RU2233184C2 - Method for treating acute salpingo-oophoritis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: magnetotherapy should be performed since the 1^st-3d d simultaneously onto anterior abdominal wall and vaginal mucosa with magnetic system consisted of 2 constant magnets, at 48-52 mTl, lamellar form, located clearance-free in one and the same plane and face the treated surface and each other with different poles, combined at one bottom. Moreover,, cavity-type emitter should be applied in turns for right and left lateral vaginal arches to affect for 5-6 min/each. Simultaneously, one should carry out magnetotherapy onto anterior abdominal wall by replacing magnetic system clockwise at 1-3 cm/sec rate. Total duration of this procedure corresponds to 10-12 min, procedures should be carried out once or twice daily at 3-4-h-long interval, 8-10 procedures/course.

EFFECT: higher efficiency of therapy.

2 ex, 1 tbl

Description

The invention relates to medicine, namely to gynecology and physiotherapy. A known method of treating acute salpingo-oophoritis by laser irradiation of blood and magnetotherapy (1). The disadvantage of this method is the complexity of the treatment process, the need for a physiotherapeutic specially equipped room, invasiveness of the technique (puncture of a vein in the elbow region and the introduction of a flexible fiber into its lumen).

The task of the invention is to eliminate the disadvantages of the prototype, namely the possibility of carrying out the procedure in a hospital ward, district hospital, feldsher-obstetric station, ease of therapeutic effect, non-invasiveness of the method.

The problem is solved by the use of magnetotherapy against the background of drug treatment, and magnetotherapy is carried out from the first to third days of treatment simultaneously on the anterior abdominal wall and vaginal mucosa with a magnetic system consisting of 2 permanent magnets of 48-52 mT plate-shaped, located without a gap in of the same plane and opposite poles facing the work surface and to each other, connected on a common base, while the cavity emitter is directed alternately to the right and left sides vaults of the vagina and act for 5-6 minutes each, simultaneously carry out magnetotherapy on the anterior abdominal wall, moving the magnetic system clockwise at a speed of 1-3 cm per second, the total duration of the procedure is 10-12 minutes, the procedures are 1-2 times per day with an interval of 3-4 hours, for a course of 8-10 procedures.

The method is carried out in the position of a woman lying on her back with divorced hips. A condom is put on the vaginal device containing the magnetic system and inserted along the back wall into the vagina to the posterior fornix. The working side is directed to the right lateral vaginal fornix, after 5-6 minutes of exposure to the magnetic field, the device is turned clockwise into the left lateral vaginal fornix, after which the exposure is continued for 5-6 minutes. At the same time, external influence is carried out by a magnetic field in the lower abdomen, smoothly moving the magnetic system in circular movements clockwise at a speed of 1-3 cm per second. The total duration of the procedure is 10-12 minutes, the procedures are carried out 1-2 times a day with an interval of 3-4 hours, for a course of 8-10 procedures.

Example 1. Patient P. (case history No. 3411), 34, was admitted for treatment to the gynecological department of the maternity hospital 4, Tomsk, 5.02.2001, with a diagnosis of acute salpingoophoritis. Complaints upon admission: pain in the lower abdomen that appeared after hypothermia. Pain is disturbed for 3 days, and the intensity of the pain increases, radiates to the leg, there is an increase in temperature to 37.8 ° C. In the anamnesis: chronic cholecystitis, chronic gastritis, anemia. Menses from 11 years old, established immediately, for 3 days, after 28-30 days, accompanied by pain in the lower abdomen, profuse. Last menstruation 09/26/01. Sexual life since 18 years. Pregnancy 7, childbirth 2, abortion 5. Upon receipt, the condition is satisfactory, the skin and mucous membranes are clean, normal in color. The lungs have vesicular breathing, no wheezing, heart sounds are clear, rhythmic, and the pulse is 86 beats per minute. On palpation, the abdomen is soft, painful in the hypogastric region. There are no symptoms of peritoneal irritation. Pasternatsky’s symptom is negative on both sides.

