RU49453U1 - SYSTEM OF INTEGRATED THERAPY OF MENTAL AND SOMATIC DISORDERS IN ACUTE ENCEPHALOPATHY IN PATIENTS WITH ALCOHOLISM AND / OR DRUG ABUSE - Google Patents

Abstract

The utility model relates to preventive medicine, in particular, to equipment for the complex therapy of mental and static disorders in acute encephalopathy in patients with alcoholism and / or drug addiction. The essence of the utility model is that the gas supply unit of the complex therapy system for mental and somatic disorders in acute encephalopathy in patients with alcoholism and / or drug addiction is equipped with a device to prevent the transition of acute encephalopathy into a chronic form of inert gas cylinders connected to an anesthesia device, the dosimeters of which calibrated for oxygen and inert gases and the inert gas collection unit, and the inert gas supply unit is made with a fixed gas flow - 0.55-1.1-1.65-2.2 liters / min, while the complex therapy system has a gas analyzer for inhaled and exhaled gases, a tonometer, a phonendoscope, a set for tracheal intubation - a laryngoscope, endotracheal tubes, an electric defibulator, a cardiomonitor, medical aspirator, elements of the spatial arrangement of ampoules - 2 ml. 5% solution of Mexidol, 5-60 ml. 20% solution of nootropil, 1-30 ml. Cerebrolysin, 1000 ml. 5% glucose solution, 2 ml. 0.5% diazepam solution, 10 ml. 0.25% droperidol solution, 1 ml. 5% solution of vitamin B-1, 2 ml. 5% solution of ascorbic acid, 2 ml. 5% solution of vitamin B-6, 1 ml each. vitamin B-12, 1 ml each. 5% solution of vitamin E, 2.0 ml. A 5% solution of ascorbic acid, phenobarbital in tablets, 0.1 g each and sterile lines for intravenous infusion of single use, and the patient accommodation unit has movable stop elements.

Description

The utility model relates to preventive medicine, in particular, to equipment for the complex therapy of mental and somatic disorders in acute encephalopathy in patients with alcoholism and / or drug addiction.

A well-known system of complex therapy of mental and somatic disorders in acute encephalopathy in patients with alcoholism and / or drug addiction, including interconnected functional units - the patient placement unit, anesthesia apparatus, gas supply unit, connection elements and face masks, / see RF patent 2128524, cl. A 61 M 16/00, 1996 /.

Also known is a system of complex therapy of mental and somatic disorders in acute encephalopathy in patients with alcoholism and / or drug addiction, including interconnected functional units - a patient placement unit, an anesthesia machine, a gas supply unit, connection elements and face masks, / RF patent 2146536, cl. A 61 M 16/00, 1999 /.

The disadvantages of the known utility models are the likelihood of a transition to a chronic form with subsequent disability of the patient and his social maladaptation, the relatively high drug load with high costs for the treatment of this category of patients, as well as the relatively high treatment time and poor prognosis of recovery.

The purpose of the utility model is to prevent the transition of acute encephalopathy to a chronic form with the exception of subsequent disability of the patient and his social maladaptation, reduction of the drug load with a decrease in the cost of treatment for this category of patients, as well as a reduction in the duration of treatment and an improvement in the quality of the prognosis of recovery.

This is achieved by the fact that the gas supply unit of the complex therapy of mental and somatic disorders in acute encephalopathy in patients with alcoholism and / or drug addiction is equipped with a device to prevent the transition of acute encephalopathy to a chronic form made in the form of inert gas cylinders connected to an anesthesia apparatus, the dosimeters of which are calibrated with oxygen and inert gases and the inert gas collection unit, and the inert gas supply unit is made with a fixed gas flow - 0.55-1.1-1.65-2.2 liters / min, while the complex therapy system has a gas analyzer for inhaled and exhaled gases, a tonometer, a phonendoscope, a set for tracheal intubation - a laryngoscope, endotracheal tubes, an electric defibrillator, a cardiomonitor, a medical suction device, and ampoules with a spatial placement of 2 ml. 5% solution of Mexidol, 5-60 ml. 20% solution of nootropil, 1-30 ml.

Cerebrolysin, 1000 ml. 5% glucose solution, 2 ml. 0.5% diazepam solution, 10 ml. 0.25% droperidol solution, 1 ml. 5% solution of vitamin B-1, 2 ml. 5% solution of ascorbic acid, 2 ml. 5% solution of vitamin B-6, 1 ml each. vitamin B-12, 1 ml each. 5% solution of vitamin E, 2.0 ml. 5% ascorbic acid solution, phenobarbital tablets in 0.1 g tablets and sterile lines for single-use intravenous infusions, and the patient's placement unit has movable stop elements.

It is advisable that the gas supply unit was installed with the release of oxygen and inert gas in ratios from 1: 1 to 1: 5.

