Method for needle position checking in posterior epidural space in epidural block
SUBSTANCE: invention refers to medicine, particularly to methods for radiation visualisation of a needle position in the epidural space accompanying epidural blocks, as well as for epidural anaesthesia. The needle assisted by ultrasonic scanning is inserted from a paravertebral oblique approach. A mark is a dura mater advance from a needle tip and an expansion of the posterior epidural space when introducing the prepared solution therein.
EFFECT: method enables the accurate diagnosis of the needle position in the epidural space using the generally available ultrasonic navigation technique with no radiation-absorbed dose.
4 dwg, 3 ex
The invention relates to medicine, in particular to a method of radiation imaging position of the needle in the epidural space when performing epidural analgesia, and epidural anesthesia.
Epidural injection of anesthetics at the lumbar level known since 1901. In addition to purely anesthetic problems, epidural blockade is one of the most effective ways of relieving pain with herniated intervertebral discs. (R.K. Sharma: Indications, technique and results of caudal epidural injection for lumbar disc retropulsion. Postgraduate Medical Journal (January 1977) 53, 1-6.)
However, many authors have noted that the herniated disc may provoke inflammation around him, thereby leading to the development of irritation of the spine and help maintain back pain. Thus, it is logical epidural injection of corticosteroids. (J.W. Lee, H.I. Shin, S.Y. Park, G.Y. Lee, H.S. Kang: Therapeutic Trial of Fluoroscopic Interlaminar Epidural Steroid Injection for Axial Low Back Pain: Effectiveness and Outcome Predictors. AJNR Am J Neuroradiol 31:1817-23 (Nov-Dec 2010)), the blockade as the Sacro-epidural and epidural traditionally performed blindly, i.e. without the use of radiological methods for monitoring the progress of the Toolkit. But when the variability of the thickness of the epidural space often is the puncture of the Dura. Literature data indicate that a significant number (up to 25-30%) so the x situations, as the correct position of the needle in the epidural blockade even in the hands of experienced physicians. A well-studied potential complications after subarachnoid injection of glucocorticosteroids is the development of arachnoiditis. (Blake A. Johnson, Kurt P. Schellhas, and Steven R. Pollei: Epidurography and Therapeutic Epidural Injections: Technical Considerations and Experience with 5334 Cases. AJNR Am J Neuroradiol 20:697-705, April 1999.)
Currently, to solve these problems is used fluoroscopically or CT control for this procedure. (el-Khoury GY, Ehara S, Weinstein JN, et al: Epidural steroid injection: a procedure ideally performed with fluoroscopic control. Radiology 1988; 168:554-557.)
However, this method is rather time-consuming and incurs significant dose radiation exposure for the patient and for the doctor performing the procedure.
The closest to the technical essence and the achieved effect and selected as a prototype is a method of ultrasonic navigation when performing spinal anaesthesia. (Chin KJ, Chan VW, Ramlogan R, Perlas A: Real-time ultrasound-guided spinal anesthesia in patients with a challenging spinal anatomy: Two case reports. Acta Anaesthesiol Scand 2010; 54:252-5) in which the needle from intralaminar access is available at Dura.
The main disadvantage of this method is the small width of the posterior epidural space, complicating the positioning of the needle tip in it until the puncture of the Dura.
Task this is part II of the invention is to develop a method of controlling the position of the needle in the posterior epidural space.
The technical result is the ability to accurately identify the location of the needle in the epidural space using widely available deprived dose radiation exposure ultrasonic method of navigation.
This task is realized due to the fact that in the known method of controlling the position of the needle in the posterior epidural space when performing epidural blockade, according to the invention, the introduction of a needle carried out under control of the ultrasonic scanning of the paravertebral oblique access, however as a guideline use the movement of the Dura forward from the tip of the needle and extending posterior epidural space with the introduction of the prepared solution.
Studies on patents and scientific and technical information sources showed that the proposed method is unknown and should not be explicitly studied the prior art, i.e meets the criteria of "novelty" and "inventive step".
