Method of evaluating motor-evacuation function of large and small parts of intestine in 7 to 15 year old children

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery and gastroenterology. Registration of sound effects from front abdominal wall is performed. Density of spectrum power in the range of low (D1) and high (D2) frequencies: 200-450 Hz and 450-700 Hz in children at the age of 7-9 years, 100-350 Hz and 350-600 Hz in 10-12 year old children, 100-350 Hz and 350-600 Hz in 13-15 year old children is determined. Ratio of density values (C), obtained at low frequencies to values at high frequencies is calculated. In evaluation of results coefficients depending on child's age (Cav) are applied: 7-9 years Cav - 1.11, 10-12 years Cav - 1.00, 13-15 years Cav - 1.01. Obtained values C larger than Cav testify to predominance of large intestine sounds; C less than Cav - about predominance of small intestine sounds.

EFFECT: method extends arsenal of means for evaluation of motor-evacuation function of intestine, which is reached due to spectral analysis of spectrum power density at low and high frequencies with taking into account child's age peculiarities.

4 dwg, 2 ex, 1 tbl

 

The invention relates to medicine, namely to surgery, gastroenterology, and can be used for evaluation of motor-evacuation function of the colon and small intestine.

The state of the motor activity of the digestive tract individually for each person and can be caused by various pathologies in a certain way. Recording and analysis of acoustic phenomena of the abdomen used to study the physiology of digestion, and for the diagnosis of many diseases of abdominal cavity organs (Cormorants centuries, Dementiev, A. P. Age-related features of motor function of the intestine in healthy children according to phonoenterography // Questions of protection of motherhood and childhood. - 1981. No. 11. - S. 33-35.).

In a known manner an objective assessment of motor function of the gastrointestinal tract is a computer financeware (CFAG), which is based on recording the total acoustic activity of the abdominal cavity by means of the electronic device and the appropriate software. The sound effects in the abdomen appear when the movement of the intestinal contents in the lumen of the gastrointestinal tract (Chistyakov, C. I. intestinal Motility in the postoperative period according to Phonography abdomen / Functional obstruction of the digestive tract. - M., 1967. - S. 305-311.) Therefore, studying the acoustic activity of the abdominal cavity through CFAG can objectively judge the state of the motility of the gastrointestinal tract at the time of the survey (Safronov, B. Diagnosis and correction of motor-evacuation function of the gastrointestinal tract in children with surgical diseases associated with abdominal pain syndrome: author. dis... Prof. the honey. Sciences. - Moscow, 2007). The existing method of analysis monoenergism involves the calculation of three parameters.

The billing system. (mV) - Effective amplitude, reflecting the strength of the contractions of the intestinal wall; Fcp. (1/min) is the Effective frequency of the sound signal characterizing quantity peristaltically segments of the intestine for 1 min; Dcp. (C) the Average duration of the audible signals, indicating the duration of the propulsive wave peristaltically segments of the intestine.

Thus, the researcher receives a score of motor-evacuation function on the basis of quantitative characteristics of the total acoustic activity of the abdominal cavity.

A known method of estimating a sound signal is a spectral analysis is performed using a mathematical Fourier transform. Analysis of the acoustic spectrum is used in electronics, musical acoustics, but in medical practice for analysis of the audio signals of the bruche the second cavity has not previously been used.

The existing method of valuation of computer monoenergism do not carry out a spectral analysis of the sound signals of the abdominal cavity, and there are no criteria by which to distinguish the motor function of the different departments of intestines.

The technical result of our proposed method lies in the fact that children from 7 to 15 years computer phoneinternet conduct the registration of sound effects from the anterior abdominal wall, evaluate the motor-evacuation function of the colon and small intestine on the distribution of power density spectrum, for this will determine the power density spectrum in the frequency range 200-450 Hz P1and 450-700 Hz P2in children aged 7-9 years, 100-350 Hz P1and 350-600 Hz P2in children aged 10-12 years, 100-350 Hz P1and 350-600 Hz P2children aged 13-15 years, calculate the ratio of the power density spectrum P1to the density power spectrum P2(K) the evaluation of the exercise, using the coefficients depending on age (cf), for children aged 7-9 years Tocf=1,11, at the age of 10-12 yearscf=1,00, aged 13-15 yearscf=1,01, the conclusion formulated in the following way:

if>cfthey say that from the totality of the acoustic phenomena of the abdominal cavity is dominated by the sounds of the colon, if K<Kcf they say that from the totality of the acoustic phenomena of the abdominal cavity is dominated by the sounds of the small intestine.