It is useful that the anesthesia machine be installed with a frequency of sessions depending on the exacerbation of the neuro-vegetative symptom complex.

It is advisable that the anesthesia machine be installed with a frequency of sessions.

It is advisable that the anesthesia machine be installed with a frequency of sessions depending on the growth of autonomic disorders.

It is useful that the anesthesia machine be installed with a frequency of sessions depending on the growth of tachycardia.

It is advisable that the anesthesia machine be installed with a frequency of sessions depending on memory disorders.

It is useful that the anesthesia machine be installed with a frequency of sessions depending on attention disorders.

It is advisable that the anesthesia machine be installed with a frequency of sessions depending on perceptual disorders.

It is useful that the anesthesia machine be installed with a frequency of sessions depending on thinking disorders.

It is advisable that the anesthesia machine be installed with a frequency of sessions depending on intellectual disorders.

It is useful that the anesthesia apparatus be installed with a frequency of sessions depending on the disorders of the emotional-volitional sphere.

It is advisable that the anesthesia machine be installed with a frequency of sessions depending on neurological disorders.

It is useful that the gas supply assembly has phenobarbital ampoules.

The system of complex therapy of mental and somatic disorders in acute encephalopathy in patients with alcoholism and / or drug addiction meets all the signs of a useful model, namely -

- the presence of a structural element, since the gas supply unit of the complex therapy system for mental and somatic disorders in acute encephalopathy in patients with alcoholism and / or drug addiction is equipped with a device to prevent the transition of acute encephalopathy to a chronic form

- the presence of a connection between the elements, since the device for preventing the transition of acute encephalopathy to a chronic form is made in the form of inert gas cylinders connected to an anesthesia machine,

- the form of the element, since the dosimeters of the device are calibrated for oxygen and inert gases and the inert gas collection unit,

- forms of communication element, since the inert gas supply unit is made with a fixed output of a gas stream of 0.55-1.1-1.65-2.2 liters / min,

- parameters and other characteristics of the element, since the complex therapy system has a gas analyzer of inhaled and exhaled gases, a tonometer, a phonendoscope, a set for tracheal intubation - a laryngoscope, endotracheal tubes, an electric defibrillator, a cardiomonitor, a medical aspirator, ampoule spatial elements,

- the material from which the element is made, since the system has elements of spatial arrangement of ampoules of - 2 ml. 5% solution of Mexidol, 5-60 ml. 20% solution of nootropil, 1-30 ml. Cerebrolysin, 1000 ml. 5% glucose solution, 2 ml. 0.5% diazepam solution 10 ml. 0.25% droperidol solution, 1 ml. 5% solution of vitamin B-1, 2 ml. 5% solution of ascorbic acid, 2 ml. 5% solution of vitamin B-6, 1 ml each. vitamin B-12, 1 ml each. 5% solution of vitamin E, 2.0 ml. 5% solution of ascorbic acid, phenobarbital in tablets of 0.1 g each and sterile lines for single-use intravenous infusions.

Figure 1 shows the structural diagram of the system.

Figure 2 is the same diagram of the system of complex therapy of mental and somatic disorders in acute encephalopathy in patients with alcoholism and / or drug addiction.

The system of complex therapy of mental and somatic disorders in acute encephalopathy in patients with alcoholism and / or drug addiction includes interconnected functional units - a patient placement unit 1, an anesthesia device 2, a gas supply unit 3, connection elements 4 and face masks 4, while the supply unit gases 3 of the complex therapy system for mental and somatic disorders in acute encephalopathy in patients with alcoholism and / or drug addiction is equipped with a device to prevent the transition of acute encephalopathy to chron the physical form 5 made in the form of cylinders 6 of inert gases connected to the anesthesia apparatus 2, the dosimeters of which are calibrated with oxygen and inert gases and the inert gas collection unit 7, and the inert gas supply unit 3 is made with a fixed gas flow output of 0.55-1, 1-1.65-2.2 liters / min, the complex therapy system has a gas analyzer 8 of inhaled and exhaled gases, a tonometer 9, a phonendoscope 10, a set for tracheal intubation 11 - a laryngoscope, endotracheal tubes, electric defibrillator, cardiomonitor, medical aspirator, elements spatial distribution of ampoules 12 to - 2 ml. 5% solution of Mexidol 13.5-60 ml. 20% solution of nootropil 14.1-30 ml.