The proposed method can be applied in any medical institution, provided with an ultrasonic device operating in b-mode real-time, therefore, practically applicable".
The claimed method is as follows:
Blockade perform in the conditions of the treatment room in situation the AI of the patient lying on the stomach with the use of ultrasound scanner with electronic convex probe with frequency range from 2.0 to 5.0 MHz. The operating frequency for each case determine the depth-dependent constitutional features of the patient. The sensor is applied ultrasonic gel and top to wear sterile protective cover. Followed the rules of asepsis and antisepsis. To fill the space between the skin and the sensor used disinfectant solution, such as solution Andes. Under the patient's stomach enclose a small cushion to reduce the severity of lumbar lordosis. First, the sensor is installed in the sagittal oblique position next to the spinous processes on the affected side for visualization Midwich intervals to counting vertebrae. The benchmark for this is the image of the sacrum in the form of a continuous reflective line with acoustic shadow behind her. After counting the vertebrae and Refine, if necessary, the level of the lesion (in fact rendering of the specified position of contraction or deformation of the dural SAC on interest level), mark the point of injection near the sensor on a site that allows you to visualize the progress of the needle. Conduct intradermal anesthesia point vcol needle and subcutaneous anesthesia with 0.5% solution of novocaine in an amount of about 10 ml Through the planned point vcol impose a special puncture needle with the rendered ultrasound tagged on to the Chica, diameter 18 G. Compare the direction of insertion of the needle to the plane of the sensor. After puncture of the subcutaneous fascia needle on the screen of the ultrasound scanner has a clear visualization. To further clarify the location of the needle tip in doubtful cases it is possible periodic introduction of a small amount of 0.5% solution of novocaine. With the passage of the needle through the yellow ligament of the piston of the syringe is stiff. At the end of the passage of the needle through the yellow ligament is typically "failure", when this is rendered the tip of the needle in the epidural space, before hyperechoic Dura mater. An additional criterion, which suggests finding the needle in the epidural space, is the reduction of the resistance of the piston of the syringe. Then introduce the mixture, usually containing, respectively, the standard recommendations, 3 ml of anesthetic solution, for example of 0.5% lidocaine, and 2.0 ml of corticosteroid, such as flosteron. With its introduction of the Dura under the current fluid is moving forward from the tip of the needle, and is displayed on the rear extension of the epidural space in the form of additional hypoechoic area between the inner contour of the yellow ligament and the Dura mater. Clinical examples:
Patient I., 54, was admitted to the hospital with complaints of pain in explain the Noi region with irradiation in the left leg, data pain concerned within 5 days. In the neurological examination revealed pronounced state-vertebral syndrome, numbness in the L5 dermatome of the spine to the left, the weakness of the thumb to the left, positive symptom Lasaga left. MRI revealed a median hernia at the level of L4-L5 4,5 mm figure 1 are given the image of the back of the epidural space prior to the blockade, figure 2 image of the rear extension of the epidural space at the level of L4-L5 after conducting epidural blockade. The next day, the patient noted a significant decrease in back pain, recovered strength in the thumb.
Patient P., 48 years old, was admitted to the hospital complaining of back pain with irradiation to the left leg. In the neurological examination revealed numbness in the L5 dermatome, S1 left, loss of Achilles reflex on the left. On MRI revealed paramedian disc herniation on the left size of 5 mm was performed epidural blockade at the level L4-L5 on the left (figure 3) After 10 minutes after the blockade, the patient noted a significant decrease in back pain. The next day when the examination of complaints about back pain has significantly decreased, Achilles reflexes become symmetrical.
Patient M., 48 years old, was admitted to the hospital complaining of severe pains in the back with irradiation to the left leg. In the neurological examination revealed syndrome compression of the S1 nerve root text by the VA. On MRI revealed paramedian hernia L5-S1 on the left to 6 mm patients received epidural blockade at the level of L5-S1 on the left (figure 4) On the next day after the blockade, the patient noted a significant decrease in back pain, hypesthesia in the area of innervation of S1 on the left denies, increased ankle reflex on the left.
