RU2757470C1 - Method for treatment of snoring with introduction of trombocytic autologous plasma - Google Patents

Abstract

FIELD: medicine; otorhinolaryngology.

SUBSTANCE: invention relates to medicine, namely to otorhinolaryngology, and concerns the treatment of snoring. To do this, trombocytic autologous plasma is obtained and injected into the soft palate, palatine arches and uvula in the amount of 0.2 ml per injection, with an interval between injections of 0.8-1 cm. The second procedure is performed 7-10 days after the first, according to the same protocol as the first. Similarly, the third procedure is performed 7-10 days after the second, with the addition of inhaling powder from lyophilized trombocytic autologous plasma. The fourth procedure is performed 14 days after the third, according to the protocol of the third procedure.

EFFECT: method provides effective treatment of snoring and elimination of its consequences – sleep apnea and dyspnea, due to the ability of growth factors and biologically active substances contained in trombocytic autologous plasma to improve microcirculation and enhance the neuro-reflex effect on the neuromuscular apparatus of the pharynx and soft palate.

1 cl, 2 ex

Description

The invention relates to medicine, in particular to restorative medicine, otorhinolaryngology, reconstructive surgery, and can be used to treat snoring and eliminate its consequences (apnea and dyspnea) during sleep.

Snoring (ronchopathy) is the vibration of the soft tissues of the pharynx and palate from the movement of air that passes through the respiratory tract during sleep. Snoring is defined as "any resonant sounds that form in the upper airway during sleep", from other structures, the palatine arches, the root of the tongue, the uvula and the walls of the larynx participate in the formation of snoring. However, the main source of sounds is the thin edges of the soft palate (curtain of the palate). Thus, snoring occurs as a result of changes in the state of the soft tissues of the upper respiratory tract and is the cause of disruption of many functions and systems of the body (respiratory, cardiovascular, nervous). The presence of snoring may indicate the presence of ENT pathology, obesity, or functional disorders. Snoring is often accompanied by attacks of apnea, which leads to oxygen deficiency of vital organs and systems and an increased risk of heart attack and stroke. Snoring leads to a violation of the proper sleep of the snoring person and those around him.

Every fifth person on Earth snores in a dream. About 3% of the population suffers from intermittent respiratory arrest during sleep. Due to some anatomical features of the structure of the airways, men are more prone to snoring. For one constantly snoring woman, there are 10 men. Every tenth man in the world experiences sleep apnea from time to time. Holding the breath in some cases lasts more than 1 minute.

Unfortunately, therapies that can help reduce snoring are often ineffective or difficult to follow.

Consider the factors that predispose to sleep and breathing disorders during sleep. Of course, anatomical factors come first: curvature of the nasal septum, hypertrophy of the turbinates, adenoids, hypertrophy of the palatine tonsils and uvula, large tongue, hypertrophy of the tongue root. Further, there are various tumors and anomalies of the maxillofacial area, as well as overweight patients with snoring.

Recently, special attention has been paid to changes in the state of the oropharynx in the form of laxity or thickening of the palatine curtain. The lower part of the nasopharynx and oropharynx is the area in which there is a violation of the patency of the upper respiratory tract during sleep, therefore, a decrease in muscle tone in the presence of negative pressure created in the trachea and bronchi causes a collapse of the pharyngeal walls (O. Selivanova, I. Fisher, V. Mann. "Diagnostics and therapy of respiratory disorders during sleep in sleep centers of otolaryngological clinics" // Russian rhinology, 2000, No. 2, pp. 30-34). Although the decrease in the tone of the muscles of the pharynx in a dream is of a physiological nature, it increases with a number of pathological processes. When breathing through the mouth, the tone of the pharyngeal dilators also decreases - m. geniogyoideus, m. genioglossus, which leads to a collapse of the lumen of the pharynx. L.I. Zuckerberg, S.L. Nersesyan ("The state of ENT organs in patients with sleep apnea syndrome and methods of surgical treatment" // Bulletin of otorhinolaryngology, 1996, No. 3, pp. 42-43) note that the occurrence of snoring and apnea is promoted by neurogenic insufficiency of the muscular apparatus of the pharynx and tongue ...

Currently, various methods of treating snoring are known - physiotherapy, medication, surgical, which, as a rule, are not effective and lead to painful sensations. Also, a significant disadvantage of surgical treatment is the laboriousness and duration of the operation.

