RU2206347C2 - Complex method and device for treating patients for myelodysplasia - Google Patents

Abstract

FIELD: medicine; medical engineering. SUBSTANCE: method involves administering presurgical conservative therapy, carrying out surgical intervention by means of microsurgical repair of distal areas of the spinal cord, meningomyeloradiculolysis with following stimulation of reparative nerve regeneration by means of physical treatment. The physical treatment is carried out with high frequency electromagnetic field formed with sinusoid signal of 200-2000 kHz frequency, amplitude-modulated signal of acoustic frequency in 20-200 Hz bandwidth using inductive radiator that is a part of resonance oscillation circuit. The treatment starts at the second day after surgical intervention on postoperative field. The procedure lasts 20 min. Treatment cycle is 12-15 procedures long. The device has electromagnetic field source and treatment unit. The electromagnetic field source is designed as autogenerator operating in frequency bandwidth of 200-2000 kHz. The treatment unit is designed as inductive coil which winding is a constituent part of autogenerator oscillation circuit. The device additionally has modulator and oscillator of swinging frequency in bandwidth of 20-200 Hz. Output of the acoustic frequency oscillator is connected to modulator input which output is connected to autogenerator circuit. The treatment unit has dielectric body having base and cover. Radiant element is designed as an inductive coil which winding is mounted on flat dielectric carcass that is produced as radially arranged leaflets with gaps. The winding is designed as spiral enveloping one and the other side of each leaflet in turn. The winding is connected to autogenerator circuit via a capacitor. The autogenerator circuit is mounted on printed circuit board fixed on the cover. EFFECT: enhanced effectiveness of treatment. 3 cl, 2 dwg

Description

 The invention relates to medicine, in particular to neurosurgery, pediatric surgery, urology.

 The treatment of neurogenic disorders of urination in malformations of the caudal spinal cord in children is an important problem. The vast majority of children with spinal hernias and myelodysplasia have neurogenic disorders of the act of defecation and urination. For the treatment of myelodysplasia, complex treatment is used, consisting of preoperative conservative therapy, surgical treatment and subsequent therapeutic treatment, including electrical stimulation of reparative nerve regeneration [1].

 It is known that to activate the spinal cord during spinal shock, electrostimulation of the spinal cord is carried out, which prevents the development of pathological processes in the nerve structures of the spinal cord [2].

 Subthreshold electrical stimulation of the spinal cord is based on the ability of an electric current to simulate the effects of a nerve impulse and exert a triggering and trophic effect on a nerve cell.

 The radiofrequency electrostimulator of the spinal cord consists of a transmitting and receiving device. Two or four electrodes are sutured to the patient on the spinal cord under the dura mater above and below the damage zone. The radio frequency receiver is placed in a specially formed subcutaneous tunnel pocket. The wound is sutured tightly. The transmitter of the radio stimulator is located above the implantation site of the receiver. Stimulation is carried out by a current of 150 μA, a frequency of 20 Hz, and a pulse duration of 0.5 ms. The duration of stimulation is 30-40 s, it is carried out 5-6 times a day and begins 3-5 days after surgery. The procedures are carried out for 14 days.

 The disadvantage of this method of postoperative electrical stimulation of the spinal cord is its traumatic and invasive nature, as well as its limited use in children with spinal hernias due to insufficiently good wound healing in the postoperative period and, therefore, a high risk of implant rejection and the need for invasive removal of electrodes.

 The objective of the invention is the postoperative stimulation of reparative regeneration of nerves in a non-invasive way.

 This is achieved by the fact that in the method for the complex treatment of myelodysplasia after the operation of microsurgical meningomyeloradiculolysis according to the invention, the physical effect is carried out by a high-frequency electromagnetic field formed by a sinusoidal signal in the frequency range 200-2000 kHz, an amplitude-modulated signal in the range of 20-200 Hz using an inductive emitter, which is an integral part of the resonant oscillatory circuit, the effect begins from the second day after surgery on osleoperatsionnuyu region, duration of the treatment 20 minutes, the cycle of treatment procedures 12-15.

 This is achieved by the fact that in the device for implementing the method containing an electromagnetic field source and an exposure element, according to the invention, the electromagnetic field source is made in the form of a self-oscillator in the frequency range 200-2000 kHz, the exposure element is made in the form of an inductor, the winding of which is an integral part of the oscillatory the oscillator circuit, while the device is equipped with an additional modulator and oscillating sound frequency generator with a range of 20-200 Hz, the output of the sound generator is often you are connected to the input of the modulator, in which the output is connected to the oscillator circuit.

 The essence of the invention lies in the fact that in the postoperative period, physical exposure is carried out by a high-frequency electromagnetic field formed by a sinusoidal signal in the frequency range 200-2000 kHz, an amplitude-modulated sound frequency signal in the range of 20-200 Hz using an inductive emitter, which is an integral part of the resonant oscillatory circuit.