The method of controlling the position of the needle in the posterior epidural space when performing epidural blockade, characterized in that the introduction of needle carried out under control of the ultrasonic scanning of the paravertebral oblique access, however as a guideline use the movement of the Dura forward from the tip of the needle and extending posterior epidural space with the introduction of the prepared solution.
SUBSTANCE: in the preoperative period, a patient is questioned to determine a degree of manifestation of the length of pain syndrome caused by the presence of deforming coxarthrosis. A diastolic blood pressure and a pulse rate are determined to assess the autonomic nervous system activity by calculating a Kerdo index. A normal autonomic neurotony is presented by the range of values -10≤Kerdo ind.≤10, a prevailing parasympathetic autonomic neurotony is shown by the values of Kerdo ind.<-10, and a sympathetic autonomic neurotony - be the values of Kerdo ind.>10. The venous blood is sampled to analyse the hemocoagulation. The derived parameters are evaluated according to the 3-score scale. The total score is calculated, and the results are used for the purpose of the postoperative pain management using the drug preparations. If the total score is 4-6, a non-selective cyclooxygenase inhibitor is used; the total score of 7-9 enables a selective neuronal K+ channel activator to be preferred, while the total score of 10-12 provides choosing a selective cyclooxygenase-2 inhibitor.
EFFECT: invention provides the more effective postoperative pain management by a rational choice of the drug preparation adequate to functional disorders resulted from the pain syndrome.
SUBSTANCE: thoracic epidural analgesia is conducted by puncturing and catheterisation of an epidural space at ThVIII - ThIX before the expiry of 24 hours from the onset of a disease after a moderate intravenous infusion therapy in the amount of 15-20 mg/kg of crystalloid solutions. 20 minutes before an expected endoscopic papillosphincterotomy, a catheter is moved 4-5 cm in a cranial direction. At ThV-ThX, 0.4% naropin 10-12 ml or 0.2% Marcaine 10-12 ml and clonidine 100 mcg are administered through a catheter. That is followed by a pre-medication by administering 0.1% atropine 0.5-1 ml and 0.5% relanium 1-2 ml. Thereafter, the patient is taken to an X-ray operation room to conduct the endoscopic papillosphincterotomy without an endoscopic retrograde cholangiopancreatography with general pancreatic duct stenting. After the operation has been completed, the patient is taken to an intensive care unit wherein an extended epidural analgesia is conducted by administering 0.2% naropin 10-12 ml or 0.15% marcaine 10-12 ml into the epidural space every 4 hours until the patient is taken to a department of surgery.
EFFECT: early intestinal motility recovery, increased pancreatic secretion, prevented spasm of the gastrointestinal sphincter ensured by a pathological complete blockade of sympathetic impulsing.
SUBSTANCE: group of inventions refers to medicine, namely otorhinolaryngology and may be used for various ear diseases. That is ensured by presenting the systems for electrophoresis drug delivery to a human or animal ear drum. The system contains an ear tampon having distal and proximal portions with a tube passing in between and having a smaller rigidity as compared to the proximal and distal portions of the ear tampon. One flexible sealing element extending from an external surface of the tube and closer to a distal end than to a proximal one. An electrode consisting of an extended shaft, a tip having a greater diameter as compared to the trunk. The electrode is placed inside of the tube of the ear tampon from the retracted position wherein a fluid can flow in the tube round the electrode into the extended position, wherein the electrode tip is in contact with the internal surface of the tube thereby preventing the fluid flow in the tube. The system can also comprise two flexible sealing members integrated with the extended tube. There are also presented methods for anaesthetising the ear drum by using the given system. There are presented kit for anaesthetising comprising the drug delivery system and controller coupled with the electrode.
EFFECT: inventions provide the drug delivery, including anaesthetics into the patients being in the vertical position, due to a possibility to retain the solution hermetically in the external ear canal with no additional conditions provided.
