RU1783422C - Method for determining the functional state of the lungs in patients with pyoseptic pathology - Google Patents

Abstract

The invention relates to medicine, in particular to surgery. The aim of the invention is to improve the accuracy of the method. For this purpose, the concentration of peptides with an average molecular weight in the central venous and arterial channels in case of endogenous intoxication syndrome and the difference in the concentrations of peptides are used to determine the functional state of the lungs. The greatest arterial-venous difference characterizes the high detoxification ability of the lungs, and a decrease or inversion indicates a deterioration in its condition. The method makes it possible to objectively evaluate the function of the lungs as an organ of natural detoxification, the depth of damage to the detoxification system of the body, 1 to establish indications for detoxification therapy, to determine the state of compensatory systems under conditions of endogenous intoxication against the background of purulent-septic diseases. The proposed method allows for dynamic observation, to evaluate the effect of therapeutic measures, to predict the outcome of the disease. cl

Description

The invention relates to medicine, in particular to surgery, and can be used to determine the severity of endogenous intoxication syndrome in patients with purulent-septic pathology.

The aim of the invention is to increase the accuracy of the method by determining the level of average molecular oligopeptides in venous and arterial blood, followed by calculating the ratio of the first to the second, at a value of less than 1.5, the pathology is determined.

The method is carried out as follows.

A patient takes a sample of arterial blood from any peripheral artery (3-5 ml) and a venous blood sample from the central (subclavian) vein (3-5 ml) using a puncture method. The concentration of medium molecular oligopeptides in these samples was determined by any known method. Next, the ratio of the concentration of average molecular oligopeptides in the venous blood sample to their concentration in the arterial blood sample is estimated. When the value of this indicator is less than 1.5, the patient's condition is assessed as a pronounced violation of the detoxification function of the lungs, requiring emergency intensive detoxification therapy.

The method is illustrated by the following examples:

Example L. Patient Milashevsky A.A., 42 years old. He entered the clinic 03/12/84, with

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diagnosis: Perforation of the Meckel diverticulum with a fish bone, secondary gangrenous perforated appendicitis. Spilled purulent peritonitis. The patient was tested for blood as described above. The ratio value was 0.98, which indicated impaired lung function. After 5 days of March 17, 84, the diagnosis of pneumonia was clinically and radiologically determined. On 23.03.84 g at autopsy, the diagnosis of bilateral pneumonia was confirmed.

Example 2. Patient Sosnowski A.M., 26 years old, was admitted to the hospital with a diagnosis of Perforated gastric ulcer. Spilled peritonitis. The patient underwent surgery: la-parotomy, suturing of the perforated ulcer of the stomach, opening of interloop abscesses, cecostomy. After the operation was examined in the manner described above. The value of the sought indicator was 0.43, which indicated a severe impairment of lung function. After 2 days, the diagnosis of pneumonia was confirmed by clinical and laboratory data.

After the treatment, the indicator increased to 1.05 and the patient's condition improved.

Example 3. Patient Kondar KF, 44 years old, was admitted to the hospital with a diagnosis of acute gangrenous perforated appendicitis. Local peritonitis without clinical signs of pneumonia. After the operation, the desired indicator is determined as described above. The ratio was 0.86, indicating a moderate impairment of lung function. Subsequently, the diagnosis of pneumonia was established. During the treatment, the value of the indicator first increased to 1.3, and then to 1.96. The patient's condition has improved significantly.

This method allows one to reliably assess the functional state of the lungs in case of endogenous intoxication syndrome caused by purulent-septic diseases, conduct dynamic monitoring of the patients' condition and the effectiveness of therapeutic measures, and determine the compensatory capabilities of the body at various stages of the disease.

Claims (1)

SUMMARY OF THE INVENTION A method for determining the functional state of the lungs in patients with purulent-septic pathology by examining a blood, characterized in that, in order to improve the accuracy of the method, the level of average molecular oligopeptides in venous and arterial blood is determined, and then the ratio of the first indicator is calculated to the second and with a value of less than 1.5, pathology is determined.