Method of endoscopic retrograde cholangiopancreatography in patient with earlier performed cholecystostomy
SUBSTANCE: introduction of endoscope into duodenum is realised. After that, "tight" filling of choledoch is performed through cholecystostoma with sterile solution, for instance, 0.25% Novocain. After that major duodenal papilla is catheterised and endoscopic papillosphincterotomy is carried out.
EFFECT: method makes it possible to provide effective surgical treatment of cholelithiasis with simultaneous reduction of probability of development of complications due to provision of possibility of fast identification and good visualisation of major duodenal papilla.
The present invention relates to the field of medicine, namely to surgery.
It is known that one of the stages of treatment of gallstone disease (GSD) is an endoscopic retrograde cholangiopancreatography (ERCP).
The known method ERCP, wherein the radiopaque substance using a special retrograde catheter is inserted through the endoscope directly into the biliary system and pancreatic ducts. ERCP allows you to visualize, diagnose and document the stones in the ducts and gall bladder, changes in the ducts in chronic pancreatitis, tumors, as well as stenosis and stricture of the ducts (the Journal news of beam diagnostics. [Electronic resource] news of beam diagnostics 1999 1: 28-30, link http://nld.by/199/stat13.htm date of access: 3.02.2014).
The closest in technical essence to the proposed method is ERCP in a patient with previously performed by cholecystectomies, including the introduction of the endoscope into the duodenum (duodenum), catheterization of the large duodenal papilla (MDP) and holding EPST.
The known method is as follows. Includes staging treatment: at the first stage examination of the patient using ultrasound (USG) of the abdomen. If there are signs of biliary and intravesical hypertension� under perform ultrasound-guided puncture and drainage of the gallbladder (cholecystectomy) or common bile duct (cholangiostomy).
The second stage performs ERCP, endoscopic papillosphincterotomy (EPST). After the pre-pass sedation for endoscopic transpapillary interventions, which include catheterization of BDS, EPST and control the contrast of the ducts with the registration of the free flow of contrast from the biliary ducts into the duodenum (Scientific electronic library disserCat - the modern science of the Russian Federation, article, dissertation research, scientific literature, texts theses [Electronic resource] // title of thesis and abstract by WAC 14.01.17, PhD Belenkov A. V.: "On the tactics of treatment of patients with the syndrome of obstructive jaundice gallstone Genesis" http://www.dissercat.com/content/o-taktike-lecheniya-bolnykh-s-sindromom-mekhanicheskoi-zheltukhi-zhelchnokamennogo-geneza date of access: 3.02.2014).
The disadvantages of the known method, and similar, should be attributed to the technical difficulties associated with the introduction of a catheter into the mouth of BDS due to poor visualization.
It is known that during prolonged manipulation attempt at imaging and catheterization of BDS may develop complications such as pancreatitis, bleeding, perforation, cholangitis and other infectious complications (Med-Practic [Electronic resource] JOURNAL of SURGERY in ARMENIA. G. S. TAMAZIAN, 3.2011 // Twenty-year analysis of complications after PR�changes ERCP, EPST in "Erebuni" http://www.med-practic.com/rus/1026/17673).
In addition, the increase in execution time of this manipulation leads to increased radiation load on the patient and the duration of anaesthesia.
The aim of the invention is the ability to perform ERCP and endoscopic papillosphincterotomy with less technical difficulties identify the mouth of the LDP and the least likelihood of postoperative complications.
The technical result of the proposed method ERCP is to increase the efficiency of treatment by reducing the complexity and duration of detection of the mouth of BDS, as well as reducing the risk of developing complications.
The technical result of the claimed method ERCP in a patient with previously performed by cholecystostomy is achieved by the introduction of the endoscope into dwenadzatiperstnuu intestine, catheterization of BDS and holding EPST.
Distinctive techniques of the proposed method lies in the fact that prior to catheterization OBD hold "tight" filling via the common bile duct cholecystitis sterile fluid such as a solution of novocaine 0.25%.
