RU2527168C1 - Method of treating bronchitis in reconvalescent children - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method enables a cycloergometric pre-measurement of exercise tolerance according to PWC170 test, a minute pulmonary ventilation (MPV) by means of pneumotachography, and arterial oxygenation by means of an ear sensor of an oxyhemograph. If observing a decrease of exercise tolerance at power less than 1 W/kg for 2 minutes, an increase of MPV more than 350% of initial values, with an increase of arterial saturation more than 98%, a treatment starts with a manual therapy covering spinal motion segments in the number of 3 procedures every two days. That is followed by a balneotherapy in the form of thermal low-radon siliceous baths at temperature 38°C, for 10 minutes in the number of 6 procedures within the therapeutic course.

EFFECT: method reduces probability of chronic processes in bronchi, reduces rate of recurrent bronchitis ensured by normalising the external respiration function by eliminating the functional blocks in the spinal motor segments.

Description

The invention relates to medicine, namely to pulmonology, and can be used for complex treatment of children with bronchitis in the stage of convalescence.

The problem of effective treatment of children after acute bronchitis is relevant. Early complex therapy using natural and preformed physical factors reduces the likelihood of a chronic process in the bronchi and reduces the frequency of relapse of bronchitis.

There is a method of treating respiratory diseases by using physical factors for certain indicators of the function of external respiration (RF patent "Method for the treatment of respiratory diseases" No. 2139063, authors A. V. Chervinskaya and S. I. Konovalov).

However, the known method is ineffective, because It only helps to improve the obstructive state of the bronchi, but does not eliminate functional blocks and does not increase exercise tolerance.

The closest technical result achieved (prototype) is a method of treating patients with bronchitis by using physical factors and manual therapy (RF patent "Method for the treatment of bronchial asthma" No. 18011462, authors O. G. Kogan, I. P. Norets, T. M. Megrelishvili, V.F. Vezhnin).

However, the known method is not effective enough and does not increase exercise tolerance.

The authors propose a highly effective method for treating bronchitis in children undergoing convalescence using complex therapy using manual medicine and weak radon-siliceous waters.

The technical result of the claimed method is to increase the effectiveness of the treatment of bronchitis in children.

The technical result is achieved by first using bicycle ergometry (VEM) to determine exercise tolerance according to the PWC ₁₇₀ test, minute lung ventilation (MB) using a pneumotachograph (PTH) and saturation of arterial blood with oxygen (SaO ₂ ) using an ear sensor of an oxyhemograph ( OG) and with a decrease in exercise tolerance with a power of less than 1 W / kg for 2 minutes, an increase in minute ventilation of more than 350% of the initial values with an increase in arterial blood oxygen saturation of more than 98%, children chayut course of manipulation on spinal motion segment in an amount of 3 treatments over two days, and then used as a balneotherapy slaboradonovyh siliceous thermal bath at 38 ° C lasting 10 minutes in an amount of 6 treatments per course.

The inventive method is as follows.

Before treatment, the patient is diagnosed with exercise tolerance using a bicycle ergometer. According to the test, physical performance at submaximal load (PWC ₁₇₀ ) gives the patient an initial power of 1 watt per 1 kg of weight. If the heart rate (HR) during exercise increases to 170 beats per minute (submaximum load), the test is stopped and the operating time is recorded. At the same time, while the patient is working on a bicycle ergometer, minute ventilation is determined using a pneumotachograph, and oxygen saturation in the arterial blood is recorded using an ear sensor of an oxyhemograph. If a patient is diagnosed with a significant decrease in exercise tolerance according to the PWC ₁₇₀ test with a power of 1 W / kg and a working time of less than 1-2 minutes with a simultaneous increase in MB more than 350% of the original and with an increase in SaO ₂ to 98% or higher, then prescribe manual therapy to remove the functional blocks and remove the imbalance of the respiratory muscles in the amount of 3 procedures in two days, and then use balneotherapy in the form of thermal weakly radon (radioactivity of 8 nCi / l) siliceous (concentration of silicic acids - 56 mg / l) baths in quantity TBE 6 procedures for the course duration to 10 minutes a day.

Clinical example

Patient O., 10 years old, was undergoing spa treatment after acute obstructive bronchitis 2 months ago.

Diagnosis: acute obstructive bronchitis in the stage of convalescence.

