Differential diagnostic technique for cardiogenic myocardial ischemia and enteral cardioinhibitory reflex
SUBSTANCE: recording ECG is followed by a bilateral translumbar block with an anaesthetic solution in an amount of 120-140 ml from each side. Then 60-90 min later ECG is recorded once again, and this recording is compared to the pre-block recording. If observing a positive dynamics of the ECG results, ischemia caused by the enteral cardioinhibitory reflex with underlying intraluminal intestinal hypertension is diagnosed. No positive dynamics observed enables diagnosing myocardial ischemia caused by a cardiac pathology.
EFFECT: enabling performing the more accurate differential diagnosis of the above pathologies by following a specific procedure in case of pain syndrome in the given category of patients.
The invention relates to medicine, cardiology and abdominal surgery and directly to the differential diagnosis of myocardial ischemia in the pathology of the heart and enterline-cardiac brake reflex, against flatulence and paresis of the intestine.
In the available literature we did not meet publication of differential diagnosis interline-cardiac brake reflex and the methods of its implementation.
At the same time on the background of paresis of the intestine and development against this background of intraluminal pressure in the lumen of the digestive tract ECG changes can be caused by pathology of the heart, and reflex influences, namely interline-cardiac inhibitory reflex, in which the spasm of blood vessels of the myocardium during transmission of pathological activity stretched from the intestines to the heart. While myocardial ischemia can itself cause inhibition of intestinal motility and development of paresis with increased intraluminal pressure in the digestive tract. In such cases, to determine the tactics of conducting the patient is difficult and error may threaten his life.
The development of intraluminal hypertension may be due to food errors, spastic colitis, adhesive disease of the abdominal organs, diseases of the organs of the retroperitoneal space, Breakfast is STV, injuries of the abdomen and retroperitoneum, subject to supervision in the hospital and so on
The technical objective of the proposed method is to optimize the differential diagnosis of myocardial ischemia in the pathology of the heart and enterline-cardiac brake reflex, against the background of intraluminal pressure in the lumen of the intestine.
The technical result is achieved by first recording the ECG, then bilateral perirenal blockade of the anesthetic solution in the amount of 120-140 ml on each side, then after 60-90 min after blockade carried out for the second ECG recording, which is compared with the ECG recording made before the blockade. Positive dynamics of pathological changes on the ECG diagnosed with myocardial ischemia due to interline-cardiac inhibitory reflex in the background intraluminal hypertension in the intestine, and in the absence of positive changes on ECG diagnosed myocardial ischemia caused by abnormalities of the heart.
The invention consists in that the first ECG recording, then bilateral perirenal blockade of the anesthetic solution in the amount of 120-140 ml on each side, then through 60-90 minutes to produce a re-recording of the ECG, which is compared with the ECG recording made prior to the blockade, and with positive dynamics of pathological change which deposits on the ECG diagnose ischemia, due interline-cardiac inhibitory reflex in the background intraluminal hypertension in the intestine, and in the absence of positive dynamics - myocardial ischemia due to cardiac pathology.
The method is as follows. On the background of intraluminal pressure in the intestines and produces ECG recording, then bilateral perirenal blockade of the anesthetic solution in the amount of 120-140 ml on each side, then after 60-90 min re-record the ECG, which is compared with the ECG recording made before the siege, and in the presence of positive changes on ECG diagnosed with myocardial ischemia due to interline-cardiac inhibitory reflex in the background intraluminal hypertension in the intestine, and in the absence of positive dynamics of ECG myocardial ischemia due to cardiac pathology.
In experiment 10 the cadaver we spent determining the amount of anesthetic that provides for adequate blockade of perirenal region.
Usually when perirenal blockade volume of injectate is from 60 to 100 ml, 25-05% solution of novocaine.
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When determining the amount of novocaine necessary to blockade the retroperitoneal nerve structures in the perirenal tissue, spending perirenal the blockade was imposed colored solution and evaluated the infiltration solution perinephral fiber. It was found that for adequate blockade perinephral fiber must enter 120-140 ml on each side. At the same time in the production of bilateral perirenal blockade with a smaller volume of solution adequate blockade of perirenal retroperitoneal nerve plexus is not achieved.