Comparative analysis of the proposed method and the prototype shows that the inventive method differs from the known above-mentioned techniques. These differences allow to draw a conclusion about conformity of the proposed technical �decision criterion of the invention of "novelty."
The analysis of patent and scientific and medical literature showed that the proposed method has the characteristics that distinguish it not only from the prototype, but also from other variants of endoscopic retrograde cholangiopancreatography.
Receiving "tight" filling via the common bile duct cholecystitis liquid can reduce the complexity and duration of detection of the mouth of BDS, through visualisation and the unfolding of the flowing fluid, which facilitates its catheterization when performing ERCP and EPST.
The use of novocaine 0.25% as a fill choledoch solution and also provides an analgesic effect, which is important when performing ERCP, because the spasmolysis facilitates catheterization of the OBD.
Distinctive techniques of the proposed method provide the possibility of obtaining the specified technical result - improving the efficiency and safety of treatment by reducing the complexity and duration of detection of the mouth of BDS, reduce the risk of developing complications.
Stated allows to draw a conclusion about conformity of the proposed method the criterion of "inventive step".
The method constituting the invention, intended for use in medicine. This method can be used in surgery in the treatment of cholelithiasis in patients with previously performed cholecystostomy�th. The possibility of its implementation confirmed as described in the application of methods and means, therefore, the proposed solution meets the criterion of invention "industrial applicability".
The essence of the proposed method ERCP in a patient with previously performed by cholecystostomy is illustrated by a clinical example.
Example. Patient B., 64 years old, was admitted to the emergency surgery Irkutsk regional clinical hospital about cholelithiasis, acute cholecystitis, complicated by mechanical jaundice with complaints of pain in the right hypochondrium and epigastric region, nausea, bitter taste in the mouth, yellowness of the skin and sclera. The examination revealed a sharp pain at the point of Kera, positive symptoms Murphy, Grekov-Ortner. In General, the analysis of blood (OAK) - leukocytosis with a shift leukocyte formula to the left, increased erythrocyte sedimentation rate. In the biochemical blood test: total bilirubin - 20.8 µmol/l; direct bilirubin of 5.4 µmol/l; ALT 89,9 IU/l; ACT 100,2 IU/l; alpha - amylase (diastase) 130,0 IU/L. abdominal ultrasound: liver is not enlarged, smooth contours, homogeneous parenchyma. Gallbladder irregular shape 10*6 cm, 5 mm wall is doubled, sealed. Volume 70 CC In the lumen of dense echostructure, giving an acoustic shadow. Choledoch 11 mm. Signs of biliary hypertension.
Breath the patient to breath under ul�travacalm control a puncture of the gallbladder. The correct position of the needle was controlled by the dark evacuation of bile. When successfully completed the puncture and there are indications for biliary decompression performed cholecystostomy, the drainage catheter was placed directly into the cavity of the gallbladder.
After pre-treatment under local anesthesia of the pharynx 10% spray lidocaine executed videothoracoscopy, fistulography, EPST.
The esophagus is freely pass on all over, slimy pink all over, longitudinal folds, straightened air well, cardia 39 cm, peristaltic, closes completely, the Z - line level, clear - on 39 see the Stomach was well disposed of air, active peristalsis, the folds are expressed in the lumen modest amount of food (Gasterosteus-?). The porter round, peristaltic, closes completely.
The mucous membrane of the duodenum is not changed. In the upper horizontal with the transition to the descending part of the duodenum revealed a diverticulum with a diameter of 15-20 mm without signs of inflammation. OBD poorly expressed point the mouth of 2 mm, the bile in the time of the survey from the mouth into the duodenum has not been received.