23 cl, 12 dwg
SUBSTANCE: invention relates to medicine, namely, to anesthesiology and reanimatology, and can be used in carrying out spinal blockade in pregnant women in Cesarian section operation. For this purpose height, body weight index and intra-abdominal pressure are determined. After that, point evaluation of obtained parameters is carried out: height (cm) higher than 171 - 1 point, 170-166 - 2 points, 165-161 - 3 points, 160-156 - 4 points, 155-150 - 5 points, lower than 150 - 6 points. Body weight index 20-24.9 - 1 point, 25-29.9 - 2 points, 30-34.9 - 3 points, 35-39.9 - 4 points, more than 40-5 points. Intra-abdominal pressure (cm H20) lower than 16 - 1 point, 17-19 - 2 points, 20-21 - 3 points, 22-23 - 4 points, higher than 24 - 5 points. If sum of points constitutes 3-6, risk is estimated as low, if sum of points is 7-9, risk is estimated as moderate, if sum of points is 10-12, risk is high, is sum of points constitutes more than 13 points, risk is estimated as extremely high.
EFFECT: method ensures prevention of development of high spinal blockade due to correction of local anesthetic dose before surgical intervention with taking into account patient's individual peculiarities.
1 tbl, 1 dwg, 3 ex
SUBSTANCE: invention refers to medicine, namely to anaesthesiology, and may be used as an anaesthesia care of a surgical intervention for carotid endaterectomy or internal carotid artery resection after pathological deformation thereof. That is ensured by general anaesthesia in a combination with deep and superficial cervical plexus blockade. Pre-medication is used the day before the operation and on the operative day in the morning. Diazepam is introduced intramuscularly 30 minutes before the operation in a combination with phentanyl; the introduction is followed by ECG monitoring and heart rate count, plethysmography with arterial blood saturation, non-invasive blood pressure measurement and neuromonitring according to a bispectral index or entropy. Catheterisation of patient's peripheral or central vein is followed by an infusion therapy, an ionotropic therapy, a cardiotropic therapy, peripheral resistance maintenance. If heart rate is no more than 80 beats per minute, the anaesthesia is induced to reach an anaesthetic depth according to the bispectral index or entropy within 40-60 units. Analgesia is provided by the intravenous introduction of 0.005% phentanyl; myoplegia is ensured by the intravenous introduction of a myorelaxant. After tracheal intubation, the patient is transferred to forced volumentic artificial pulmonary ventilation with the CO2 level within 35-45 mm Hg according to capnography. The anaesthesia is maintained by supplying an inhalation anaesthetic to the steam level of 0.8-1.0 MAK 0.8-0.9 litre of the air and oxygen flow containing 50% oxygen with controlling the inhalation anaesthetic volume by the level of the anaesthetic depth according to the bispectral index or entropy. That is followed by deep cervical plexus blockade. A tubercle of the VI cervical vertebra (a carotid tubercle) and a mastoid process are localised; thereafter a line connecting the above reference points is drawn on skin. The second line is drawn 1 cm below the first one in parallel. To verify an injection point of a local anaesthetic, the spines of IV, III, II cervical vertebras being at 1.5 cm from each other are palpated, and the reference point is the VI cervical vertebra. The needle is inserted perpendicularly to the skin and slightly in the caudal direction to reach the spines. The anaesthetic is introduced in a dose of 5-7 ml in each point C4, C3, C2. Another 5-7 ml of the anaesthetic is introduced in a point found in an apex of the mastoid process. The superficial cervical plexus blockade requires introducing he fan-shaped introduction of the anaesthetic solution in a dose of 15 ml in a point found in the middle of a lateral crus of the nodding muscle under the above muscle, 4-5 ml in each direction from the same point; the first and following injections are performed at a depth of a usual intramuscular needle perpendicularly to nodding muscle.
EFFECT: method provides the adequate and safe anaesthesia ensured by avoiding linear blood velocity reduction in the medial cerebral artery during the surgical intervention, preventing intracranial pressure increase, reducing cerebral perfusion pressure in a combination with providing adequate protection against surgical invasion with maintaining stroke volume and arterial pressure.
