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首页> 外国专利> METHOD FOR ASSESSING THE MESENTERIC BLOOD FLOW IN ENDOVASCULAR INTERVENTIONS IN THE MESENTERIC BASIN BY ELECTROPHYSIOLOGICAL MONITORING AND RESONANCE STIMULATION

METHOD FOR ASSESSING THE MESENTERIC BLOOD FLOW IN ENDOVASCULAR INTERVENTIONS IN THE MESENTERIC BASIN BY ELECTROPHYSIOLOGICAL MONITORING AND RESONANCE STIMULATION

机译：电生理监测和共振刺激评估肠系膜内血管介入中肠血流量的方法

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摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to diagnosis. Prior to the planned endovascular intervention, a non-invasive electrographic examination of each portion of the digestive tract is performed, obtaining in a row at least 10 cycles of background spectral curves of peristaltic activity of the departments comparable in amplitude. That is followed by electric stimulation of each portion of the digestive tract for 10–15 min using a resonance effect by stimulating sinusoidal pulses with a current intensity of 10–12 mcA by means of a resonance stimulator of the gastrointestinal tract (GIT). Following sequence of pulses is used: stomach duodenum – small intestine – large intestine – 5-20-12-8 pulses respectively. That is followed by graphical recording of spectral curves obtained in response to stimulation and after obtaining synchronization of recorded spectra of peristaltic waves of stomach, duodenum, small and large intestine, curves of fine- and large intestinal peristaltic activity are analyzed. If observing at least 10 cycles of spectral curves comparable to each other in terms of amplitudes, the result is an estimate of the preoperative propulsive reserve of the digestive tract. If the background recording amplitude is lower than 29 mcV and amplitude gain in electric stimulation is less than 50 %, stimulation tolerance to the load is considered to be low, which is an indication for reperfusion surgical intervention – therapeutic angiography. If background recording amplitude is lower than 29 mcV, and amplitude gain in electric stimulation ranges from 50 to 75 % of background stimulation, then tolerance to load is considered doubtful, which is an indication for diagnostic angiography. If background recording amplitude corresponds to 29 mcV, and amplification gain in electric stimulation is less than 75 % compared to background recording, then tolerance to load is considered to be doubtful, which is an indication for diagnostic angiography. If background recording amplitude corresponds to 29 mcV, and amplitude gain in electric stimulation is more than 75 % of background, wherein clinical symptoms in the form of pains are absent, then tolerance to load is considered satisfactory, which is an indication for conservative therapy without therapeutic angiography with reperfusion endovascular intervention. Further, in the case of reperfusion endovascular intervention 2–2.5 hours after the operation, electrographic examination of each digestive tract is performed to produce at least 10 cycles of background spectral curves of peristaltic activity of the areas comparable in amplitude. That is followed by electric stimulation of each portion of the digestive tract for 10–15 min using a resonance effect, for which stimulating sinus pulses are applied by a resonance GIT stimulator with a current intensity