Made shallow, up to 2-3 mm, canulate OBD. Canulate of the common bile duct is not possible because of the presence of stricture of the terminal segment of the common bile duct (TOX) - according to fistulography has a conical narrowing of the TOX in the form of "Peschiera". After the introduction of cholecystitis (respectively in the gallbladder and bile ducts) solution of novocaine 0,25%, the flow through the common bile duct (OVC), the liquid spreads and renders the mouth and relieves spasms of the OBD.
The creation of high pressure fluid in the ducts and prolapse of BDS in the lumen of the duodenum was able to freely spend canulation the catheter into the lumen of the OVC.
Performed antegrade filling of the ducts: OVC is not expanded, the contents are homogeneous, the contours of smooth ducts. When fistulography marked uniform constriction TOCH (cicatricial stricture). Choledoch entered the stretch papillotome made EPST to 9-10 mm; minimal bleeding from papillotomes incision stopped by coagulation. On the control cholangioscopy revealed free flow of contrast from the biliary ducts into the duodenum.
Conclusion: Stricture (scar?) the terminal segment of the common bile duct. Diverticulum of the duodenum. Gastrulas. Chronic gastritis.
The postoperative period was uneventful. The symptoms of pain fully docked, nausea, bitter taste in the mouth does not bother me. The skin is clean, pale pink. Urine light yellow. Labratory indicators normalized. In the control ultrasound gallbladder 6,6*4 cm, wall 3 mm. Volume 55 CC In the lumen of dense echostructure, giving ten acoustic�. Choledoch 7 mm. Signs of biliary hypertension no.
Thus, the proposed method allows to visualize the mouth of BDS with less technical difficulties, to reduce the time necessary manipulations and reduces the risk of possible complications.
Method of endoscopic retrograde cholangiopancreatography in a patient with previously performed by cholecystectomies, including the introduction of the endoscope into the duodenum, catheterization of the major duodenal papilla and endoscopic papillosphincterotomy, characterized in that prior to catheterization papillary hold "tight" filling via the common bile duct cholecystitis sterile fluid such as novocaine 0.25% solution.
SUBSTANCE: invention refers to thiacalixarene derivatives of general formula I , which can be used as agents for DNA delivery into eukaryotic cells.
EFFECT: there are produced new heterocyclic compounds possessing the effective biological properties.
2 dwg, 8 ex
SUBSTANCE: invention relates to medicine, namely to neurosurgery, neurooncology, and can be used for the treatment of glial brain tumours of a supratentorial localisation. For this purpose photodithazine in a dose of 1 mg/kg of body weight is introduced to a patient 2 hours before the tumour ablation. After that, surgical access to the tumour is performed. The operation wound is illuminated by blue colour with a wavelength of 400 nm, and the tumour boundaries are determined by means of fluorescence of photodithazine, selectively accumulated in the tumour tissue. The tumour is ablated under control of the tumour luminescence in blue colour with the application of an operation microscope. After that, a flexible light guide from a radiation source with a wavelength of 662 nm and power of 2.0 W with a light dispersing nozzle is placed into the tumour bed and the perifocal zone of the tumour is irradiated. The dose of irradiation is determined by the disappearance of fluorescence.
EFFECT: method provides an increase of the treatment efficiency due to the reliable clear determination of the tumour tissue boundaries with the normal brain substance independent on the malignancy degree and character of the tumour growth, with an increase of its ablation radicality, as well as due to the destruction of cells, located in the perifocal zone.
2 cl, 1 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention relates to field of pharmaceutics and deals with application of aqueous balanced solution of electrolytes as external washing solution, for washing and purification in case of surgery, for washing and purification of wounds and burns, for washing body cavities, for eye washing, for washing and purification of instruments and in servicing stomas or as carrier solution for compatible electrolytes, nutrients and medications. Aqueous balanced solution contains: 138-146 mmol/l of sodium, 4-5 mmol/l of potassium, 0.5-2.0 mmol/l calcium, 1.0-1.5 mmol/l of magnesium, 100-108 mmol/l of chloride, 0.5-1.5 mmol/l of phosphate, 18-26 mmol/l of gluconate, 20-28 mmol/l of acetate.