For the treatment of patients with snoring, uvulopharyngopalatoplasty is performed using a surgical laser, which helps to reduce bleeding ("Condition of ENT organs in patients with sleep apnea syndrome and methods of surgical treatment." Bulletin of Otorhinolaryngology, 1996, No. 3, pp. 42-43). The disadvantages of this method include: the need for hospitalization of the patient, trauma, the possibility of bleeding, the possibility of excessive removal of healthy areas of the soft palate, the formation of reactive edema of the pharynx in the postoperative period, the complexity of the surgical procedure using expensive equipment (surgical laser).

In recent years, one of the popular treatments for snoring has been physiotherapy.

For example, there is a known method for the treatment of snoring (RF patent No. 2014016, M.cl. A61N 1/36 "Method for the treatment of snoring"), which consists in determining the tone of the muscles of the soft palate, posterior palatine arches and their vibration at the time of fixed inhalation through the nose , then cryoinfluence with liquid nitrogen is carried out for 12-15 seconds by the contact method on those formations whose muscle tone is reduced and accompanied by vibration, then with the subsequent detection of residual vibration and reduced tone, cryoinfluence is repeated on the corresponding structures.

The disadvantage of this method is that expensive equipment is needed, treatment can only be carried out in a hospital, laboriousness, the method causes vomiting from the introduction of a foreign object into the oral cavity, discomfort from vibration, fear of the patient.

Also known is a method of treating snoring (RF patent No. 2166337 "Method for treating snoring"), which consists in the fact that electrostimulation of the muscles of the soft palate is carried out with electric current in various modes by means of an otological electrostimulator "ESOT 1", the active electrode of which is installed on the middle line of the soft palate above small uvula, and then to the points on the soft palate to the right and left of the previous one. The disadvantage of this method, as well as analogues of such treatment, is that it causes pain reactions and vomiting from the introduction of foreign objects into the oral cavity, which leads to an increased rehabilitation period after treatment.

The complexity of therapy, the high cost of equipment, the high frequency of side effects, and a long rehabilitation period create the need to search for more effective and affordable methods.

The closest method of therapy is a method of treating snoring by using an artificial oxygen-xenon mixture containing, vol.%: Xenon - 5-20, the rest is oxygen, while breathing with an oxygen-xenon mixture is carried out for 2-5 minutes twice with an interval in one day and is repeated three times within three months. However, this method requires specialized expensive equipment and specialization of doctors.

The object of the present invention is to develop a new method for the therapy of snoring. This technique makes it possible to carry out therapy on an outpatient basis, to reduce the cost of the treatment method, to ensure a comfortable condition for the patient, and to shorten the rehabilitation period.

The technical result of the claimed method is to enhance the neuro-reflex effect on the neuromuscular apparatus of the pharynx and soft palate, due to growth factors and biologically active substances contained in autologous platelet plasma, as well as due to improved microcirculation and increased oxygen tension, muscle activity is enhanced.

The specified technical result is realized due to the following methods.

Venous blood is drawn from the patient in a volume of 9 ml by a vacuum blood sampling system through a 21-23G catheter. Then the blood is centrifuged at an acceleration of 1000G for 5 minutes. After centrifugation, 3.5-4.5 ml of autologous platelet plasma is taken from the test tube with a 5.0 ml syringe.

Injections of platelet autoplasma are carried out through a 5.0 ml syringe with a 30G × 13 mm needle, along the soft palate, palatine arches, into the uvula, 0.2 ml per injection, the interval between injections is 0.8-1 cm.

2 procedure is carried out 7-10 days after the first, according to the same protocol.

3 procedure is carried out 7-10 days after the second, according to the same protocol. After that, inhalation of powder from lyophilized platelet autologous plasma is added to improve the condition of the mucous membranes of the respiratory tract. For the manufacture of the powder, additional sampling of 9 ml of whole blood from the patient, centrifugation, sampling of autologous platelet plasma with a 5.0 ml syringe is carried out. In the future, autologous plasma is subjected to lyophilization on a special sterile vinyl material. The patient inhales the received volume of powder through the nose, with a powerful breath.

4 procedure - carried out 14 days after the third, according to the protocol the previous procedure is repeated.

The introduction of platelet autoplasma is carried out according to the following protocol:

1 procedure, interval from 7 to 10 days, 2 procedure, interval 7-10 days, 3 procedure, interval 14 days, 4 procedure. The course requires 4 procedures.

