RU2234953C1 - Method for treating the cases of uterus hypotonia - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves acting with bipolar asymmetric impulse batches in abdominovaginal applications in alternating excitation periods of 1 s and relaxation periods of 1 s long with impulse succession frequency being equal to 10 Hz and frequency reduction and increase of 20% with respect to a given value.

EFFECT: enhanced effectiveness of treatment.

Description

The invention relates to medicine ”, in particular to gynecology, and may find application for the prevention of complications after medical abortion.

It is a well-known way to achieve a uterotonic effect for the prevention of endometritis, caused by a violation of the contractile activity of the uterus, after childbirth and abortion using medications (oxytocin, methylergometrine) [Ailamazyan E.K. et al. On the mechanism of action of oxytocin on the contractile activity of the uterus // Bulletin of the Russian Association of Obstetricians and Gynecologists. "1995, - No. 4, - pp. 96-105].

However, it has certain disadvantages: the possibility of allergic reactions and side effects - abdominal pain, nausea, vomiting, dizziness, headache, increased blood pressure.

Closest to the proposed is the use of interference currents according to the four-electrode technique [V. Strugatsky et al. Interference currents - an alternative to uterotonic drugs after cesarean section // Issues of balneology, physiotherapy and physiotherapy. - 1993, - No. 6, - p.40-41].

However, the implementation of the uterotonic effect of interference therapy is impeded by the presence of liquid contents in the uterine cavity. In addition, inert interference therapy is characterized by great technological complexity and the complexity of the procedure due to the frequent need to change the localization of the electrodes during exposure to obtain the desired sensations of "beating" precisely in the depth of the pelvis.

The objective of the invention is a method for the treatment of uterine hypotension, which can be applied in the presence of liquid contents in the uterine cavity and is simpler to implement.

The problem is achieved by the action of packs of bipolar asymmetric electric pulses, both positively and negatively inverted, which act with alternating periods of excitation (1 s) and relaxation (1 s), with a frequency of 10 Hz, with a decrease and increase in frequency by 20% of the set value abdominally vaginally. The intensity of exposure ranges from 0 to 100 mA, taking into account the individual response of the patients.

In practice, the method is as follows.

Treatment is carried out daily for 3 days. Use the domestic hardware-software complex “Andro-Gin”, intracavitary and plate electrodes of this device.

The method of treatment. Patient's position: lying on his back, legs bent at the knee joints and divorced. An intracavitary electrode is inserted into the posterior vaginal fornix. The plate electrode is contacted in the suprapubic region. Impact - “electrical stimulation”; the choice is “intracavitary”; polarity - positive and negative (10 min each); mode - 3; frequency 10 Hz; deviation of 20%; excitation 1 s; pause 1 s The indices of the individually desired amplitude are determined by the patient's sensations (pronounced, but painless vibration under the plate electrode, extending deep into, and muscle contractions of the anterior abdominal wall). The total duration of the procedure is 20 minutes. Daily. Course 3 treatments.

The following examples illustrate the proposed method.

Example 1. Patient S., born in 1977, outpatient card No. 18524/2.

Appealed due to the lack of blood discharge after curettage of the walls of the uterine cavity. From the anamnesis: 10/11/02, an interruption of an undeveloped pregnancy was performed in the period of 5-6 weeks. 10/12/02 and 13/10/02 no blood discharge. According to transvaginal ultrasound from 10/14/02: the uterus is bipod. The cavity of the right horn is expanded to 1.2 / 1.3 / 1.4 cm due to blood clots and decidual tissue elements. Clinical diagnosis: Two-horned uterus. Condition after termination of a frozen pregnancy. Hematometer.

On October 14, 02, electric pulse therapy was started. They used the Andro-Gin agricultural complex. Method of treatment: The patient is lying on his back, legs are bent at the knee joints and divorced. An intracavitary electrode was inserted into the posterior vaginal fornix. The plate electrode was placed contact in the suprapubic region. Impact - “electrical stimulation”; the choice is “intracavitary”; polarity - positive and negative (10 min each); mode - 3; frequency 10 Hz; deviation of 20%; excitation 1 s; pause 1 s Indicators of individually desired amplitude were determined by the patient's feelings. The total duration of the procedure is 20 minutes. Daily. Course 3 treatments.

During treatment, the patient noted the appearance of bleeding from the genital tract. According to the TE from 10.16.02: The uterine cavity is closed. Previously identified blood clots and the remains of the ovum in the uterine cavity are not determined.

Example 2. Patient Sh., B. 1982, outpatient card No. 20525/2.