EFFECT: invention makes it possible to use aqueous balanced solution as effective means of external washing solution or as carrier solution for compatible electrolytes, nutrients and medications.
11 cl, 2 tbl, 4 ex
SUBSTANCE: stellaria grass infusion is introduced to laboratory animals in a dose of 5 ml/kg of weight 20 minutes before irradiation in an ultraviolet chamber for 14 days daily.
EFFECT: stable pharmacological effect under conditions of reduction of the phytocorrection course duration.
SUBSTANCE: invention refers to medicine and can be used for making a drug for removing subcutaneous fat. That is ensured by using a composition containing: at least one phospholipid, at least one glycyrrhizic acid or a glycyrrhizic acid salt, and wherein total content of phospholipids and glycyrrhizic acid or its salts makes 2-80 wt % and a weight ratio of phospholipids and glycyrrhizic acid or its salts makes from 30:1 to 0.5:1. The composition can additionally contain additives. As phospholipid, the composition contains animal or herbal phosphatidylcholine. The composition can also contain glycyrrhizic acid or potassium, sodium, ammonium or magnesium salt of glycyrrhizic acid. As an additive, the composition contains sugar, particularly glucose, or maltose, and/or their derivatives, mannitol, sorbitol or lactose. The composition contains phosphatidylcholine in a total amount of 15 to 98 wt %, preferentially 30 to 98 wt %, more preferentially 50 to 98 wt %, especially preferentially 75 to 98 wt %, and most preferentially 75 to 90 wt % of total content of phospholipids. The composition is used in the dry form, preferentially in the form of lyophilisate prepared by freezing and drying, or in the form of a solution. The composition can contain physiologically acceptable solvents, including water, normal saline, glucose solution, such monohydric alcohols, as ethanol, 2-propanol, n-propanol, such polyatomic alcohols, as glycerol and/or propane diol, such polyglycols, as polyethylene glycol and/or Miglyol, glycerol, formal, dimethylisosorbitol, natural and synthetic oils and/or esters. Diseases of subcutaneous fatty tissue can be particularly related to local fat maldistribution. Fatty tissue tumour decomposition and reduction can be also solved. The drug can be presented in the form of cream, ointment, gel, hydrogel, lotion, paste, powder or solution. Undesired unaesthetic and pathological local fat maldistribution involve lipoedema, adipose growth, abdominal adiposis, cellulites, pseudogynecomasty, "buffalo hump" in HIV-infected patients, panniculitis or nonspecific subcutaneous fat deposition. The preparation is administered by subcutaneous, intra-abdominal, intramuscular or intravenous injection. The administration is implemented by a method specified in a group consisting of ioophoresis, electroporetion and phonophoresis.
EFFECT: described invention is successfully used for the above purposes.
17 cl, 11 ex, 7 tbl, 11 dwg
SUBSTANCE: what is presented is using meso-tetra(3-pyridyl)bacteriochlorin of structural formula (I) as a near-infrared photosensitiser for a photodynamic therapy. Doses 1.0-2.5 mg/kg of the declared photosensitiser have provided 70-100% tumour growth inhibition, 80-131% increase in life expectancy and 25-100% animals' recovery by selective tumour collection and fast clearance.
EFFECT: high photoinduced activity on human tumour cells of various epithelial origin and high dose-dependent anti-tumour effectiveness in the animal with tumours of various origins.
5 dwg, 8 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: presented invention refers to immunology. There are disclosed versions of a dimer compound for forming a multimer capable to reproduce the effector function of aggregated IgG with identical monomers. Each monomer of the dimer comprises: a monomer of IgG2 link region or a monomer of isoleucine zipper, dimerising each of which forms a multimerising region, and at least Fc-domain monomer containing a link region, CH2 domain and CH3 domain of IgG1. What is described is a multimer compound capable to reproduce the effector function of aggregated IgG and containing two or more dimers. There are disclosed a method for changing the immune response using the dimer or multimer, as well as a multimer-based method of treating an inflammatory disease.