Notes on the volume injected novocaine:
When intrapelvic blockade (Shkolnikov-Selivanova) on the background of fracture of the pelvis enter from two sides of 250-300 ml of 0.25% solution of novocaine on each side, which corresponds to 125,0-of 150.0 ml of 0.5% solution of novocaine (http://medarticle.moslek.ru/articles/27717.htm).
That is, even when increasing concentrations of procaine 0.5% of the amount required for blockade of perirenal and retroperitoneal neoplasms, does not exceed used in medicine.
It should be noted that previously under local infiltration anesthesia was performed extensive abdominal surgery (cholecystectomy, gastrectomy, and so on), which indicates the safety of use of significantly large amounts of novocaine.
The method of differential diagnosis of cardiogenic myocardial ischemia and enterline-cardiac brake reflex was used in 23 patients with signs of myocardial ischemia on the fo is e flatulence, due to the development of intraluminal pressure in the intestine. Of these, 18 were found to have myocardial ischemia, caused interline-cardiac inhibitory reflex, and 5 - myocardial ischemia due to cardiac pathology. Diagnostic with no errors.
The example of the patient: the Patient P., 38 years old, delivered by ambulance complaining of intense pain in the chest, palpitations, interruptions in heart work, epigastric pain, bloating in the epigastric and methoctramine areas, and nausea. Palpation of the abdomen is soft, moderately painful in the epigastric and left methoctramine areas, signs of peritoneal irritation negative, percutere determined timpani in the epigastrium and methoctramine areas. History underwent surgery for blunt abdominal trauma with damage to the jejunum and transverse colon, complicated spilled peritonitis. ECG is marked tachycardia, single polytope extrasystoles, ST segment depression. On survey radiographs of the abdominal cavity revealed a single bowl Kloiber, swelling of the transverse colon. Given the more pronounced pain in the sternum, the disruption of the heart, ECG data on the one hand and moderately distinct clinical symptoms from abdominal organs, primarily in the formulation D. the diagnosis leaned in favor of myocardial ischemia. However, given the presence of a single bowls Kloiber and the inability to eliminate the risk of adhesive disease and intestinal obstruction was made bilateral perirenal blockade 0.25% solution of novocaine in the amount of 120,0 ml on each side. Within 15 minutes after the blockade was a decrease in the intensity of pain in the chest and stomach. When repeated electrocardiographic study, after 1 hour and 20 minutes after blockade showed normalization of the ECG. The patient was hospitalized in the surgical Department, where conservative phenomenon of intestinal obstruction have been resolved. In this situation, the use of the method of differential diagnosis of myocardial ischemia in the pathology of the heart and enterline-cardiac brake reflex on the background of intraluminal pressure in the intestine is allowed to specify the diagnosis and to determine the address of hospitalization and treatment of the patient.
Additional symptoms consider new and significant, in order to enhance the differential diagnosis of myocardial ischemia in the pathology of the heart and enterline-cardiac brake reflex on the background of intraluminal hypertension in the gut.
The method of differential diagnosis of cardiogenic myocardial ischemia and enterline-cardiac brake reflex on the background of paresis of cichecki is a, including ECG recording, and then produce bilateral perirenal blockade of the anesthetic solution in the amount of 120-140 ml on each side, and after 60-90 min after blockade re-record the ECG and the obtained record is compared with the ECG recording made prior to the blockade, with positive dynamics of ECG diagnose ischemia caused interline-cardiac inhibitory reflex in the background intraluminal hypertension in the intestine, and in the absence of positive dynamics - myocardial ischemia due to cardiac pathology.