 The method is as follows. In the case of myelodysplasia associated with spinal hernia, surgical treatment is performed by excision of the cerebral sac, microsurgical meningomyeloradiculolysis, sealing the meninges, plastic hernia gate, skin-aponeurotic plastic soft tissue defect. The impact of the resonant emitter begins on the second day after surgery on the postoperative area. The duration of the procedure is 20 minutes. The treatment cycle is 12-15 procedures, the current in the emitter coil is 10-15 μA.

 Monitoring of the result of treatment includes clinical observation, neurological examination, urodynamic examination, including retrograde cystonometry, profilometry, rectometry, sphincterometry. The proposed method for the complex treatment of patients with myelodysplasia is simple, the method of physical stimulation of reparative regeneration of the nervous tissue is non-invasive, painless, and can be used even in newborns.

 In FIG. 1 shows a functional diagram of a device for implementing the method; figure 2 shows the exposure element with a flat inductor.

 A device for implementing the proposed method of treatment comprises a self-oscillator 1, consisting of a circuit 2 and an oscillating circuit formed by an inductor 3 and a capacitor 4. The winding of the inductor 3 acts as an emitter of electromagnetic will. The emitted frequency of electromagnetic waves is determined by the inductance of the coil winding and the capacitance of the capacitor 4. The device contains a modulator 5, the input of which is connected to the output of the sound frequency generator 6, operating in the frequency range 20-200 Hz. For greater efficiency, the generator 6 is performed with a "swinging" frequency. The device is equipped with a detector 7, an amplifier 8 and a light indicator 9. All elements of the device are powered by a battery-powered source 10. Figure 2 shows an exposure element containing an emitter made in the form of a flat inductor. The exposure element comprises a dielectric housing 11, a cover 12, a flat dielectric frame 13, on which the winding of the inductor 3 is placed. On top of the base there is a printed circuit board 14 on which circuit elements of the oscillator 2, modulator 5, sound frequency generator 6, detector 7 are mounted amplifier 8, as well as a light indicator 9. The impact element by means of a flexible cable 15 is connected to a power source 10. The winding of the inductor 3 is made in the form of a spiral and placed on a dielectric frame 13, which is made in the form of radially spaced lobes with gaps. The number of petals is odd. The wire of each spiral alternately bends around one or the other side of each petal. The circuit board is closed by a casing 16.

 A device for implementing the method of treatment works as follows. The oscillator 1 generates a sinusoidal signal, the frequency of which is determined by the magnitude of the inductance of the emitter winding 3 and the capacitance of the capacitor 4. The device circuit has a low-frequency oscillator 6 of a pumping frequency in the range of 20-200 Hz, the voltage of the modulating frequency from the output of the generator 6 is supplied to the modulator 5. During operation devices on the winding of the emitter there is a voltage of a high-frequency signal, amplitude-modulated by a low-frequency signal. A small part of the signal is fed to the input of the detector 7, amplified by an amplifier 8, and then fed to the indicator light 9. Indicator 9 lights up only when there is voltage on the winding of the emitter 3.

 Sources of information.

 1. Prityko A. G. Reconstructive microsurgery in the complex treatment of children with neurogenic bladders. Abstract of dissertation for the degree of candidate of medical sciences. Moscow, 1993.

 2. Livshits A. Century. Surgery of the spinal cord. - M .: Medicine, 1990. - S. 104-111.

Claims (3)

 1. A method for the complex treatment of patients with myelodysplasia, including preoperative conservative therapy, surgical treatment by microsurgical reconstruction of the distal spinal cord, meningomyeloradiculolysis, followed by stimulation of reparative regeneration of nerves by physical action, characterized in that the physical effect is carried out by a high-frequency electromagnetic field formed by a sinusoidal signal frequency range 200 kHz-2000 kHz, amplitude-modulated audio signal The notes in the range of 20-200 Hz by means of an inductive transducer which is part of the resonant tank circuit with a second exposure begins on the day after surgery on postoperative region, duration of procedure 20 min, 12-15 cycle treatment procedures.  2. A device for implementing the method of complex treatment of patients with myelodysplasia, containing an electromagnetic field source and an exposure element, characterized in that the electromagnetic field source is made in the form of a self-oscillator in the frequency range 200 kHz-2000 kHz, the exposure element is made in the form of an inductor, the winding of which is an integral part of the oscillatory circuit of the oscillator, while the device is equipped with additional modulator and oscillator of the "swinging" sound frequency with a range of 20-200 Hz, output An audio frequency generator is connected to the input of the modulator, in which the output is connected to the oscillator circuit.  3. The device according to claim 2, characterized in that the exposure element comprises a dielectric housing consisting of a base and a cover, a radiating element made in the form of an inductor, in which the winding is placed on a flat dielectric frame, which is made in the form of radially arranged petals with the gaps, the winding is made in the form of a spiral, and the wire of each spiral alternately bends around one or the other side of each petal, the winding is connected via a capacitor to the oscillator circuit, which is located on printed circuit board mounted on the cover.

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