EFFECT: using the invention provides the new compounds capable to bind at least one FcR specified in a group consisting of: FcγRI, FcγRII, FcγRIII, FcγRIV, or their non-human version that can find application in medicine for IVIG substitution for treating a wide range of diseases, including the inflammatory and autoimmune diseases.
7 cl, 25 dwg, 5 tbl, 25 ex
FIELD: veterinary medicine.
SUBSTANCE: product comprises Lycopodium clavatum, Acidum arsenicosum, Phosphorus, Podophyllum peltatum, Thuja occidentalis, Echinacea purpurea, Silybum marianum, Selenocysteine, and the components are taken in the dilutions described below in the following ratio, in parts: Lycopodium clavatum ⌀=D1 0.004, Podophyllum peltatum ⌀ 0.003, Acidum arsenicosum ⌀=D2 0.0001, Phosphorus ⌀=D3 0.001, Thuja occidentalis ⌀ 30, Echinacea purpurea ⌀ 30, Silybum marianum ⌀ 60, Selenocysteine 0.2.
EFFECT: product has an effective stress-protective and growth-stimulating effect, it regulates the metabolism in young farm animals.
3 cl, 10 tbl, 1 ex
SUBSTANCE: method for producing an agent for stimulating body cells involving preparing a mixture of aqueous solution of selenious acid and PEG 400; that is followed by preparing a mixture of hydrazine hydrochloride and PEG 400; the prepared mixtures are combined; the solution is put to dialyse against distilled water; surplus of water is driven off; the produced solution is added with hexamethylene tetramine; pH is reduced to 7.2-7.4; the method is implemented in certain circumstances.
EFFECT: producing high-effective, ecologically safe agent by the synergism of colloidal selenium and hexamethylene tetramine on body cell stimulation.
1 dwg, 2 tbl, 4 ex
SUBSTANCE: invention relates to medicine and can be used for the treatment of radiation-thermal injury of an organism. For this purpose a single subcutaneous introduction of bifidumbacterin, irradiated by gamma-rays in a dose of 14.0 Gy, is carried out. Bifidumbacterin is introduced in a dose of 1.43·106 CFU/kg. After that, 10% hypericum oil is applied on the burnt region. Then a 10% hypericum cream is applied after 3-4 days.
EFFECT: method makes it possible to carry out the treatment of combined radiation-thermal injuries in an effective way with the application of available and cheap pharmacotherapeutic means.
1 tbl, 4 ex
SUBSTANCE: transpedicular transdermal puncture of vertebra body is performed with trocar needle. After that, venospondilography is carried out, and time of appearance of contrast substance in bodies of adjacent vertebrae is determined. After that, catheter is introduced into lumen of trocar needle. Catheter and port are implanted subcutaneously with further introduction of cytostatics with injectomat through port-system. Rate and minute volume of cytostatics introduction are calculated by time of contrasting of adjacent vertebrae in the process of venospondilography. For thoracic part volume of cytostatics must not exceed 2-2.5 cm3 for the time of filling adjacent vertebrae with contrast, with volume being from 3 to 4.5 cm3 for lumbar part.
EFFECT: effective treatment of patients with spine tumours due to introduction of anti-tumour chemical preparations directly into body of vertebra, affected with tumour or metastasis, which makes it possible to increase concentration of chemical preparations directly in tumour and results in reduction of its continued growth or recurrence.