Cerebrolysin 15, 1000 ml. 5% glucose solution 16, 2 ml. 0.5% solution of diazepam 17, 10 ml. 0.25% solution of droperidol 18, 1 ml. 5% solution of vitamin B-1 19, 2 ml. 5% solution of ascorbic acid 20, 2 ml. 5% solution of vitamin B-6 21, 1 ml each. Vitamin B-12 22, 1 ml each. 5% solution of vitamin E 23, 24 phenobarbital tablets 0.1 g each 25 and sterile lines for intravenous infusion of single use 26, and the patient accommodation unit 1 has movable locking elements 27, and the gas supply unit is installed with the release of oxygen and inert gas in

in ratios from 1: 1 to 1: 5, the anesthesia machine is installed with a frequency of sessions depending on the exacerbation of the neurovegetative symptom complex, or depending on the exacerbation of the neurovegetative and painful symptom complex, or depending on the growth of autonomic disorders, or depending on the increase in tachycardia, or with the frequency of sessions, depending on memory disorders, or depending on attention disorders, or depending on perceptual disorders, or depending This is due to mental disorders, or depending on intellectual disorders, or depending on disorders of the emotional-volitional sphere, or depending on neurological disorders, and the gas supply unit has phenobarbital ampoules.

The system is as follows.

Initially, interconnected functional units are prepared for operation — a patient placement unit 1, an anesthesia device 2, a gas supply unit 3, connection elements 4 and face masks 4, while a gas supply unit 3 of the complex therapy system for mental and somatic disorders in patients with acute encephalopathy alcoholism and / or drug addiction are provided with a device to prevent the transition of acute encephalopathy to chronic form 5; it is performed in the form of cylinders 6 of inert gases, which are connected to anesthesia apparatus 2, whose trays are calibrated for oxygen and inert gases and an inert gas collection unit 7, and the inert gas supply unit 3 is performed with a fixed gas flow output of 0.55-1.1-1.65-2.2 liters / min, a complex therapy system provide a gas analyzer 8 inhaled and exhaled gases,

tonometer 9, phonendoscope 10, set for tracheal intubation 11 - laryngoscope, endotracheal tubes, electric defibrillator, cardiomonitor, medical aspirator, ampoules of 12 - 2 ml. 5% solution of Mexidol 13, 5-60 ml. 20% solution of nootropil 14, 1-30 ml.

Cerebrolysin 15, 1000 ml. 5% glucose solution 16, 2 ml. 0.5% solution of diazepam 17, 10 ml. 0.25% solution of droperidol 18, 1 ml. 5% solution of vitamin B-1 19, 2 ml. 5% solution of ascorbic acid 20, 2 ml. 5% solution of vitamin B-6 21, 1 ml each. Vitamin B-12 22, 1 ml each. 5% solution of vitamin E 23, 2.0 ml. 5% solution of ascorbic acid 24, phenobarbital in 0.1 g tablets 25 and sterile single-use intravenous infusion lines 26, and the patient accommodation unit 1 is equipped with movable stop elements 27, the gas supply unit being installed with the delivery of oxygen and inert gas to in ratios from 1: 1 to 1: 5, the anesthesia apparatus is established with a frequency of sessions depending on the exacerbation of the neurovegetative symptom complex, or depending on the exacerbation of the pain symptom complex, or depending on the exacerbation of the neurovegeta obvious and painful symptom complex, or depending on the growth of vegetative disorders, or depending on the growth of tachycardia, or on the frequency of sessions, depending on memory disorders, or depending on attention disorders, or depending on perceptual disorders, or depending on thinking disorders , or depending on intellectual disorders, or depending on disorders of the emotional-volitional sphere, or depending on neurological disorders, and the gas supply unit is supplied with phenobarbital ampoules, then pa cents are placed on the placement unit 1, fixed using movable locking elements and carry out all the required procedures based on pre-prepared solutions and

tablets, after which the movable locking elements are unlocked, the patient is moved to a stationary place and the cycle of complex therapy is repeated.

XENON as a treatment for astheno-depressive conditions and other mental disorders in the treatment of acute encephalopathy in a narcological clinic.

The main advantage of the technique is the possibility, with the help of xenon therapy, to cause a clear reduction in the clinical manifestations of acute encephalopathy and polyneuropathy in patients with a narcological profile:

- stop hallucinatory-delusional disorders within the framework of the psycho-organic syndrome;

- improve cognitive function;

- stop acute cortical, mesencephalic, diencephalic and cerebellar neurological disorders;

- stabilize autonomic regulation.

Patient “C” 50 years old, (IB 18555) was admitted to the NKB No. 17 for the purpose of treatment for alcoholism, and in connection with auditory and visual hallucinations that appeared against the background of alcohol withdrawal. Previously treated three times in a hospital.

Hallucinations during the period of withdrawal symptoms persisted for a long time (up to three weeks), did not stop with the use of antipsychotics. Moreover, taking antipsychotic drugs worsened the patient's condition. Ataxia, dysarthria, disorientation in place and time appeared, and memory worsened.

