation syndrome due to objective control of respiratory depth with improved heart rate variability.
1 ex, 3 tbl, 3 dwg
SUBSTANCE: group of inventions relates to medicine and medical equipment, namely, to systems of image obtaining, in particular, to computed tomography. In first version of implementation system of image obtaining contains component of window management, which receives ECG signal, which contains premature cardiac cycle and preliminarily obtained X-ray projection data of beating heart. ECGF signal is synchronised with the time of preliminarily obtained X-ray projection data of beating heart. Component of window management places first reconstruction window within the limits of the first cardiac cycle to correspond desirable cardiac phase of preliminarily obtained X-ray projection data, when premature cardiac cycle ensures correspondence of the first reconstruction window to another cardiac phase. Such system contains device of reconstruction which reconstructs projection data, corresponding to multitude of windows of reconstruction of different cardiac cycles to create image data, characteristic of desirable heart phase. In second version of implementation system contains component of window management which deletes first reconstruction window corresponding to suboptimal cardiac phase of preliminarily obtained X-ray projection data of beating heart resulting from abnormal signal in ECG signal. ECG signal is presented in time with preliminarily obtained X-ray projection data of beating heart on multitude of heart cycles, and component of window management adds replacing reconstruction window to optimise set of data for reconstruction, basing on abnormal signal and available preliminarily obtained projection. System also contains reconstruction device which reconstructs set of data for reconstruction in order to create image data characteristic of desirable phase of heart beating. In third version of implementation system contains recommendation component which recommends reconstruction window for cardiac phase within the multitude of preliminarily obtained successive cardiac cycles based on ECG signal and arrhythmia in it, and device of reconstruction, which reconstruct data corresponding to data for each cycle, corresponding to reconstruction window. ECG signal is obtained with simultaneous scanning of beating heart by of computed tomographic scanner. In fourth version of implementation system contains component of window management which automatically changes location or moves first window of reconstruction for cardiac cycle on the basis of premature cardiac cycle within ECG, which is signal synchronised with preliminarily obtained X-ray projection data of beating heart; recommendation component which automatically recommends, at least, one additional reconstruction window, on the basis of premature cardiac cycle; and reconstruction device which reconstructs data, corresponding to reconstruction windows. In order to obtain image received is ECG signal which contains premature cardiac cycle, ECG signal is synchronised in time with preliminarily obtained X-ray projection data of beating heart by multitude of cycles of heart beating. After that, first reconstruction window is moved within the limits of first cardiac cycle, which corresponds to data, different from desirable cardiac phase as a result of premature cardiac cycle. Each from multitude of cardiac cycles contains reconstruction window. Then preliminarily obtained projection data, corresponding to multitude of reconstruction windows, are reconstructed to create image data, characteristic of desirable phase of heart beating. Group of inventions also contains computer-readable data carrier, which stores commands, which, when performed by computer, make computer perform claimed method of image obtaining.
EFFECT: application of claimed group of inventions will make it possible to increase quality of resulting data of reconstructed image.
34 cl, 10 dwg
SUBSTANCE: invention relates to medicine, namely to pediatrics. In children of pre-school age with tuberculosis of intrathotacic lymph nodes indices of heart rhythm variability are determined: rhythmograms - interinterval differences RMSSD (ms), coefficient of variability CV (%), spectrograms - total spectrum power TR (ms2), very low frequency waves of spectrum VLF (ms2), low frequency waves of spectrum LF (ms2), high frequency waves of spectrum HF (ms2). If their values equal: interinterval differences RMSSD - 76.8±3.92, coefficient of variability CV - 9.9±0.50, total spectrum power TR - 3437±175.3, very low frequency waves of spectrum VLF - 1067±54.4, low frequency waves of spectrum LF - 1003±51.2, high frequency waves of spectrum HF - 1900.2±96,9 vegetative dysfunction is diagnosed.
EFFECT: method increases reliability of diagnostics of impairment of vegetative regulation in children with tuberculosis.
1 tbl, 1 ex
SUBSTANCE: invention relates to medicine, namely to pediatrics. Parameters of cardiorhythmogram (CRG) are registered in lying position: at rest - heart rate, SDNN index; tension index (TI); total spectrum power - Total; value of power in range VLF; value of power in range LF; value of power in range HF. After that in standing position reactivity of sympathetic nervous system is determined by Lf/HF index. In five minutes in lying position recovery of initial heart rate, total spectrum power - Total, increase or reduction of initial power in range of waves: VLF, LF, HF are determined. On the basis of CRG indices, it is estimated which type of cardiac rhythm regulation level prevails: reflex or humoral-metabolic; vegetative balance of sympathetic and parasympathetic impact on cardiac rhythm; reactivity of sympathetic nervous system to functional load: adequate or inadequate. Favourable adaptation is predicted if reflex type of cardiac rhythm regulation prevails over humoral-metabolic, at rest balance of sympathetic and parasympathetic impact on cardiac rhythm is determined, under functional load adequate reactivity of sympathetic nervous system is observed. Unfavourable prediction of adaptation is made if reflex type of cardiac rhythm regulation prevails, but at rest sympathetic or parasympathetic impact on cardiac rhythm is observed, under functional load adequate or increased reactivity of sympathetic nervous system is observed. Unfavourable prediction is made if humoral-metabolic type of level of cardiac rhythm regulation prevails, at rest sympathetic impact on cardiac rhythm prevails and under functional load - inadequate: increased or reduced reactivity of sympathetic nervous system is observed.