SUBSTANCE: invention refers to medicine, namely to anaesthesiology and emergency medicine, and can be used in anaesthetic management of nasal and oropharyngeal operations in otorhinolaryngeal surgery in children. To this effect, the surgical intervention is preceded by inhalations of 2% lidocaine through a nebuliser at 4 mg/kg of body weight in the maximum dose of 200 mg. A peripheral vein is catheterised. A riskless challenging trancheal intubation requires inducing anaesthesia with Sevorane 8 vol %, N2O/O2 1/1 6 l/min. The intubation is preceded by 2 forced inhalations through an anaesthetic apparatus with a face mask. The pulmonary ventilation effectiveness is assessed by the respiratory excursion. The adequate pulmonary ventilation requires intravenous administration of the nondepolarising muscle relaxant Tracrium 0.4 mg/kg. Once reaching stage III2 narcosis, the trachea is intubated, and a gas flow in the contour is reduced to 1.0 l/min. Anaesthesia is maintained with Sevorane 1.5-2 vol %, 0.7 MAK, with N2O/O2 1/1 1 l/min, 0.5 MAK. The signs of the challenging trancheal intubation enable inducing anaesthesia with Sevorane 8 vol % at a high O2 gas flow at 6 l/min. The intubation is preceded by 2 forced inhalations through the anaesthetic apparatus with the face mask. The pulmonary ventilation effectiveness is assessed by the respiratory excursion. Once reaching stage III2 narcosis with adequate pulmonary ventilation and maintained unassisted respiration, the trachea is intubated, and the gas flow in the contour is reduced to 1.0 l/min. The nondepolarising muscle relaxant Tracrium 0.4 mg/kg is administered intravenously. Anaesthesia is maintained with Sevorane 2-3 vol %, 1 MAK with the artificial pulmonary ventilation with the gas mixture of O2/Air - 0.5/0.5 l/min. Once the operation is completed, inhalation with 100% O2 in a semi-open contour with a high gas flow at 5.0 l/min is performed.
EFFECT: method provides the adequate anaesthesia in the given category of patients with no narcotic analgesics used by a differentiated approach to a dose schedule of inhalation anaesthetics and a myorelaxant caused by a risk degree of the challenging tracheal intubation.
4 tbl, 2 ex
SUBSTANCE: radionuclide indicator is administered to record the dynamics of its distribution in limb tissues by a radionuclide method. The examination is performed at rest and during a load test. The load test represents an epidural block by gradual administration of bupivacaine 25-30 mg between L2-L3 vertebrae for 5-7 minutes. That is followed by measuring a blood flow as a percentage of its value to the same level in an analogous segment of a collateral limb.
EFFECT: qualitative assessment of the circulation reserve in various categories of patients, including disabled ones by inhibiting sympathetic and minimally sensory activity with maintaining the patients' motor activity.
2 dwg, 2 ex
SUBSTANCE: invention refers to medicine, namely to abdominal surgery and anaesthesiology, and can be used where it is necessary to anaesthetise after the prosthetic hernioplasty for median postoperative ventral hernias. That is ensured by placing an endoprosthesis under the aponeurosis, a polyvinylchloride catheter is placed into the formed spaced around the periphery of a postoperative wound in the form of an oval above the endoprosthesis plane at 2.5-3 cm from its edges. Along its full length, the catheter has multiple side holes. Single openings are created in a projection of a lower corner of the wound, and the catheter ends are brought out onto the skin. An inlet of the catheter is attached to a local anaesthetic dosage device by means of a cannula. That is followed by a controlled prolonged irrigation with 2.5% Ropivacaine 20 ml every 6-8 hours during 2-3 days.
EFFECT: method enables the adequate postoperative anaesthesia, as well as the length of the postoperative intestinal distention by providing the uniform controlled administration of the local anaesthesia solution.
7 dwg, 1 ex
SUBSTANCE: what is involved is infusion therapy with crystalloid solutions at 15 ml/kg of a patient's body weight. That is followed by puncturing and catheterising an epidural space at the level of ThVII-ThVIII according to the standard practice and introducing a test dose of 2% lidocaine 3 ml. If observing no signs of intrathecal introduction of local anaesthetics 10 minutes later, a basic dose containing 0.75-1% naropin 10 ml or 0.25-0.5% marcaine 10 ml and clofelin 3-5 mcg/kg is introduced. Total intravenous anaesthesia follows 20 minutes after pre-medication with atropine 0.01 mg/kg, 1% diphenylhydramine 1 ml and relanium 10 mg and urethral catheterisation. A narcosis is induced with propofol in a dose of 2 mg/kg. Anaesthesia is maintained with propofol 2-4 mg/kg·h. After that, within the first hour following the detoxification, naloxone 12 mg is introduced intravenously; a naloxone measurement rate is supposed to make 0.8 mg/h for 4-5 following hours of general anaesthesia. The repeated introduction of 0.75-1% naropin 6 ml or 0.25-0.5% marcaine 6 ml and clofelin 2-3 mcg/kg into the epidural space is performed 90 minutes later. After the procedure is terminated, and the patient recovers, prolonged epidural analgesia is conducted by introducing 0.2% naropin 10 ml and clofelin 1 mcg/kg into the epidural space every 4 hours for 24-48 hours.