4 cl, 3 ex
SUBSTANCE: invention refers to medicine, namely anaesthesia, and may be used as a postoperative anaesthesia accompanying low- and medium-injury operations. For this purpose, at the stages of anaesthetising and de-anaesthetising, nonsteroidal anti-inflammatory compounds (NSAICs) are introduced intravenously. The NSAIC dose is equivalent to ketorol 0.5-3.0 ml. The introduction is performed 1-3 times.
EFFECT: method provides the complete prevention of developing postoperative pain syndrome ensured by the intravenous introduction of the NSAIC at the specific stages of anaesthesia in certain doses.
1 tbl, 5 ex
SUBSTANCE: invention refers to medicine, namely to anaesthesiology and neurology, and may be used in spinal anaesthesia. Laser Doppler flowmetry is used to measure skin microcirculation on an anterolateral body surface. For this purpose, before the spinal anaesthesia the microcirculation is measured at T10 and 5 minutes after the spinal anaesthesia, at L1, T12, T11, T10, T9, T8, T7, T6, T5, T4, T3, T2. If the microcirculation appears to increase by 40% or more of the initial values, the effective sympathetic block from this segments and below is diagnosed. When the microcirculation increases less than 40%, it is stated that the sympathetic block is absent.
EFFECT: method enables the most quick determination of the levels of the sympathetic block component in the spinal anaesthesia ensured by measuring the skin microcirculation parameters of the anterolateral body surface.
SUBSTANCE: invention refers to medicine, namely to anaesthesiology and neurology, and may be used in epidural anaesthesia. Laser Doppler flowmetry is used to measure skin microcirculation on an anterolateral body surface before the epidural anaesthesia at T10 and 15 minutes after the epidural anaesthesia at L5, L4, L3, L2, L1, T12, T11, T10, T9, T8, T7, T6, T5, T4, T3, T2. If the microcirculation appears to increase by 40% or more of the initial values, the effective sympathetic block within the segments that meet these conditions is diagnosed. When the perfusion growth is less than 40%, it is stated that the sympathetic block is absent.
EFFECT: method enables the most quick determination of the levels of the sympathetic block component in the epidural anaesthesia ensured by measuring the skin microcirculation parameters of the anterolateral body surface.
SUBSTANCE: invention refers to medicine, namely to anaesthesiology, and may be used in epidural anaesthesia. What is presented is an apparatus comprising a guide cylinder with a digital scale, with the mark pitch for an epidural needle. The guide cylinder is fixed on the periphery of a support plate window rotating in a perpendicular plane at an angle up to 160°. The window is placed in a projection of the interspinous space selected for puncture. The cylinder is specified to have the length of 0.44-0.45 equal to the effective length of the epidural needle, and an internal diameter greater than an outer diameter of the needle not more than in 1.42 times.
EFFECT: provided direct needle penetration into the epidural space by preventing lateral needle deviation when passing through patient's spinal soft tissues and ligaments with puncture of the epidural space from the median approach.
3 cl, 2 tbl, 4 dwg
SUBSTANCE: invention refers to medicine, in particular to anesthesiology and intensive care, and may be used if preoperative preparation of the patients with chronic pancreatitis and manifested pain syndrome required. For this purpose, back skin of a sitting patient is treated within a puncture at the Th7-Th8 level. Then, an epidural space is punctured, and a puncture catheter needle is introduced therein, and the catheter is pushed forward in the cranial direction to a depth of 3 cm. The needle is removed, and the catheter is placed along the spine and is brought out to the subclavian region while strapped all over. Thereafter, a test dose of 2% lidocaine 3.0 ml is introduced. If observing no effects of spinal block, prolonged permanent introduction of 0.2% ropivacaine at rate 4-5 ml/hour 3 times a day. With underlying it, 30 minutes before a meal, fractional introduction of 0.75% ropivacaine 3.0 ml and 0.005% fentanyl 1.0 ml for 4-5 days is performed.
EFFECT: method provides the adequate preparation of the patients for pancreatic surgery due to pain relief that enables supplying proteins and eliminating hypovolemia, as well as due to improved pancreatic-duodenal microcirculation.