EFFECT: method makes it possible to increase reliability of prediction of children's adaptation school.
4 tbl, 3 ex
SUBSTANCE: invention refers to medicine, pulmonology and perinatology. A pregnant woman suffering bronchial asthma of slight severity, in an attack-free period is examined for the functional state of the vegetative nervous system by cardiorhythmography. Detecting a prevailing effect of the sympathetic nervous system by regional lung rheography technique is used to determine a degree of involvement (%) of a medium region of a left lung in air fill (DOmrll%) and a pulse wave propagation time between the heart and the medium region of the left lung (gamrll). It is followed by a discriminant equation: D=-0.054×DOmrll%-11.781×gamrll. If the value D is equal to or more than -2.55, a baby in a in satisfactory condition is expected to be born, while D being less than -2.55, a baby in asphyxia is predicted.
EFFECT: method provides higher prediction reliability.
FIELD: medicine, cardiology.
SUBSTANCE: one should register rhythmocardiogram, measure current total power in low-frequency and high-frequency areas of dynamic row of cardiointervals. Evaluation of psychophysiological state should be performed by the value of stress index S calculated due to original mathematical formula by taking into account the power of low-frequency and high-frequency constituents of the range of dynamic row of cardiointervals. In case of standard conditions of measurement - the rest lying at one's back position the value of S stress index should be considered to be equal to 1. The method enables to rapidly and noninvasively detect and range human psychophysiological state.
EFFECT: higher accuracy of evaluation.
2 dwg, 1 ex, 2 tbl
SUBSTANCE: method involves estimating vegetative tonus using cardiointervalography approach and its medication adjustment under cardiointervalography control. The cardiointervalography examination is carried out before applying treatment, in the course of and after the treatment. Each time vegetative tonus increment is estimated on the basis of voltage index. When applying medication adjustment, nootrop group preparations are used that are selected before applying treatment with initial vegetative tonus disorder distinguished by vagotonia or sympathicotonia being taken into account. Preparation or combination of preparations or their doses and application duration is adjusted on basis of vegetative status direction changes obtained from cardiointervalography examination data. The treatment is continued until vegetative status direction change stops towards normotonia.
EFFECT: enhanced effectiveness in selecting individual treatment course.
3 cl, 3 dwg
SUBSTANCE: method involves recording rhythmocardiogram. Then, spectral analysis of RR intervalogram components in frequency bandwidth from 0.04 to 0.4 Hz is carried out and information value Z is determined from formula Z=Ahf/Alf, where Ahf is the maximum of high frequency component in bandwidth from 0.14 to 0.4 Hz, Alf is the minimum of high frequency component in bandwidth from 0.04 to 0.14 Hz. Z value being greater than 45 and lower than 14, persons consuming narcotic drugs are detected. Z value being lower than 14, persons consuming sedative drugs like opium, morphine, heroine are detected. Z value being greater than 45, persons consuming psychostimulating drugs like cocaine, amphetamine, efedrone, sydnocarb are detected.
EFFECT: high reliability of screening study data.
4 cl, 6 dwg
FIELD: medicine, diagnostics.
SUBSTANCE: the method deals with monitoring the difference in signals obtained from N pickup units, where N ≥ 2, ECG, pulse, temperature and analysis of the range and variability of their rhythms, nonlinear chaotic fluctuations during the period of registration. During analysis one should detect the values for fractal dimensions of Hirst's index and informational Fischer's index standardized, correspondingly, by the average value during either nocturnal or diurnal period. One should conclude upon improved body state by the normalization of signals' difference of peridiurnal rhythm, increased fractal dimensions, Hirst's index, decreased standardized informational Fischer's index, and one should conclude upon worse physiological or pathophysiological processes according to the opposite alterations. The method enables to widen functional possibilities during diagnostics.
EFFECT: higher accuracy of diagnostics.
3 dwg, 6 ex
FIELD: medicine; cardiology.