EFFECT: method provides safety of ultrafast opioid detoxification and prolongs the remission in the given category of patients.
SUBSTANCE: reparative-reconstructive stage of the oviduct operation is followed by introducing an indigo carmine coloured saline into the abdominal cavity. Catheters are placed transvaginally into the uterine cavity within internal openings of the oviducts to be fixed to the inner thighs. That is followed by an intraoperative two-sided block of mesosalpinx within the isthmic oviduct by introducing an anaesthetic 2.0-3.0 ml. The postoperative period involves a two-sided block of a round ligament of the uterus by introducing an anaesthetic 10.0 ml every 4-6 hours. If observing the coloured solution in the catheter 24 hours later, the preserved oviduct transport function is diagnosed. If observing no inflow of the coloured solution into the catheters, the oviduct transport dysfunction is diagnosed.
EFFECT: more reliable diagnosis of the oviduct transport dysfunction, including the intramural portion by eliminating spasms of corners of the uterus.
SUBSTANCE: invention refers to medicine, namely to anaesthesiology and resuscitation, and may be used in epidural anaesthesia. That is ensured by administering slowly intravenously a basic dose of the local anaesthetic: 0.2-1% naropin or 0.2-0.5% marcaine, or 1-2% lidocaine; 1% Sol. Nicotini acidi 1% - 0.5-1 ml into the epidural space 10-20 minutes later. After 5-10 minutes, nicotine test results are visually evaluated by determining a clear interface of skin colour - hyperemic and normal - along an axillary line from both sides. The normal skin interface corresponds to the sympathetic block.
EFFECT: method provides higher accuracy and simplification of measuring the sympathetic 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
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: group of inventions relates to medical equipment. In the method realisation ECG graphs and graphs of tracks of coordinates of the heart electric activity source are built in the system of coordinates, connected to electrodes on the patient's body. After that, the time "zone of beginning" of a P/Q impulse is identified. In the "zone of beginning" a time ECG track is approximated and an intersection of an approximated curve with an isoline is found to determine the time moment of the point of P/Q "beginning". The determined time moments of the "beginning" points are transferred onto an initial track of impulses. The origin of the myocardium coordinate system is transferred into the determined point P of the track. Coordinates of the sinus node of the myocardium SU are tied to the track origin for the complex P, and those of the interventricular septum IVS - to the track origin for the impulse Q. The device for the method realisation contains an electrocardiograph, a unit for the identification of the time area of the "beginning" of the impulse P/Q, a unit of fixation of the "beginning" point on the graph of the tracks and a unit of transfer of the primary system of coordinates into the myocardium coordinate system.
EFFECT: group of inventions makes it possible to increase the efficiency of electrocardiographic examination due to an increased accuracy in the measurement of coordinates of the heart electric activity source.
2 cl, 5 dwg
SUBSTANCE: patient is tested to determine clinical characteristics, each of which is scored to calculate a diagnostic index. The following clinical characteristics are determined: arterial hypertension taking into account its stage and length; diabetes mellitus, its length taking into account the patient's age and complications; ischemic heart disease and its length, cardiac angina, myocardial infarction and its length; the patient's age; compliance; smoking. The absence of any of the above characteristics is scored as 0 points. That is followed by calculating the total score; depending on the derived value, a high, moderate or low probability of the suffered silent stroke is predicted.
EFFECT: method enables establishing the presence of the suffered silent stroke reliably.
3 dwg, 4 tbl, 3 ex
SUBSTANCE: invention refers to medicine, namely to physiology and dermatovenerology, to diagnostic technique for a risk of developing pitted keratolysis accompanied by stress as an uncurable element of the professional environment for the purpose of the goal-oriented prevention of the above disease in the individuals having hazardous occupations. A heart rate variability is examined twice - before and 15 minutes after a hot test on a plantar surface. If observing no decrease of the LF/HF value as compared to the reference, a risk of developing stress-induced pitted keratolysis is diagnosed.