Appealed due to lack of blood discharge after a medical abortion. From the anamnesis: November 9, 02, an abortion was performed in the period of 5-6 weeks. 10.11.02 and 11.11.02 no blood discharge. According to transvaginal ultrasound from 11/12/02: the uterus is rejected posteriorly. Uterine dimensions: 6.0 / 5.1 / 7.8 cm. The uterine cavity is expanded to 1.1 cm due to blood clots and decidual tissue elements. Clinical diagnosis: Condition after abortion. Hematometer.

11/12/02 started the electric pulse therapy. They used the Andro-Gin agricultural complex. Method of treatment: The patient is lying on his back, legs are bent at the knee joints and divorced. An intracavitary electrode was inserted into the posterior vaginal fornix. The plate electrode was placed contact in the suprapubic region. Impact - “electrical stimulation”; the choice is “intracavitary”; polarity - positive and negative (10 min each); mode - 3; frequency 10 Hz; deviation of 20%; excitation 1 s; pause 1 s Indicators of individually desired amplitude were determined by the patient's feelings. The total duration of the procedure is 20 minutes. Daily. Course 3 treatments.

During treatment, the patient noted the appearance of bleeding from the genital tract, which persisted on the day of the study (11/14/02). According to the TE from 11/14/02: Uterine size: 5.6 / 4.4 / 7.8 cm. The uterine cavity is expanded to 0.8 cm due to liquid blood and clots. 11/15/02, blood discharge stopped. 11.16.02 according to the TE: Uterus size: 5.6 / 3.4 / 6.8 cm. The uterine cavity is closed.

Example 3. Patient M., born in 1978, outpatient card No. 20370/2.

From the anamnesis: October 30, 02 an interruption of an undeveloped pregnancy was performed in the period of 9-10 weeks. 10/31/02 - 3/11/02 scarce allotment. According to transvaginal ultrasound from 3.11.02: The uterine cavity is expanded to 1.0 due to blood clots. Antibacterial and uterotonic therapy was prescribed (Oxytocin 1.0 v / m). Amplification of blood secretions did not occur. November 4, 2002, a vacuum-aspiration of the contents of the uterine cavity was performed. 5.11.02 no blood discharge. According to TE: the uterine cavity is expanded to 1.5 cm due to liquid blood and clots. The introduction of medical uterotonic drugs - without effect. 6.11.02 no bleeding. Body temperature 36.7. Rectal temperature 36.8. Clinical blood test from 6.11.02 - without signs of inflammation. Clinical diagnosis: Condition after termination of a frozen pregnancy, vacuum aspiration of the contents of the uterine cavity. Hematometer.

On 6.11.02, electro-pulse therapy was started. They used the Andro-Gin agricultural complex. Method of treatment: The patient is lying on his back, legs are bent at the knee joints and divorced. An intracavitary electrode was inserted into the posterior vaginal fornix. The plate electrode was placed contact in the suprapubic region. Impact - “electrical stimulation”; the choice is “intracavitary”; polarity - positive and negative (10 min each); mode - 3; frequency 10 Hz; deviation of 20%; excitation 1 s; pause 1 s Indicators of individually desired amplitude were determined by the patient's feelings. The total duration of the procedure is 20 minutes. Daily. Course 3 treatments.

During treatment, the patient noted the appearance of bleeding from the genital tract, which persisted for 2 days. According to TE from 11.11.02: The uterine cavity is closed.

In order to treat uterine hypotension, 8 women underwent electrical exposure. All patients received therapy for emptying hematometers that occurred after abortion. In 4 people, the pregnancy was not developing. Four before the start of treatment, repeated intrauterine interventions were performed (curettage of the walls of the uterine cavity in 1, vacuum aspiration in 1, cervical canalization in 2). Only 3 women have children. In all patients, immediately before physiotherapy, according to TE, the uterine cavity was expanded by 0.8-1.9 cm due to blood, clots and decidual tissue elements. Control TE immediately after 3 procedures of electropulse therapy showed: in 6 patients, the uterine cavity is closed, in 1 partially empty, after 2 days it is closed, in 1 without dynamics. In a patient with no effect of the treatment (initial TE conclusion: the uterine cavity was expanded to 1.9 cm due to blood, clots and decidual tissue elements), the walls of the uterine cavity were scraped out (according to the histological study: the remains of the ovum). The postoperative period was uneventful.

Claims (1)

A method for the treatment of uterine hypotension after artificial termination of pregnancy by electro-exposure, characterized in that they are abdominally vaginally exposed to packs of bipolar asymmetric impulses with alternating excitation periods of 1 s and relaxation of 1 s, with a pulse repetition rate of 10 Hz, with a decrease and increase in frequency by 20 % of the set value.