At the end of the course of procedures, patients note a decrease in snoring, an improvement in breathing at night, and a relief of smell. This course is recommended to be repeated 1-2 times a year, depending on the clinical picture.

Example 1.

Patient, M., 65 years old. I went to the otolaryngologist with complaints of snoring at night.

Diagnosis: R06.5 Breathing through the mouth.

The patient collected venous blood in a volume of 9 ml, obtained after centrifugation of 3.8 ml of autologous platelet plasma. Autologous platelet plasma in a volume of 3.8 ml was collected into a 5.0 ml syringe.

Injections of autologous platelet plasma were carried out according to the protocol - injection into the uvula in a volume of 0.2 ml, into the palatine arches on each side of 0.2-0.4 ml and diffusely across the soft palate, on average, 0.2 ml per injection with an interval of 1 cm between injections.

1 procedure was done, then with a weekly interval, 2 procedures were done according to the protocol of the first, then a week later, 3 procedures were done according to the second protocol.

Then the procedure of inhalation of powder from lyophilized platelet autologous plasma was performed. For this, an additional test tube with blood was taken from the patient to obtain autologous platelet plasma. Powder for inhalation through the nose was obtained on a special vinyl material from autologous platelet plasma 3.5 ml. The volume of the received powder was enough for a single inhalation through the nose.

After 14 days, the 4th procedure was carried out, similar to the third.

After a course of 4 procedures, the patient noted a pronounced decrease in snoring, an increase in breathing volume, ease of breathing, an improved sense of smell, and a decrease in symptoms of congestion. His night's sleep became more sound.

Example 2.

Patient, J., 54 years old. I went to the otolaryngologist with complaints of snoring at night, restless sleep.

Diagnosis: R06.5 Breathing through the mouth.

The patient collected venous blood in a volume of 9 ml, obtained after centrifugation of 4.5 ml of autologous platelet plasma. Autologous platelet plasma in a volume of 4.5 ml was collected into a 5.0 ml syringe.

Injections of autologous platelet plasma were carried out according to the protocol - introduction into the uvula in a volume of 0.4 ml, into the palatine arches on each side of 0.2 ml and diffusely across the soft palate, on average, 0.2 ml per injection with an interval of 0.8 cm between injections.

1 procedure was done, then 10 days later, 2 procedure was done according to the protocol of the first, then 10 days later, 3 procedure was done according to the protocol of the second procedure.

Then the procedure of inhalation of powder from lyophilized platelet autologous plasma was performed. For this, an additional test tube with blood was taken from the patient to obtain autologous platelet plasma. Powder for inhalation through the nose was obtained on a special vinyl material from autologous platelet plasma of 4.5 ml. The volume of the received powder was enough for two inhalation through the nose, on the day of the procedure and the next day in the morning.

After 14 days, the 4th procedure was carried out according to the protocol of thirds.

After a course of 4 procedures, the patient noted a pronounced decrease in snoring, ease of breathing, improved sense of smell, and decreased symptoms of congestion.

Thus, the use of the claimed method, in the aggregate of all its techniques, allows the method to enhance the neuro-reflex effect on the neuromuscular apparatus of the pharynx and soft palate, due to growth factors and biologically active substances contained in autologous platelet plasma, as well as by improving microcirculation and an increase in oxygen tension increases muscle activity, relieve a person from snoring, improve sense of smell and breathing.

Claims (1)

A method for treating snoring by introducing autologous platelet plasma includes taking venous blood from a patient in a volume of 9 ml; then the blood is centrifuged at an acceleration equal to 1000 G for 5 minutes; after centrifugation, 3.5-4.5 ml of autologous platelet plasma is taken from the test tube with a 5.0 ml syringe, then the first procedure is performed by injection of platelet autoplasma into the soft palate, palatine arches, into the uvula, 0.2 ml per injection, the interval between injections of 0.8-1 cm; the second procedure is carried out 7-10 days after the first, according to the same protocol as the first; the third procedure is carried out 7-10 days after the second, according to the same protocol as the second, while additionally inhalation of powder from lyophilized platelet autologous plasma is added, for which an additional 9 ml of whole blood is taken from the patient, centrifuged, and taken with a syringe the obtained platelet autologous plasma and subjected to lyophilization; then the patient inhales the received volume of powder through the nose; the fourth procedure is carried out 14 days after the third, according to the protocol of the third procedure.