Complaints of dry cough are intermittent at night, inadequate discharge of serous sputum, pain in the scapular region and difficulty breathing out, intensified by physical exertion, in the cold and at night. Objectively, there was difficulty in exhaling and its lengthening relative to inspiration, respiratory rate (RR) of 16 per minute, heart rate of 74 per minute, blood pressure (A / D) 105/65 mm Hg. In the lungs, hard breathing was auscultated. From the side of the heart - without features. In manual diagnostics in the thoracic spine, functional blocks were determined in the vertebral-motor segments at the level of the thoracic spine (Th _V , Th _VI , Th _VIII , Th _IX ).

Functional research. According to the electrocardiogram, no changes were noted. According to the function of external respiration, significant deviations were determined by the obstructive type (vital capacity of the lungs - VC 1.4 l, 98% to the proper VC; pneumatic tachometry (PTCM) of the exhalation 1.8 l / sec, to the proper PTCM 65%; forced expiratory volume (FEV ) in 1 sec 1.2 l, 65%; maximum ventilation of the lungs (MVL) 26 l, to due 60%). With bicycle ergometric load, the patient showed a significant decrease in exercise tolerance. According to the PWC ₁₇₀ test, the power at a submaximum load of 1 W / kg withstood 2 minutes (at a rate of 2 W / kg for 6 minutes). MB with such a small load immediately increased to 350% of the original - hyperventilation (at a rate of 220%). Saturation in arterial blood oxygen rose to 98% (at a rate of 95%). Recovery time after bicycle ergometry increased to 10 minutes (normal 5 minutes).

According to laboratory data, there were no signs of activity of the inflammatory process (erythrocyte sedimentation rate - ESR 8 mm / h, white blood cells 5.5 thousand in mm ³ ).

Rehabilitation treatment consisted in the appointment of a manual therapy session in order to eliminate functional blocks in the spinal-motor segment in the amount of 3 procedures in two days per course. After the adoption of three procedures of manual therapy, balneotherapy was prescribed in the form of thermal (38 ° C) weak radon siliceous mineral baths lasting 10 minutes in the amount of 6 procedures every other day.

After the treatment, the patient's condition was clinically noted: the cough stopped, the pain in the near scapular region disappeared, breathing became even. Functional indicators of respiration were normalized: BH decreased to 13 per min, expiratory flow resistance increased (1.8 l / s; 95% to the due), indicators of CRF for 1 sec (1.9 l, 81% to due) and MBL (38 l, 87% due).

In manual diagnostics in the thoracic spine, functional blocks in the vertebral-motor segments were not determined.

With bicycle ergometric load, the patient noted normalization of indicators of tolerance to physical activity. According to the PWC ₁₇₀ test, power increased at a submaximum load of up to 2 W / kg with a duration of 5 minutes on the ergometer. MB at this load increased to 250% of the original. SaO ₂ after exercise remained at 96%. The recovery period after VEM decreased to 6 minutes.

Examination of the patient 1 month after the rehabilitation therapy did not notice negative changes in the condition. In the remote period after rehabilitation (3, 6, 12 and 24 months), no deterioration in the general condition was determined. Relapse of bronchitis during this period was not recorded.

Thus, the claimed method of treatment is highly effective due to the normalization of the function of external respiration and increased tolerance to physical activity, which helps to improve the well-being of the patient.

The inventive method allows with higher efficiency to provide medical care for patients with bronchitis in the stage of convalescence in the presence of their reduced tolerance to physical activity.

Claims (1)

A method of treating bronchitis in children undergoing convalescence, including the use of preformed physical factors and manual therapy, characterized in that preliminary exercise tolerance is determined with the help of bicycle ergometry using the PWC ₁₇₀ test, minute ventilation of the lungs using a pneumotachograph and oxygen saturation of the arterial blood with the ear ear sensor of the oxyhemograph and with a decrease in tolerance to physical activity with a power of less than 1 W / kg for 2 minutes, an increase in minute ventilation of more than 350% t of initial values with an increase in oxygen saturation in arterial blood of more than 98%, children are first prescribed a course of manual therapy for the vertebral-motor segments in the amount of 3 procedures in two days, and then balneotherapy is used in the form of thermal weak radon silicon baths at a temperature of 38 ° C for 10 minutes in the amount of 6 procedures per course.