SUBSTANCE: invention refers to medicine, namely to obstetrics and gynaecology, and can be used in delivery. That is ensured by localising predominantly a placenta in the uterus and a place of umbilical cord attachment with an ultrasound detector in a projection of the above place on a woman's stomach. A foetus image is visualised simultaneously with the uterus and placenta under the detector in a cross section with a front or side the predominant localisation of the placenta in the uterus. The detector is fixed, and dynamics of foetus's physical activity, uterine wall thickness, ultrasonic echogenicity of the uterus, placenta, thickness of their blood vessels and pulsation amplitude are controlled continuously. If observing constant thickness and ultrasonic echogenicity of the uterus and placenta, thickness and pulsation amplitude of their vessels and continuous weak contraction and relaxation of the muscular groups of all foetus's body parts that are represented by image vibrations on the screen, the foetus's condition is considered to be good with no labours. If observing regular reductions of the thickness of uterine walls, vessel and pulsation amplitude, ultrasonic echogenicity of the uterus and placenta coinciding with the periods of a foetus's rest in a position with legs and arms pressed tightly to the body and with hands clenched, an excellent foetus resistance to hypoxia in labour is stated. If the foetus shows respiratory rib movements, multiple flexion-extension movement of the limbs and opening hands before the period of reduction of uterine wall thickness, ultrasonic echogenicity of the uterus and placenta, thickness and pulsation amplitude of the blood vessels is completed, the length of the rest period is started with the above period. If the length tends to zero testifies to bad foetus resistance to hypoxia in labour.
EFFECT: method provides the well-timed preparation of the pregnant woman fort the delivery by improving accuracy and safety of detecting uterine and placental ischemia periods and assessing the foetus's state under the conditions preventing the uncontrolled intensification of the hypoxic foetus involvement.
SUBSTANCE: invention refers to medicine, namely recreation therapy, and may be used for human health improvement. That is ensured by traditional medical examination of the patient. The findings are used to draw up the rehabilitation program including body cleansing, intestine and liver purification, physical exercises. One week before the beginning of the rehabilitation program, the patient starts separate nutrition with preferential vegetable food and dairy products, limited consumption of salt, alcohol and sugar. One day before the rehabilitation program, a fasting day is kept with taking 1% kephir or fresh apple juice. Further, on the first two days of the three-day program or on the first four days of the seven-day program, the body is cleansed by keeping a juice diet. The juice diet contains fresh vegetable and fruit juices, herbal infusions and mineral water. Water is unlimited. On the first day of the cleansing program, the intestine is purified with the preparation Fortrans. Starting from the first day the liver and gall bladder are cleansed with using herbal and saline choleretics for four days of the 7-day program and for two days of the 3-day program. That is combined with paradoxical respiration by Strelnikova's technique and hydrotherapy. Physical exercises involve physical loads on a cardio-vascular machine, one training as prescribed by the doctor - yoga, pilates, chi gong, water aerobics or hypoxi capsule. Therapeutic massage and lymph drainage massage follow. Then body-detox, ozone therapy, collagenarium procedures are performed. Cold training procedures involve Linear Kneipp, saunas, swimming pool, turpentine bathes. Bathing and cold training procedures are followed by pilling and algae wraps. From the 5th day of the 7-day program, or from the 3rd day of the 3-day program, the diet involves water cereals, vegetable and fruit salads, vegetable fast soups.
EFFECT: method provides effective patient's health recovery, namely weight loss, health improvement, blood value normalisation, formation behavioural model of health preservation over a shortest possible period of time.
SUBSTANCE: group of inventions relates to medicine, restoring blood flow in occluded vessels with application of device, which contains self-expansible distal element (SDE) with tube structure (TS), which possesses cells. TS can take configuration with increased volume in place of thrombus location in vessel and turn into configuration with reduced volume to be delivered through microcatheter. Configuration with reduced volume has size of transverse profile smaller than configuration with increased volume. TS has possibility of expansion from configuration with reduced volume into configuration with increased volume in case of proximal removal of microcatheter. Distal end of TS interacts and renders radial force impact on at least part of thrombus in order to connect it with TS. Device in addition contains proximally elongated element (PEE), fastened to SDE in such a way, that PEE as a whole is located parallel to central longitudinal axis of TS with displacement relative to said axis. Cellular structure of TS represents connection of bridges, threads or bonds. Distal element has conical structure in its proximal end, where bridges, threads and bonds diverge in connective point. Distal part of distal end of tube structure contains cells, whose size is smaller than size of cells, located proximally relative to distal part.