SUBSTANCE: electrocardiogram of patients with arterial hypertension is subject to twenty-four-hours monitoring. Spectral analysis of variability of heart beating is conducted and low-frequency, very low frequency and high frequency wave components of heart beating are selected. Strength of wave components of heart beating is determined as general, day and night ones. Generalized factor W is calculated by original relation. Value of W is used for diagnosing absence or presence of hormone-active hyper-plastic process of adrenal glands.
EFFECT: screening testing at out-patient conditions.
2 ex, 2 tbl
FIELD: medicine; cardiology.
SUBSTANCE: electrocardiogram of patients suffering from arterial hypertension is subject to twenty-four-hours monitoring. Spectral analysis of variability of heart beating is carried out. Very low frequency, low frequency and high frequency wave components are selected. General, day and night strength of wave components of heart beating is determined. Any factor is estimated according to the data taken from the spreadsheet. Generalized factor Z is calculated by original mathematical relation. Value of Z is used for judging on level of influence of hormones of adrenal gland onto pace-maker activity of sinus node.
EFFECT: comfort at usage; higher efficiency at non-invasive application.
2 ex, 2 tbl
FIELD: medicine; functional medicine.
SUBSTANCE: method in based upon remote irradiation of human body with set of super wide-band electromagnet pulses with duration of 0,2-1,0 ns, repetition rate of 0,05-30,0 MHZ and average density of flow of energy at irradiated part of human body being equal or less than 0,2 mcW/cm2. Modulation component of pulse repetition rate is selected from received reflected signal which pulse repetition rate is determined by heart activity, which is used for forming heart beat rate signal. The latter is used additionally for estimating index of stress which value of index of stress is included into transmitted communication message of mobile phone.
EFFECT: prolonged monitoring of functional condition of human.
3 cl, 2 dwg
FIELD: medicine, cardiology.
SUBSTANCE: one should register a rhythmocardiogram, detect spectral values for variability of cardiac rhythm, calculate the value of autonomic index, calculate the value of autonomic tonicity by the following formula: AI/lnTp m sq. sec., where AI - autonomic index, lnTp - total power for the spectrum of variability of cardiac rhythm. At values above 3.1 one should diagnose severe flow of autonomic dystonia syndrome, at values being 3.1-2.2 - moderate flow of the mentioned disease, at values ranged 2.1-1.5 - light flow. The method enables to predict the development of hemodynamic disorders.
EFFECT: higher efficiency and accuracy of diagnostics.
FIELD: medicine; cardiology.
SUBSTANCE: device for processing intervals of electrocardiogram has plate with Q-T (J-T) and R-R scales applied onto the plate. Plate is additionally provided with legs, rod and scale pointer at the end, arrows, and catches disposed at ends of Q-T (J-T) scale, Q-Tc (J-Tc) correlated values curves and Q-Tc (J-Tc) scale related to them. Rod is divided by axis to parts to relate as 1:5 in such a way that shorter part of rod has to be movable leg and longer part has to be the pointer of Q-T (J-T) scale. Pointer takes "0" position of Q-T (J-) scale to rest against left catch when legs close up. Motionless arrow is disposed onto longer part of rod under pointer of Q-T and/or J-T scale at level of "0" position of R-R scale. Slider with lock is mounted onto pointer to move along pointer. Slider is provided with two arrows. Formulas for building curves of Q-Tc (J-Tc) corrected values are given.
EFFECT: higher speed and comfort at processing of electrocardiograms.
3 cl, 8 dwg, 1 tbl
FIELD: medicine, electrocardiography.
SUBSTANCE: the present innovation deals with measuring parameters of electrocardiosignal (ECS) ST-segment and their analysis to detect deviations against the norm. At every step of quantization one should form the readings of first-order differences and modules of first-order differences. One should memorize N of readings for the modules of first-order differences coming after ECS readings that correspond to the onset of cardiocycle. Then it is necessary to sum up memorized values of modules and at every step of quantization one should compare the obtained current sum value with previous one. It is necessary to memorize the greater of them and according to maximal value one should form threshold level to compare current value of modules sum. Time moments when sum value is at first greater and then lower against threshold level one should consider to be, correspondingly the onset and the end of ST-segment. Time segment between the onset and the end of ST-segment should be considered as duration of ECS ST-signal. Device to isolate ECS ST-signal on-line contains a block for forming ECS, a block for primary ECS processing, a quantization block, a block for isolating the point of cardiocycle onset and measurement of its duration, a block to form first-order differences, a block to form modules of first-order differences, a block to memorize readings for the modules of first-order differences, a block to detect the number of summarized readings for the modules of first-order differences, a summarizing block, a block to form a threshold level, a block for comparison and a key device. The innovation enables to isolate ST-segment more reliably for wider class of electrocardiograms at different modifications of QRS-complex form.
EFFECT: higher efficiency.
2 cl, 12 dwg