EFFECT: technique provides more accurate diagnosis of a risk of developing stress-induced pitted keratolysis by examining the heart rate variability and using the hot test.
1 dwg, 2 tbl, 2 ex
SUBSTANCE: invention refers to medical equipment. A device for suppressing a power-frequency noise effect on an electric cardiosignal comprises a TR-segment time domain selection unit (2), a key element (8), a filter (14), an amplifier (15), a delay unit (16) and a subtract unit (17). An input of the device is connected to the first input of the key element and an input of the delay unit; an output of the device is an output of the subtract unit. The device comprises an electric cardiosignal second derivative forming unit (1), a comparator (3), an RS-trigger (4), an AND circuit (5), a binary counter (6), a decoder (7), second (9), third (10), fourth (11) and fifth (12) key elements and a scaling amplifier (13).
EFFECT: using the invention enables the higher noise resistance of the analysed electric cardiosignal without misrepresenting information components.
SUBSTANCE: diagnostic technique for the ischemic heart disease is implemented by stating risk factors, symptoms and ECG findings, diagnostic characters (DC) of which are distributed into groups and assigned with certain numerical scores. Conditional probabilities of the presence or absence of IHD in a specific patient are calculated. The findings are used to establish the diagnosis of IHD or not.
EFFECT: technique enables providing establishing the more accurate diagnosis of IHD by taking into account a complex of various DCs, the records of which are processed by a mathematical model.
SUBSTANCE: invention refers to medicine, namely to diagnostics and physiology. The RR intervals are recorded, and the derived sequence is processed. The RR sequence length is specified not less than 300 sec. That is followed by dividing the RR sequence into data windows A1…An of the length of 75 sec≤A≤300 sec at a window shift pitch B of 1 sec≤B≤10 sec. Further, for each data window: the frequency Fourier transform is used to derive power distribution of the initial window; the derived power distributions are integrated at all frequencies within not less than 0.015-0.6 Hz to produce total power TP of the heart rate variability; low frequency power PLF is calculated by not less than 0.04-0.15 Hz; high frequency power PHF is calculated by not less than 0,15-0.6 Hz; the relation PLF/PHF is calculated; the derived TP sets and PLF/PHF relations are normalised to produce standard values X1…n of the derived TP sets and standard values Y1…n of the PLF/PHF set. That is followed by calculating a synchronism analysis function of each data window f1…n=(sinX1…n-sinY1…n)/|sinX1…n-sinY1…n|. The presence or absence of the stress condition is stated by analysing the derived values f1…n.
EFFECT: method enables providing more reliable diagnosis of the beginning individual's stress condition by analysing the RR interval.
2 ex, 1 dwg
FIELD: oil and gas industry.
SUBSTANCE: treating bronchial asthma (BA) in a child suffering from a mild, moderate or severe episode involves measuring a peak expiratory flow rate (PEFR). The child's age, height and sex are stated. The derived data are used to determine the adequate peak expiratory flow rate. That is followed by calculating the peak expiratory flow rate coefficient by specific formula. The following data of the past medical history are taken into account: the child's duration of the disease, the length of basic therapy, completed months, for one year preceding the acute period of the disease, as well as the presence of allergic diseases in immediate maternal and paternal relatives. A severity of the BA episodes is assessed. Each value derived from the past medical history is assigned with numerical values reflecting their prognostic significance. Heart rates are measured. Cardiointervalography is performed, and a vagosympathetic balance coefficient is determined. That is followed by calculating a risk of cardiohaemodynamic disorders (CHD) taking into account the above criteria by specific formula. If CHD<0.34, Fenoterol selective β2-adrenoceptor agonist is selected as a bronchial spasmolytic in the acute period of the disease. If 0.34≤CHD≤0.46, ipratropium bromide m-cholinoblocker is selected as the bronchial spasmolytic. If CHD>0.46, combined ipratropium bromide + Fenoterol is used as the bronchial spasmolytic.
EFFECT: reduced number of cardiovascular complications in the above category of children.