Our proposed method is as follows.

Phonoenterography examination is conducted in a separate room to prevent external interference. The research is being done with the patient lying on the back, which is to the right of the navel impose sensor. Record peristaltic noises perform 5 sessions over 1 minute. Then evaluate the motor-evacuation function of the colon and small intestine on the distribution of power density spectrum, for this will determine the power density spectrum in the frequency range 200-450 Hz P1and 450-700 Hz P2in children aged 7-9 years, 100-350 Hz P1and 350-600 Hz P2in children aged 10-12 years, 100-350 Hz P1and 350-600 Hz P2children aged 13-15 years, calculate the ratio of the power density spectrum P1to the density power spectrum P2(K).

K=P1P2

The interpretation of the exercise, using the coefficients depending on age (cf), for children aged 7-9 years Tocf=1,11, at the age of 10-12 yearscf=1,00, aged 13-15 yearscf=1,01, formulate conclusion is as follows:

if>cfthey say that from the totality of the acoustic phenomena of the abdominal cavity is dominated by the sounds of the colon,

if K<Kcfthey say that from the totality of the acoustic phenomena of the abdominal cavity is dominated by the sounds of the small intestine.

The accuracy of the proposed method proves conducted biological experiments on laboratory animals (dogs) and the study of motor-evacuation function in healthy children. In the experiment, the peculiarities of spectral characteristics of sounds colon, jejunum, ileum intestine in dogs, as well as the total acoustic activity recorded from the anterior abdominal wall of the animal. The study included 13 dogs, weighing from 10 to 35 kg. Financeware was made after the provision of anesthesia. As anaesthesia funds were used Zoletil, Rometer. First recorded total acoustic activity from the anterior abdominal wall. Then the operations carried out by the access to different sections of the gastro-intestinal tract. Record monoenergism was carried out by immersing interested intestine in a container filled with saline, fitted with a rubber membrane, which established the microphone phonoenterography. Thus, the sound ox is s, arisen in the intestine, through the saline solution was applied on the membrane, and perceived phoneinternet.

The data obtained are presented in table and figure 1.

The analysis of the obtained data statistically significant difference spectrum of acoustic signals of the ileum and jejunum intestine was not detected (p>0,05). However, when comparing the power density spectrum of sounds thick with the sounds of a thin intestine detected differences in the range of 160-210 Hz and above 280 Hz (p<0.05 Calculation of the probability justice "null" hypothesis was carried out taking into account corrections for multiple comparisons, Bonferroni at the significance level of each comparison 0,017).

In the field of low frequency range 160-210 Hz dominates the power density spectrum of the acoustic signals of the colon on this indicator for the sounds of the small intestine, and in the frequency range above 280 Hz, conversely, decreases the power density spectrum of the sounds of the colon and increases the acoustic activity of the thin intestine. The observed phenomenon is understandable, as the sections of the gastro-intestinal tract in its lumen has a different environment, different lumen diameter and wall tension.

In the field frequency 240 Hz power density spectrum of the sounds of the colon and small intestine is approximately equal,and in the frequency ranges above and below 240 Hz are observed indicated statistically significant differences. Thus, a frequency of 240 Hz corresponds to the area of intersection of the graphs of the distribution of the power density spectrum of the sounds of the colon and small intestine. Therefore, the frequency of 240 Hz is used as the boundary of high and low frequency range (140-240 Hz and 240-340 Hz). Then to the large intestine value of the ratio of the density power spectrum in the range of 140-240 Hz to the density power spectrum in the range 240-340 Hz greater than 1 (average of 1.31±0,07, n=9), and for thin intestine is less than 1 (average of 0.91±0,05, n=13).