With a gynecological examination: the external genitalia are developed correctly, the perineum is low, the vagina is capacious, the arches are free. The uterus is not enlarged, the appendages on both sides are slightly enlarged, pasty, painful, traction for the neck is also painful, the discharge is serous-purulent.

Complete blood count: hemoglobin - 110 g / l, red blood cells 3.2 g / l, white blood cells 8.9 g / l, n - 11, s - 38, e - 3, b - 0, m - 14, l - 34 , ESR 16 mm / hour.

A smear for the degree of purity of the vagina: 8-10 epithelial cells in the field of view, white blood cells completely, cocci flora. Trichomonads and gonococci are absent.

General analysis of urine: color light yellow, transparent, specific gravity 1018, sugar otr, bile pigments otr, microscopy: squamous cells 6-8 in the field of view, white blood cells up to 5-6 in the field of view.

Ultrasound examination of the pelvic organs: the uterus in the center, anteriorly, the contours are even, the structure is homogeneous. Dimensions: 43 × 47 × 50 mm, neck length: 38 mm. M-echo 10 mm, the endometrium corresponds to the 2nd phase of the cycle. Right ovary: 42 × 34 × 30 mm, its contours are fuzzy, echogenicity is reduced. Left ovary: 40 × 32 × 28 mm, its contours are fuzzy, echogenicity is reduced. In the rear arch there is a small amount of liquid.

Dopplerometry of blood flow in the vessels of the uterus: the right uterine artery СО - 4.15, ИСР - 0.74. The left uterine artery СО - 4.10, ИСР - 0.73.

Prescribed drug treatment (anti-inflammatory, antibacterial, infusion, hyposensitization therapy). From the 3rd day (after lowering the temperature), the treatment was supplemented with a magnetic field in accordance with the claimed method: a condom was put on the vaginal device containing the magnetic system and inserted into the vagina along the back wall to the back arch. The working side was sent to the right lateral vaginal fornix, after 5 minutes of exposure to the magnetic field, the device was turned clockwise into the left lateral vaginal fornix, after which the exposure was continued for 5 minutes. At the same time, external exposure to a magnetic field was performed along the lower abdomen, smoothly moving the magnetic system in circular movements clockwise at a speed of 1-3 cm per second. The total duration of the procedure is 10 minutes, the procedures were performed 2 times a day with an interval of 4 hours, for a course of 10 procedures. Upon discharge from the hospital: no complaints, satisfactory condition. During a gynecological examination: the external genitalia are developed correctly, the arches are free, the uterus is not enlarged, the appendages on both sides are not enlarged, when examined, they are painless, traction behind the neck is painless, white discharge.

Complete blood count: hemoglobin - 118 g / l, red blood cells - 3.4 g / l, white blood cells - 5.6 g / l, n - 2, s - 56, e - 2, b - 0, m - 4, l - 36, ESR 12 mm / hour. A smear on the degree of purity of the vagina: epithelial cells 3-4 in the s / w leukocytes are single, flora is not. Trichomonads and gonococci are absent. Urinalysis: color light yellow, transparent, ud.v. 1010, sugar - neg, bile pigments - neg, microscopy: squamous cells 3-4 in s / s, white blood cells up to 1-2 in s / s.

Ultrasound examination: the uterus in the center, anteriorly, the contours are even, the structure is homogeneous. Dimensions: 34 × 34 × 50 mm, neck length: 38 mm. M-echo corresponds to the phase of the cycle. Right ovary: 16x23x28 mm with follicles no more than 10 in a section. Left ovary: 18 × 25 × 29 mm with follicles no more than 10 in a section. In the back arch, fluid is not visualized.

Dopplerometry of blood flow in the vessels of the uterus: the right uterine artery СО - 3.08, ИСР - 0.67. The left uterine artery СО - 3.12, ИСР - 0.66. Observation during the year revealed the absence of recurrence of salpingo-oophoritis.

