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首页> 外国专利> METHOD OF LIFE-TIME STUDY OF ANATOMICAL AND PHYSIOLOGICAL FEATURES OF SUPERFICIAL LYMPHATIC VESSELS OF LOWER EXTREMITIES IN NORM AND IN CHRONIC VENOUS INSUFFICIENCY

METHOD OF LIFE-TIME STUDY OF ANATOMICAL AND PHYSIOLOGICAL FEATURES OF SUPERFICIAL LYMPHATIC VESSELS OF LOWER EXTREMITIES IN NORM AND IN CHRONIC VENOUS INSUFFICIENCY

机译：正常人和慢性静脉功能不全下肢上肢浅表淋巴管的解剖和生理特征的终身研究方法

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FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to angiology, and can be used for lifetime assessment of anatomical and physiological features of surface lymphatic vessels of lower extremities in norm and in chronic venous insufficiency. To assess the anatomical and physiological features of the surface lymphatic vessels of the lower extremities, fluorescent lymphography is used with subcutaneous injection of fluorescein into the extremity zone and exposure to the region of introduction with a light source with wavelength of 480 nm. 15 minutes after administration of fluorescein, vessels are visualized to observe yellow-green fluorescence. According to fluorescence, the medial, lateral and posterior groups of the limb vessels of the limb are isolated, the number and direction of which are used to assess the norm or chronic venous insufficiency. Prior to the procedure, fluorescein is dissolved in physiologic saline. Obtained 1 % solution is injected subcutaneously into the area of the first and second interlocked spaces, and the area of the right and left ankle is 2 ml each. Regions of introduction are documented by a digital camera at intervals. In each time interval increase in length of stained vessels is considered to calculate rate of lymphatic drain by formula: V=S/T, where S – length of colored vessel, T – time elapsed after drug administration. Localization, number, rectilinearity and diameter of lymphatic vessels, as well as direction of lymph current are evaluated. Patient's condition is evaluated proceeding from the following conditions. In the healthy individuals with 0-1 class of varicosis by CEAP for first 25 seconds after the fluorescein solution injection, the place of introduction retains the round shape elongated in the direction of injection. In next 60 seconds, the shape is elongated in the proximal direction. Preparation is delivered to the lymph capillary at 30th second. There is a projection in upper part of the spot. In 20 seconds said projection is clearly visible. In medial part of shin, preparation when examining medial commutator in healthy person appears in 5.3±1.1 min, lateral – 4.6±0.8 min later. Antegrade lymph rate by surface lymphatic vessels is 11.3±1.7 cm/min. Increased diameter and tortuosity of the lymphatic vessels in the shin area are noted in the patients with the initial stage of 2-3 class of varicosis by CEAP. Superficial lymphatic vessels of the lower extremities consist of diverting commissural lymphatic vessels, and in the shin area three directions of surface collector lymphatic vessels guided to the hip are preserved. Number of collector lymphatic vessels of the medial group is 6 lymphatic vessels, the lateral group – 5 vessels, the rear group of headers consists of 2 vessels. In the projection of the knee joint lymphatic shin collectors are merged into 3 vessels and directed along an anteromedial surface. Antegrade rate of lymph on surface lymphatic vessels makes – 6.4±0.8 cm/min. In patients with 4th clinical class according to CEAP, the expansion or constriction, as well as tortuosity of the lymphatic vessels on the foot, absence of contrasting in the zone of trophic changes in the lower and middle thirds of the shin. When fluororate is introduced into an ankle, the lymphatic vessels are colored retrograde. Antegrade rate of lymph on surface lymphatic vessels on back of foot is 1.3±0.2 cm/min. Established retrograde current of fluorenate from the ankles passes at rate of 2.7±0.9 cm/min. Patients with 5-6 clinical class of CEAP are diagnosed with constriction and tortuosity of lymphatic vessels on the foot, in the shin area, where there are indurative skin changes. Contrasting of lymphatic vessels is not observed. When fluororate is administered into the ankle region, the coloring takes place in the retrograde direction at rate of 1.5±0.4 cm/min.;EFFECT: method provides a quality lifetime study of anatomy and assessment of functional state of surface lymphatic vessels of lower extremities, both in norm, and in chronic venous insufficiency of lower extremities due to fluorescent lymphography.;1 cl, 6 dwg, 1 tbl
机译：领域：药物：本发明涉及医学，即血管病学，可用于正常和慢性静脉功能不全下肢下表面淋巴管的解剖和生理特征的终生评估。为了评估下肢表面淋巴管的解剖和生理特征，使用荧光淋巴造影术将荧光素皮下注射到四肢区域，并使用波长为480 nm的光源暴露于引入区域。荧光素给药后15分钟，观察血管以观察黄绿色荧光。根据荧光，将肢体的肢体血管的内侧，外侧和后组隔离开，其数量和方向用于评估正常或慢性静脉功能不全。手术前，将荧光素溶解在生理盐水中。将获得的1％溶液皮下注射到第一和第二个互锁空间的区域中，左右脚踝的区域分别为2 ml。导入区域由数码相机定期记录。在每个时间间隔内，考虑增加染色血管的长度，可通过以下公式计算淋巴引流率：V = S / T，其中S –着色血管的长度，T –给药后经过的时间。评估淋巴管的位置，数量，直线度和直径以及淋巴电流的方向。从以下条件出发评估患者的状况。在荧光素溶液注射后的头25秒内，通过CEAP在0-1级静脉曲张的健康个体中，引入部位保持沿注射方向拉长的圆形。在接下来的60秒内，形状沿近端方向拉长。在第30秒将制剂送入淋巴管。该点的上部有一个投影。在20秒内，上述投影清晰可见。在胫骨内侧部分，在健康人中检查内侧换向器时的准备工作出现在5.3±1.1分钟，外侧-4.6±0.8分钟后。表面淋巴管的整体淋巴速度为11.3±1.7 cm / min。在CEAP初发2-3级静脉曲张的初期阶段，患者胫骨区域的淋巴管直径和曲折性增加。下肢浅表淋巴管由分叉的连合淋巴管组成，在胫骨区域，保留了引导至臀部的表面收集器淋巴管的三个方向。内侧组的收集器淋巴管数量为6个淋巴管，外侧组为5个血管，集管的后组由2个血管组成。在膝关节的投影中，淋巴胫骨收集器合并为3个血管，并沿前表面引导。表面淋巴管上的淋巴积分速度为– 6.4±0.8 cm / min。在根据CEAP属于第四级临床的患者中，足部淋巴管的扩张或收缩以及曲折，在胫骨下半部和中部的营养变化区域没有形成对比。当将氟酸盐引入脚踝时，淋巴管的颜色会逆行。足背表面淋巴管上的淋巴整合率是1.3±0.2 cm / min。确立的来自脚踝的氟化物逆行电流以2.7±0.9cm / min的速度通过。 CEAP为5-6临床等级的患者被诊断出足部淋巴管狭窄和曲折，在胫骨区域，皮肤有硬变。没有观察到淋巴管的对比。当在脚踝部位施用氟酸盐时，以1.5±0.4 cm / min的速度沿逆行方向进行着色;效果：该方法可提供高质量的解剖学寿命研究并评估下肢表面淋巴管的功能状态，无论是正常情况，还是由于荧光淋巴造影导致的下肢慢性静脉供血不足; 1 cl，6 dwg，1 tbl

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