of 10–12 mcA. Pulse supply sequence is used: stomach – duodenum – small intestine – large intestine – 5-20-12-8 pulses, respectively, before synchronizing spectra of oscillations of all recorded digestive tract. Graphical recording and analysis of spectral curves obtained in response to stimulation is carried out for 30–60 minutes. When observing at least 10 cycles of spectral curves comparable to each other in terms of amplitudes, a result of assessing the postoperative propulsive reserve of the digestive tract is considered to be achieved. If the background postoperative amplitude is below 29 mcV and the amplification amplitude in electric stimulation is less than 75 % of the postoperative background, tolerance to load by stimulation is considered to be low that is unsatisfactory result of treatment, and MSCT-angiography with assessment of mesenteric blood flow is considered to be shown to determine further tactics. If the background recording amplitude is lower than 29 mcV, the amplification amplitude during stimulation is 75 % or more, the evaluation is carried out in dynamics with the decision on the adequacy of collateral blood flow at the arcade vascular level. If amplitude of background recording curves is more than 29 mcV, as well as gain of amplitude, having value at background recording below 29 mcV, above 75 % in electric stimulation, reperfusion endovascular intervention is adequately conducted. If observing an amplitude of background recording lower than 29 mcV within a day, and an increase in stimulation is 75 % or more, a risk of developing acute intestinal ischemia is considered to be high, which is an indication for performing MSCT angiography or reagiography with resolving the question of recurrent surgical treatment.;EFFECT: method enables providing adequate electrophysiological monitoring and resonance stimulation of GIT in the examined pathology, both immediately before angiography or stenting, and on the first day after this procedure.;1 cl, 4 ex
机译：技术领域本发明涉及医学，即诊断。在计划进行的血管内干预之前，对消化道的每个部分进行无创电描记检查，连续获取至少10个周期的振幅变化可比的科室蠕动活动背景光谱曲线。随后，通过共振效应，通过胃肠道共振刺激器（GIT）刺激电流强度为10-12 mcA的正弦脉冲，对消化道的每个部分进行电刺激10-15分钟。使用以下脉冲序列：胃十二指肠–小肠–大肠–分别为5-20-12-8个脉冲。接下来是响应刺激而获得的光谱曲线的图形记录，并且在获得胃，十二指肠，小肠和大肠的蠕动波的已记录光谱的同步之后，分析了细肠和大肠蠕动的曲线。如果观察至少10个在振幅上可彼此比较的光谱曲线周期，则结果是术前消化道推进储备的估计值。如果本底记录振幅低于29 mcV，并且电刺激的振幅增益小于50％，则认为对负荷的刺激耐受性很低，这是再灌注外科手术-治疗性血管造影的指征。如果本底记录振幅低于29 mcV，并且电刺激中的振幅增益范围是本底刺激的50％至75％，则对负载的耐受性被认为是可疑的，这是诊断性血管造影的指征。如果背景记录幅度对应于29 mcV，并且与背景记录相比电刺激中的放大增益小于75％，则对负载的耐受性被认为是可疑的，这是诊断性血管造影的指标。如果本底记录振幅对应于29 mcV，并且电刺激中的振幅增益超过本底的75％，其中不存在疼痛形式的临床症状，那么对负荷的耐受性就被认为是令人满意的，这是不采用保守疗法的一种适应症再灌注血管内介入治疗性血管造影。此外，如果在手术后2–2.5小时进行再灌注血管内干预，则对每个消化道进行电子照相检查，以产生至少10个周期的振幅可比区域的蠕动活动背景光谱曲线。随后，利用共振效应对消化道的每个部分进行电刺激10-15分钟，为此，由共振GIT刺激器施加电流强度为10-12 mcA的刺激性窦性脉冲。在同步所有记录的消化道振荡频谱之前，分别使用脉冲供应顺序：胃–十二指肠–小肠–大肠– 5-20-12-8个脉冲。响应刺激而获得的光谱曲线的图形记录和分析进行了30-60分钟。当观察至少10个在振幅方面彼此可比的光谱曲线周期时，认为获得了评估消化道的术后推进储备的结果。如果本底术后振幅低于29 mcV并且电刺激的扩增振幅小于术后本底的75％，则认为对刺激的负荷耐受性较低，这是治疗效果不理想的，并且MSCT血管造影评估肠系膜血流被认为可以确定进一步的策略。如果本底记录振幅低于29 mcV，刺激期间的扩增振幅为75％或更高，则在动态分析中进行评估，并决定在拱廊血管水平的侧支血流是否充足。如果本底记录曲线的振幅大于29 mcV，并且振幅的增益超过29 mcV，在电刺激下高于75％的本底记录值，则应进行足够的再灌注血管内干预。如果一天内观察到的背景记录振幅低于29 mcV，并且刺激增加为75％或更多，则认为发生急性肠缺血的风险较高，这是进行MSCT血管造影或造影检查的指征解决复发性手术治疗的问题。效果：该方法能够在血管造影术或支架置入术之前以及该手术后的第一天对检查的病理情况提供足够的电生理监测和GIT共振刺激。1cl，4 ex

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