Example 2

Patient J. (medical history No. 3524), 24 years old, was treated at the gynecological department since May 5, 2002. Diagnosis: acute salpingoophoritis. Complaints at admission: severe pain in the lower abdomen, appeared 6 hours ago. The intensity of pain increases, body temperature is increased to 39 ° C. A history of chronic cholecystitis. Menses from 13 years, established immediately, for 3 days, after 28-30 days without pain, moderate. Last menstruation 2.04.02. Sexual life since 16 years. Pregnancy - 2, abortion - 0, childbirth - 2.

Upon admission: satisfactory condition, skin and mucous membranes are clean, normal color. In the lungs, vesicular breathing, no wheezing, heart sounds are clear, rhythmic, pulse 120 beats per minute. On palpation, the abdomen is soft, painful in the lower abdomen. Pasternatsky’s symptom is negative on both sides.

During a gynecological examination: the external genitalia are developed correctly, the vagina is capacious, the arches are free, the uterus is not enlarged, the appendages on both sides are enlarged, pasty, sharply painful, traction for the neck is sharply painful, the discharge is serous-purulent.

Complete blood count: hemoglobin - 126 g / l, red blood cells - 4.2 g / l, white blood cells - 9.4 g / l, n - 5, s - 45, e - 4, m - 5, l - 41, ESR - 24 mm / hour.

A smear for the degree of purity of the vagina: epithelial cells 6-8 in the field of view, white blood cells 60-80 in the field of view, flora - hemophilic bacillus. Trichomonads and gonococci are absent.

General analysis of urine: color light yellow, transparent, specific gravity 1016, sugar-OTR, bile pigments - OTR, microscopy: squamous cells 2-3 in s / s, white blood cells up to 2-3 in s / s.

Ultrasound examination: the uterus in the center, anteriorly, the contours are even, the structure is homogeneous. Dimensions: 34x54x57 mm, neck length: 30 mm. M-echo 7 mm, the endometrium corresponds to the first phase of the cycle. Right ovary: 30 × 30 × 45 mm, its contours are fuzzy, echogenicity is reduced. Left ovary: 32 × 36 × 43 mm, its contours are fuzzy, echogenicity is reduced. In the rear arch there is a small amount of liquid. Dopplerometry of blood flow in the vessels of the uterus: the right uterine artery СО - 4.15, ИСР - 0.72. The left uterine artery СО - 4.14, ИСР - 0.76.

Prescribed drug treatment (anti-inflammatory, antibacterial, infusion, hyposensitization therapy). From 3 days, the treatment was supplemented with a magnetic field in accordance with the claimed method: a condom was put on the vaginal device containing the magnetic system and inserted into the vagina along the posterior wall to the posterior fornix. The working side was directed to the right lateral vaginal fornix, after 6 minutes of exposure to the magnetic field, the device was turned clockwise into the left lateral vaginal fornix, after which the exposure was continued for 6 minutes. At the same time, external exposure to a magnetic field was performed along the lower abdomen, smoothly moving the magnetic system in circular movements clockwise at a speed of 1-3 cm per second. The total duration of the procedure is 12 minutes, the procedures were performed 1 time per day, a total of 8 procedures.

After the 4th procedure, the patient noted the disappearance of pain in the lower abdomen. Upon discharge from the hospital: no complaints, satisfactory condition. During a gynecological examination: the external genitalia are developed correctly, the arches are free, the uterus is not enlarged, the appendages on both sides are not enlarged, painless when examined, traction for the neck is painless, leucorrhoea.

Complete blood count: hemoglobin - 124 g / l, red blood cells - 4.1 g / l, white blood cells - 3.2 g / l, n - 1, s - 58, e - 2, m - 2, l - 37, ESR - 14 mm / hour. A smear for the degree of purity of the vagina: epithelial cells 3-4 in the s / s, white blood cells 10-15, flora - small sticks. Trichomonads and gonococci are absent. General analysis of urine: color light yellow, transparent, specific gravity 1014, sugar - neg, bile pigments ant, microscopy: squamous cells 3-4 in s / s, white blood cells up to 1-2 in s / s.