Total acoustic activity recorded from the anterior abdominal wall, includes the sounds of all departments of the intestine. When analyzing the total spectrum of acoustic signals of the abdominal cavity revealed that the maximum power density spectrum is the field frequency 240 Hz and corresponds to the area of intersection of the graphs of the distribution of the power density spectrum of the sounds of the colon and small intestine.

Thus, the experiment proves that the maximum power density spectrum of the sounds of the colon is in a lower frequency range (less than 240 Hz) than the sounds of the small intestine (more than 240 Hz). For the evaluation of the acoustic activity of the colon and small intestine apply the ratio of the density power spectrum in the low-frequency d is apatone to the density power spectrum in the high frequency range. Frequency, which corresponds to a maximum power density spectrum of the total acoustic activity of the abdominal cavity, can be used as the boundary of high and low frequency ranges. The coefficient, depending on the value reflects the acoustic activity of a thick or thin intestine.

Given the common anatomical and physiological characteristics of the gastrointestinal tract, affecting the characteristics of the acoustic signals of the abdominal cavity of dogs and humans, and the lack of opportunities for the described experiment, people have developed an approach for the evaluation of motor-evacuation function of the gastrointestinal tract is applicable in clinical practice.

We conducted a survey of motor-evacuation function in 65 healthy children. The children are divided into 3 age group 7-9 years - 16, 10-12 years - 26, 13-15 years was 23. Gender differences in the groups were not. The study regularities of the distribution of the power density spectrum of the total acoustic activity recorded from the anterior abdominal wall. In the first group from the range 0-1000 Hz 70% power spectrum is in the range 200-700 Hz, maximum power density spectrum corresponds to 450 Hz (figure 2). In the second group from the range 0-1000 Hz 70% of the power spectrum is the range of the e 100-600 Hz, the maximum power density spectrum corresponds to 350 Hz (figure 3). In the third group, as well as in the second group from the range 0-1000 Hz 70% of the power spectrum is the range of 100-600 Hz, maximum power density spectrum corresponds to 350 Hz (figure 4). In all groups the distribution is symmetric. Considering the results of the biological experiment for the evaluation of motor-evacuation function of the colon and small intestine apply the ratio of the density power spectrum in the low frequency range to the power density spectrum in the high frequency range. As the boundaries of high and nizkochastotnogo ranges, you can use the frequency, which corresponds to a maximum power density spectrum of the total acoustic activity of the abdominal cavity.

Thus, for calculation of the coefficient of the used frequency band: P1(200-450 Hz) and P2(450-700 Hz) for children aged 7-9 years, P1(100-350 Hz) and P2(350-600 Hz) for children aged 10-12 years, P1(100-350 Hz) and P2(350-600 Hz) for children aged 13-15 years. The average value of the ratio for children aged 7-9 years Tocf=1,11±0,08, at the age of 10-12 yearscf=1,00±0,07, aged 13-15 yearscf=1,01±0,1.

Clinical example 1

Surveyed H., age 10, was diagnosed healthy.

Evaluation of the totality of acoustic signals.

The power density spectrum in the range of 100-350 Hz - 7,58 ms2

The power density spectrum in the range of 350-600 Hz - 10,43 ms2

The ratio - 0,73

Tocf=1,00; 0,73<1,00

Conclusion: from the totality of the acoustic phenomena of the abdominal cavity is dominated by the sounds of the small intestine.

Clinical example 2

The subject M, 14 years old, the diagnosis of gangrenous appendicitis.

Evaluation of the totality of acoustic signals.

The power density spectrum in the range of 100-350 Hz at 13.84 ms2

The power density spectrum in the range of 350-600 Hz to 9.66 ms2

The ratio was 1.43

Tocf=1,01; 1,43>1,01

Conclusion: from the totality of the acoustic phenomena of the abdominal cavity is dominated by the sounds of the colon.

The distribution of the spectral power density of the acoustic signals of different parts of the intestine in dogs.