SUBSTANCE: invention relates to methods and devices of identifying reasons of cardiac rhythm disturbance. Method consists in perception of signals of heart excitation in multitude of locations with application of multitude of sensors, collection of data from multitude of sensors. Collected data include sensor location for each sensor and time of heart excitation origination in each sensor location, so multitude of times of excitation origination in multitude of locations of sensors are collected, and then their sequence is formed. Obtained data are then analysed and approximate central areas, connected with excitation pathway, pointing to reasons of said cardiac rhythm disturbance, are determined.
EFFECT: application of invention makes it possible to determine location of reasons of cardiac rhythm disturbance for the following treatment with minimally invasive, surgical and other methods.
37 cl, 16 dwg
SUBSTANCE: invention relates to the field of medicine and can be applied as a method of predicting an unfavourable outcome of cerebral circulation impairment. A level of stab neutrophils and erythrocyte sedimentation rate are determined in blood tests. The presence of displacement of midline brain structures is identified on a computer tomography scan. A number of ventricular and supraventricular extrasystoles is determined on an electrocardiogram. If the value of stab neutrophils is 3.5-4.5%, erythrocyte sedimentation rate is 12-20 mm/h, displacement of midline structures is 7 mm and more, an average day value of ventricular and supraventricular extrasystoles is respectively 490-670 and 1530-1880, and in case of blood presence in liquor, an unfavourable outcome of cerebral circulation impairment is predicted.
EFFECT: method makes it possible to increase the prediction reliability.
SUBSTANCE: invention refers to medicine, labour safety, vocational selection of rescue workers. The invention can be used for vocational selection in the sectors of industry using personal protective equipment, as well as for the workers labour safety in the sectors of industry with harmful working conditions. The method involves vocational selection and duty control on the basis of electroencephalogram (EEG) values and cardiological findings. The examination is performed prior to and when using the personal protective equipment. The cardiological examination involves assessing the heart rate variability with using the amplitude-frequency spectrum Fourier analysis VLF at a vibration frequency within the range of 0.0033-0.04 Hz, LF - at a frequency of 0.05-0.15 Hz and HF - at a frequency of 0.16-0.80 Hz, and is five-staged: initial resting state, mental work load, recovery of mental work load, hyperventilation load, recovery of hyperventilation load. At the beginning, the heart rate variations and EEG are examined prior to using the personal protective equipment. If any of the five stages of the heart rate variation examination shows the pulse more than 90 beats per minute, as well as changes from the normal values of: approximating entropy - less than 180, LF - less than 6 point, an alpha wave amplitude - to 12 vibrations per second and the presence of the paroxysmal activity by EEG, the prevailing sympathetic nervous system is stated, or if any stage of the heart rate variation examination shows the pulse less than 60 beats per minute, as well as changes from the normal values of: blood pressure - more than 140/90 mmHg, VLF - more than 130 points, HF - more than 16 points, an alpha wave amplitude - less than 25 mcV, the prevailing parasympathetic nervous system is stated; a low level of adaptation to the personal protective equipment is predicted, and a rescue work is not recommended during the vocational selection; the examination is terminated. If the heart rate variation and EEG prior to using the personal protective equipment fall within the normal values, the heart rate variation when using the personal protective equipment is started with the patient examined when using the personal protective equipment and performing a cycle ergometer test, and recording the hyperadaptotic changes of the assessed values: VLF - more than 130 points in relation to the normal value when using the personal protective equipment and LF and HF vibrations; an incomplete or unfinished adaptation to the personal protective equipment, and the rescue worker is suspended from work for several hours; if VLF is more than 130 points recorded 10-15 min after activating the personal protective equipment, a good adaptation level to the personal protective equipment is predicted.
EFFECT: method enables assessing the vegetative nervous function and predicting the rescue workers' adaptation level to the personal protective equipment.
11 tbl, 5 ex
SUBSTANCE: method involves carrying out pulsating Doppler echocardiographic examination. Mean pressure is determined in pulmonary artery. Mean pressure in pulmonary artery being less than 13 mm of mercury column, no cardiac rhythm disorders risk is considered to take place. The value being greater than 13 mm of mercury column, complex cardiac rhythm disorder occurrence risk is considered to be the case.
EFFECT: accelerated noninvasive method.