SUBSTANCE: duodenoscopy is performed with the use of an endoscope with its inspection window on the side. The greater duodenal papilla is visualised. It is cannulated with a Teflon catheter with a working end having an aperture in the middle. An end face of the working end of the catheter is inclined at an angle of 45°. Two apertures of 0.2 cm in diameter are arranged oppositely diametrically on its sides. The first aperture is arranged at 0.4 cm from the end face. The second is found at 0.8 cm. A metal lift is actuated to advance the catheter into a lumen of the common bile duct. A sterile syringe is attached to a connector of the catheter; the syringe is pulled out to draw the bile into the catheter. The syringe piston is pulled out to a 8 ml mark and then released. The manipulation is repeated until the bile penetrates into the syringe. After the bile ingress into the syringe is visualised, the piston is pulled out to a 5 ml mark. A 2-second pause is made. The piston is released. In the course of bile aspiration, the catheter is advanced along the common bile duct 1-2 cm above.
EFFECT: method enables fast and effective bile aspiration from the lumen of the common bile duct, preparation of the material free from the intestinal discharge and pancreatic fluid, as well as reduces a risk of the catheter suction to a wall of the common bile duct ensured by the catheter structure and a certain sequence of the syringe piston motions.
4 dwg, 1 ex
SUBSTANCE: invention refers to medicine, namely to anaesthesiology and resuscitation, and can be used as an anaesthetic support in the necrectomy of the lower limbs in the patients with the diabetic foot. That is ensured by performing the nerve block anaesthesia of the sciatic nerve with a local anaesthetic. The block anaesthesia is performed for 72 hours.
EFFECT: method provides reducing the length of the wound epithelialisation and accelerating its healing by improving blood circulation caused by prolonged retention of the vasodilatation effect, including after administering anaesthesia in these patients is terminated.
2 dwg, 3 tbl, 2 ex
SUBSTANCE: spinal anaesthesia is followed by catheterisation of an epidural space at the level of L1-L2. The spinal anaesthesia is performed at the level of L4-L5 by administering 0.5% bupivacaine. Bupivacaine is administered in a dose of 5-6 mg if the pregnant woman's height is less than 165 cm, and the dose is 6-7 mg if the pregnant woman is from 165 to 175 cm high. After the local anaesthetic is administered into the epidural space, normal saline is introduced. If the intra-abdominal pressure is ≤16 cm H2O, normal saline 15 ml is administered; if the intra-abdominal pressure is 17-21 cm H2O, an amount of normal saline is 10 ml, whereas the intra-abdominal pressure of 22-28 cm H2O requires an amount of 5 ml.
EFFECT: performing the effective spinal anaesthesia combined with reducing a probability of hypertension by dilating the epidural space preliminary in accordance with the intra-abdominal pressure.
1 tbl, 1 dwg, 2 ex
SUBSTANCE: group of inventions refers to medicine and can be used for the restoration of an adequate passage or opening a passage through a vascular occlusion. The device uses a tension element and a spring-assisted element, e.g. a compression spring for oscillations. The system comprises a device and a control unit for adjusting the motion frequency and amplitude of the oscillation element.
EFFECT: device and system can be used for passing through the complete or partial vascular occlusion and for improving the catheter passage through a partially occluded vessel or a bending vessel.
23 cl, 4 dwg
SUBSTANCE: ozone-oxygen mixture is administered from both sides of a retroperitoneal space into paranephric fat in an amount of up to 500 mg included from each side. The ozone concentration makes 10 mg/l and less. The therapeutic course makes 5-10 sessions every 1-3 days.
EFFECT: effective treatment of the given pathology by supplying the ozone-oxygen mixture directly to an arterial trunk that causes its targeted action.
SUBSTANCE: invention refers to medicine, namely to gynaecology, and can be used for diagnosing the transport dysfunction of the uterine tubes. That is ensured by hysteroscopy accompanied by inserting catheters into the uterine cavity within openings of the uterine tubes, bringing them out through the vagina and fixing to the inner thigh. A colour solution is introduced into the abdominal cavity through a puncture of the posterior vaginal vault. That is followed by a double-side block of the round ligament of the uterus with the anaesthetic solution in an amount of 15.0 ml every 4-6 hours. Keeping the transport function is shown by observing the colour solution 24 hours later in the catheter lumen. The transport dysfunction of the uterine tubes is shown by no ingress of the colour solution into the catheter.