Ultrasound examination: the uterus in the center, anteriorly, the contours are even, the structure is homogeneous. Dimensions: 34 × 44 × 57 mm, neck length: 30 mm. M-echo - 10 mm, the endometrium corresponds to the 2nd phase of the cycle. Right ovary: 22 × 23 × 32 mm with follicles no more than 10 mm in a section. Left ovary: 18 × 26 × 29 mm with follicles no more than 10 in a section. There is no fluid in the rear arch.

Dopplerometry of the blood flow of the uterine vessels: the right uterine artery СО - 3.24, ИСР - 0.65. The left uterine artery СО - 3.05, ИСР - 0.67. Observation for 6 months is healthy.

The use of a magnetic field at the same time according to the intracavitary and intracavitary methods using magnetic systems of a special design enhances the therapeutic effect. It is established that when applying a magnetic field, the penetration depth is 5-7 cm ³ . With simultaneous exposure to the anterior abdominal wall and the vaginal mucosa, inflamed uterine appendages are between two magnets, which allows maximum use of the positive effects of the magnetic field (decongestant, anti-inflammatory, analgesic). The rotation during the procedure of the intracavitary magnetic system alternately in the right and left vaginal arches guarantees a more accurate effect on the uterine appendages, both on the one hand and on the other. In the inventive method, a magnetic field non-uniform in the direction of the lines of force is used. The use for treatment of an intracavitary system consisting of 2 plate-shaped magnets located without a gap in one plane and facing opposite poles to the surface to be treated and each other with opposite poles makes it possible to create a magnetic field inhomogeneous in direction and induction with a pronounced gradient in direction (2). In this case, both when the system is stationary, and when moving it into the vagina with a rotation of 180 degrees, the effect is not a constant, but a low-frequency magnetic field on the damage zone.

The table presents comparative data on the dopplerometry of uterine arterial blood flow in patients with acute salpingo-oophoritis. When comparing the obtained indicators, there is a significant decrease in indicators both in the group receiving treatment in accordance with the prototype, and in the group receiving treatment by the claimed method. However, positive trends are more pronounced in the group treated with the claimed method. The indicators of this group came closer to the indicators of the group of healthy women.

The method improves the effectiveness of treatment in acute salpingo-oophoritis. It has an anti-inflammatory, analgesic effect, actively affects the blood circulation of the pelvic organs. For its implementation does not require expensive equipment, special conditions. It can be used both in inpatient and outpatient settings.

Sources of information

1. Agarkova L.A. Comparative evaluation of the treatment of inflammatory processes of the uterus with the use of various factors of physical impact. Abstract. diss .... cand. honey. Sciences, Tomsk, 2000, 15 pp.

2. V.M. Bogolyubov, G.N. Ponomarenko. General physiotherapy. M .: “Medicine”, 1999, 431s.

3. E.F. Levitsky, D.I. Kuzmenko, B.I. Laptev. The complex application of natural healing factors and the field of permanent magnets in the experiment and clinic. Tomsk University Press, 2001, 149p.

Claims (1)

A method of treating acute salpingo-oophoritis, including magnetotherapy against the background of drug treatment, characterized in that magnetotherapy is carried out from the first to third day simultaneously on the anterior abdominal wall and vaginal mucosa with a magnetic system consisting of 2 permanent magnets, 48-52 mT, lamellar in shape located without a gap in the same plane and facing the opposite surface and each other with opposite poles connected on a common base, while the cavity emitter is directed alternately to the right nth and left lateral vaginal arches and act for 5-6 minutes each, simultaneously carry out magnetotherapy on the anterior abdominal wall, moving the magnetic system clockwise at a speed of 1-3 cm / s, the total duration of the procedure is 10-12 minutes, the procedures are performed 1 -2 times a day with an interval of 3-4 hours, for a course of 8-10 procedures.