EFFECT: application of claimed device ensures high speed and efficiency of revasculisation of brain arteries, occluded with thrombus.
26 cl, 19 dwg
SUBSTANCE: invention relates to medicine, namely to obstetrics and gynecology, and can be used in obstetric aid in case of intrauterine hypoxia of fetus and asphyxia of newborn baby. For this purpose US examination of skin of finger-pads of fetus during birth pangs and in breaks between them is performed. Unchanged ultrasonic echogenicity of skin of finger-pads is estimated as good adaptation of fetus to hypoxia in labour and labour is managed in accordance with general rules. Reduction of ultrasonic echogenicity of skin of finger-pads in labour testifies to presence of acrocyanosis in fetus. In this case woman in childbirth is asked to start deep and frequent breathing. If the woman is unconscious, artificial hyperventilation of lungs with breathing gas is carried out up to appearance of first symptoms of oxygen poisoning in the woman, with continuation of hyperventilation until lung respiration in the newborn baby begins and umbilical cord is cut. State of the newborn baby's health is performed by means of thermovision camera. Analysis of the newborn baby's thermal radiation intensity by means of thermovision camera is started simultaneously with beginning of its body contact with atmospheric air. Birth of newborn baby with normal temperature testifies to absence of cyanosis in it. In this case labour is finished in accordance with general rules. Identification of section of local hypothermia in newborn baby's skin testifies to cyanosis and acrocyanosis. In case if newborn baby after its birth does not breath independently, after removal of content of airways and appearance of local hypothermia of skin in peripheral sections of newborn baby's body, its reanimation is started by interrupted double compression of chest. Reanimation is stopped when newborn baby starts crying and chest starts to perform respiratory movements. If baby is immobile, respiratory mask, connected with breathing apparatus is applied on its face, and artificial lung ventilation is carried out by them. When temperature in zone of local hypothermia increases, umbilical cord is clipped and dissected.
EFFECT: method ensures prevention of hypoxic damage of cerebral cortex due to timely assessment of fetus's state in labour.
SUBSTANCE: invention relates to field of medicine and can be used for diagnostics of hematogenous meta-epiphyseal osteomyelitis in children from birth to 6 months. Ultrasonic examination by means of longitudinal scanning of soft tissues, joint cavity, periosteum, cortical bone layer is carried out. Symptoms of edema of soft tissues, presence of: joint capsule thickening in comparison with symmetrical section of healthy joint, synovial fluid, increase of periosteum thickness in comparison with symmetrical section of healthy extremity, inhomogeneity of meta-epiphyseal zone are determined. Transverse scanning is performed and symptoms of meta-epiphyseal zone affection are determined. If the following symptoms are present: edema of soft tissues, joint capsule thickening in comparison with symmetrical section of healthy joint, synovial fluid, increase of periosteum thickness in comparison with symmetrical section of healthy extremity, iroughness of cortical layer, together with signs of change in meta-epiphyseal zone due to: either indistinctness, irregularity of meta-epiphyseal line, or combination of indistinctness, irregularity of meta-epiphyseal line with identification of inhomogeneity of metaphysis structure in form of presence of unecogenic inclusions, localised only in metaphysic, adjacent to growth zone, without crossing it, or in case of intermittence of meta-epiphyseal line with formation of from 0.6 to 6.0 mm defect is identified in combination with unechogenic inclusions in metaphysic and epiphysis, acute hematogenous meta-epiphyseal osteomyelitis is diagnosed.
EFFECT: method makes it possible to visualise early signs of meta-epiphyseal osteomyelitis in non-invasive way with possibility of determining pathological changes in joint, epiphyseal and metaphyseal parts of bone, metepiphyseal zone.