EFFECT: technique provides the reliable diagnosis of the transport dysfunction of the uterine tubes, including their intramural departments, except for the functional component of the transport dysfunction, with no surgical intervention required.
SUBSTANCE: invention refers to medical equipment, namely to devices for the small intestinal drainage in acute abdominal surgical pathology. A device for the small intestinal intubation in the technically complex environment consists of an outer elastic tube of 12 mm in diameter, 280-300 cm long and having holes at a caudal end. A supplementary tube of 3 mm in diameter is inserted into a lumen of the outer tube along the entire length; a longitudinal rubber bag is attached to the caudal end of the supplementary tube brought out through the caudal end of the outer tube; at the end of the caudal end, there is an olive movable in relation to the outer tube. Progressive motion of the olive in the intestinal lumen is ensured by the inflation and elongation of the bag. The device is movable by fixing the olive in the intestinal lumen by the elastic contraction of the bag after de-aeration.
EFFECT: invention provides reducing injuries that might accompany the intestinal intubation manipulations in the technically complex environment.
SUBSTANCE: invention refers to medicine, namely to traumatology and orthopaedics, and can be used in hip replacement surgeries. That is ensured by preparing a silicone tube of a drain system a distal end of which is cut off perpendicularly to a long axis of the tube so that to leave two perforations. This end of the prepared tube is inserted into the prepared intramedullary femoral canal until it stops against the distal bone plug. The perforations are directed into the intramedullary canal cavity. The tube is placed to its inner or outer wall and retained until removed. After placing, the tube us connected to a surgical suction unit, and bone cement mass is tightly implanted into a proximal portion of the intramedullary canal at the phase of modelling. The surgical suction unit is actuated at pressure with a uniform filling of the canal with bone cement mass. A surgeon states the cement visually in the tube and deactivates the surgical suction unit and removes the tube.
EFFECT: method provides generating the uniform cement blanket with minimum foreign matters in the form of bone fragments, blood and air, as well as enables implanting the femoral components of the cement fixation of various configurations without the use of complex expensive devices for introducing the bone cement.
8 dwg, 1 ex
SUBSTANCE: treating tuberculous spastic microcystis with underlying anti-tuberculosis chemotherapy requires peridural anaesthesia 5-7 days long. That is combined with the exposure to a laser light at a wave length of 632 nm of power 12 mW covering a biologically active point of the urinary bladder on a hand. The 4-minute exposure is daily for 5-7 days.
EFFECT: higher clinical effectiveness by the fast reduction of pain syndrome, higher urinary bladder capacity, avoiding the need of surgical intervention and disability.
1 tbl, 2 ex
SUBSTANCE: 10-day conventional drug therapy comprising a daily vascular therapy by intravenous drop-by-drop administration of Trental 5 ml dissolved in 0.9% normal saline 200 ml is followed by a local therapeutic exposure on the involved shoulder joint. That is ensured by intramuscular administration of a therapeutic mixture containing Depot-Medrol 1 ml - 40 mg, 2% lidocaine hydrochloride 6 ml - 120 mg and cyanocobalamine 3 ml - 1.5 ml into trigger areas of supraspinous, infraspinous, deltoid and subscapular muscles. Administering the therapeutic mixture follow the schedule: on the first therapeutic day, the therapeutic mixture is injected into the trigger areas of supraspinous and infraspinous muscles in an amount of 5 ml into each muscle once a day; on the second therapeutic day, the therapeutic mixture is injected into the trigger areas of deltoid and subscapular muscles in an amount of 5 ml into each muscle once a day; from the third to ninth therapeutic day, the therapeutic mixture is introduced in a dose of 10 ml every second day into the trigger areas of the subscapular muscle.
EFFECT: method enables increasing the clinical effectiveness in the patients with scapulohumeral periarthrosis by recovering the shoulder joint function with reducing the recurrent pain syndrome considerably.