Table
Frequency range, HzThe spectral power density, %
Jejunum (n=12)The ileum (n=13)The colon (n=9)Total range (n=12)
100-110 2,20±0,182,15±0,161,77±0,362,89±0,32
110-1202,39±0,192,37±0,16of 2.26±0,373,01±0,28
120-1302,64±0,182,62±0,152,84±0,413,16±0,25
130-1402,93±0,192,80±0,183,31±0,393,34±0,21
140-1503,10±0,203,11±0,173,80±0,343,52±0,17
150-1603,40±0,263,37±0,204,22±0,333,71±0,14
160-1703,59±0,313,61±0,224,57±0,31*3,86±0,12
170-1803,70±0,253,82±0,245,08±0,39*4,01±0,11
180-1903,85±0,22Android 4.04±0,275,28±0,48*4,14±0,11
190-2003,99±0,204,10±0,245,19±0,41*4.26 deaths±0,11
200-2104,10±0,184,14±0,21equal to 4.97±0,36*4,36±0,11
210-2204,21±0,154,17±0,204,69±0,274,42±0,10
220-2304,35±0,144.26 deaths±0,194,50±0,294,46±0,09
230-2404,36±0,154,33±0,204,33±0,254,48±0,08
240-2504,40±0,174,40±0,214,20±0,214,47±0,09
250-260to 4.52±0,154,51±0,244,16±0,214,43 is 0,10
260-270and 4.68±0,184,72±0,394,01±0,254,37±0,11
270-2804,70±0,224,85±0,463,79±0,234,30±0,12
280-2904,69±0,234,65±0,363,62±0,24*4,25±0,13
290-3004,63±0,30of 4.49±0,343,62±0,264,19±0,40
300-3104,57±0,334,22±0.273,41±0,25*4,15±0,15
310-3204,50±0.36was 4.02±0,253,20±0,23*4,11±0,16
320-3304,40±0,35a 3.87±0,253,07±0,22*4,08±0,17
330 to 340the 4.29±0,37a 3.87±0,352,98±027* Android 4.04±0,19
340-350to 4.23±0,373,54±0,272,91±0,28*4,00±0,20
* Indicator significantly different (p<0,05) from the analogous parameters for the jejunum, ileum intestine.

The method of evaluation of motor-evacuation function of the colon and small intestine in children from 7 to 15 years on the basis of spectral analysis of acoustic signals of the abdominal cavity, characterized in that the computer phoneinternet conduct the registration of sound effects from the anterior abdominal wall, evaluate the motor-evacuation function of the colon and small intestine on the distribution of power density spectrum, for this will determine the power density spectrum in the frequency range 200-450 Hz P1and 450-700 Hz P2in children aged 7-9 years, 100-350 Hz P1and 350-600 Hz P2in children aged 10-12 years, 100-350 Hz P1and 350-600 Hz P2children aged 13-15 years, calculate the ratio of the power density spectrum P1to the density power spectrum P2(K) the evaluation of the exercise, using the coefficients depending on age (cf), for children aged 7-9 years Tocf=1,11, at the age of 10-12 yearscf=1,00, age is e 13-15 years cf=1,01, the conclusion formulated in the following way: if>cfthey say that from the totality of the acoustic phenomena of the abdominal cavity is dominated by the sounds of the colon, if K<Kcfthey say that from the totality of the acoustic phenomena of the abdominal cavity is dominated by the sounds of the small intestine.



 

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1 cl, 2 dwg, 2 ex, 4 tbl

FIELD: medicine, functional diagnostics.

SUBSTANCE: one should apply active electrodes in frontal (Fz), occipital (Cz), parietal (Td, Ts) areas, as for reference electrode it should be applied in area of right-hand wrist. Registration of constant potential level (CPL) should be performed under conditions of decreased impact of cutaneous resistance. Then the data obtained should be compared with pre-established normative ones for this age group. One should apply mean values and root-mean-square (rms) deviations, moreover, if CPL value obtained is not beyond the limits of Fz = 15.95 ± 3.88 mV, Cz = 25.71 ± 4.56 mV, Oz = 25.92 ± 5.39 mV, Td = 24.18 ± 5.45 mV, Ts = 22.51 ± 6.06 mV, in this case CPL distribution shows normal cerebral energetic state.

EFFECT: higher accuracy of evaluation.

2 ex

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