4 dwg, 1 ex
SUBSTANCE: disclosed is a method of sounding facilities, which involves selecting spectral components of an electrical signal corresponding to different frequency bands, converting electrical signals into sound signals using loudspeakers mounted in parallel with given deviation of parallelism. The method also involves using a reflecting surface which is acoustically connected to the loudspeakers, tuning the system to establish in each loudspeaker - reflecting surface pair a standing wave at a frequency selected in accordance with external meteorological parameters and individual perceptibility, said frequency being determined by test listening with simultaneous measurement of human vital physiological parameters.
EFFECT: improved matching of standing waves in an acoustic system and a facility with frequencies of external field agents.
SUBSTANCE: invention relates to field of medical diagnostics, in particular, ultrasonic, and can be used to estimate correspondence of spleen dimensions to the norm or its deviation in children. Ultrasonic examination of spleen with application of convex sensor 3-6 MHz is carried out. Length and thickness of spleen are measured. The organ weight is calculated by formula m=0.34l2h, where l is spleen length, h is spleen thickness. Coefficient of spleen weight is determined by formula:
EFFECT: method makes it possible to estimate interrelation of linear dimensions of spleen and child's body weight, which makes it possible to determine functional state of organ.
6 dwg, 5 tbl
SUBSTANCE: invention relates to medical equipment, namely to medical diagnostic ultrasonic systems. Sensor contains matrix converter, circuit of beam formation, connected to it, controller of data collection, transceiver, sensitive to, at least, echo-signals, partly focused by beam former, which performs function of wireless transmission of information signals of image to host-system, power supply circuit and battery, connected to power supply circuit. Matrix converter, beam former circuit, controller of data collection, transceiver, power supply circuit and battery are placed into sensor case, with total weight of sensor case and components placed into it not exceeding 300 grams. Host system additionally contains display, which reflects images, transmitted into host system in wireless way by said sensor transceiver.
EFFECT: application of the invention makes it possible to simplify wireless transmission of images into distant host-system during surgical procedure.
20 cl, 14 dwg
SUBSTANCE: invention relates to medicine, namely to surgery and ultrasonic examination and is intended for diagnostics of infection in area of surgery. Examination of postoperative wound is carried out from proximal angle of wound to distal angle in transverse and longitudinal scanning in B-mode with determination of pathological formations in the depth of soft tissues. Examination of local arterial blood flow is additionally carried out by performing colour duplex scanning. Parameters of postoperative wound area are compared with parameters of intact zone. If one or more indirect signs of inflammation, increase of diameter and number of vessels by 50% and more, increase of average values of peak systolic rate by 50% and more, index of resistance in arteries of surface layer of abdominal wall by 30% and more, are determined, presence of infection in area of surgery is diagnosed.
EFFECT: infections of operation wound area are detected at early stages.
2 cl, 2 ex
SUBSTANCE: invention relates to medicine, namely to therapy and functional diagnostics, and can be used for diagnostics of β2-microglobulin amyloidosis in patients with chronic kidney disease of fifth stage, who are on renal replacement therapy. For this purpose ultrasonic examination of shoulder and hip joints is performed. Thickness of tendon of shoulder joint subcapularis muscle and thickness of neck-capsular space of hip joint are estimated. If values of thickness of tendon of shoulder joint subcapularis muscle are higher than 8 mm and those of thickness of neck-capsular space of hip joint are higher than 10 mm, β2-microglobulin amyloidosis is diagnosed.
EFFECT: method makes it possible to diagnose β2-microglobulin amyloidosis in said category of patients without application of invasive diagnostic methods, and start treatment procedures in due time in case of necessity
2 ex, 2 tbl
SUBSTANCE: method involves carrying out skeletotopic conjunction and organ element localization description relative to vertebra body. Neck organ picture is described in skeletotopic manner using anterior contour of cervical vertebra body and transverse processes in upper, median and inferior portion of cervical vertebra with the exception of the first and the second one.
EFFECT: high accuracy in diagnosing pathological processes in neck organs and creating computer models.