The patient began to regularly take alcohol in the last five years, after retirement. She worked as a trolley bus driver.

History of repeated traumatic brain injury (concussion), dyscirculatory encephalopathy, otosclerosis.

Auditory and visual hallucinations appear on the background of alcohol withdrawal syndrome for the past 2 years. He sees relatives sitting on the ceiling or on the window and scolding her for drinking alcohol.

Orientation in place and time is saved. Answers to questions in terms of the given, verbose, not always in essence, "jumping" from one thought to another, speech is fast, loud, jerky. The mood is benign, elated. He reports anamnestic data completely, flaunts his drunkenness. He is critical of hallucinations, realizing that these are deceptions of perception, but believes that she was “spoiled”.

Given the history and nature of hallucinatory delusional disorders, endogenous disease was excluded.

The patient willingly agreed to xenon therapy, immediately after the doctor’s approval, believing that the procedure would help her.

Xenon therapy sessions went smoothly. Hemodynamics and respiration were stable. Immediately after the first session, the hallucinations disappeared, the patient calmed down and fell asleep. In the following days, the mood background, night's sleep returned to normal. On the second and third day of treatment, hallucinatory symptoms appeared in the evening and only in the form of an unclear whisper or illegible words and immediately stopped with xenon inhalations for 3 to 4 minutes.

On the fifth day, the patient was in satisfactory condition transferred from the intensive care unit and intensive care unit to the narcological department, where vitamin therapy, vascular therapy, physiotherapy, and rational psychotherapy continued. Tranquilizers, sleeping pills, antipsychotics

the patient did not receive antidepressants and other psychocorrectors. After 30 days, the patient was discharged from the hospital in satisfactory condition.

Patient "I" 55 years old, (IB No. 12459) was transferred to the NKB No. 17 from the neurological department of the GKB No. 7, where he stayed for 20 days with a diagnosis of

Toxic encephalopathy with episindrome. Korsakovsky syndrome. Right upper lobar pneumonia. Retinal angiopathy.

The condition at admission is serious: it is sharply inhibited, disoriented in place and time, it answers monosyllables, dysortria, gross cerebellar and diencephalic disorders, fixative amnesia. Clinically and radiologically revealed right-sided upper lobar pneumonia, on the ECG - signs of decreased coronary blood flow in the anterior wall of the left ventricle.

When collecting an anamnesis (according to the son), it was found that the patient has been abusing alcohol for a long time, more than 20 years. Over the past 10 years, drinking has been practically permanent. Over the past 4 years, against the background of alcohol withdrawal, epipressures have appeared. A sick surgeon by profession, candidate of medical sciences, associate professor was engaged in medical and teaching activities. For the past 5 years he has been working as a consultant in a children's clinic. For a long time the patient treated withdrawal symptoms on his own, hid his alcohol addiction from others, did not turn to a narcologist for help. Before entering the neurological department, City Clinical Hospital No. 7 was found by relatives of the house unconscious, which was the reason for hospitalization.

Given the signs of acute acute toxic toxic encephalopathy, it was decided to conduct a course of xenon therapy.

Xenon therapy sessions were carried out daily for 12 days. In parallel, general strengthening therapy, cerebrovascular therapy, and vitamin therapy were carried out.

During xenon therapy sessions, stabilization of hemodynamic and respiratory parameters, muscle relaxation, and deep sleep for 3 to 4 hours after the completion of the session were noted.

After the third session, the patient began to clearly improve neurological neuropsychiatric symptoms:

- the patient became more active in the daytime and night sleep normalized;

- the speech became clear and emotionally colored;

- memory for current and past events has clearly improved, while professional memory began to recover first of all;

- There was a critical attitude to his condition and illness and a desire to recover.

On the seventh day of treatment, the patient began to get out of bed, from the beginning with the help of medical staff, and then, on his own.

On the 12th day of treatment, the patient was transferred to the narcological department where vasocerebral, metabolic and vitamin therapy was continued, as well as physiotherapy and psychotherapy.

2.5 months after admission, the patient was discharged from the hospital in a relatively satisfactory condition.

Claims (2)

1. A system for the comprehensive treatment of mental and somatic disorders in acute encephalopathy in patients with alcoholism and / or drug addiction, including interconnected functional units - a patient placement unit, anesthesia apparatus, gas supply unit, connection elements and face masks, characterized in that the delivery unit gas system of the complex therapy of mental and somatic disorders in acute encephalopathy in patients with alcoholism and / or drug addiction is equipped with a device that prevents the transition of acute encephalopa chronic form, made in the form of inert gas cylinders connected to an anesthesia apparatus, the dosimeters of which are calibrated with oxygen and inert gas, and an inert gas collection unit, and the inert gas supply unit is made with a fixed gas flow output of 0.55-1, 1 ÷ 1.65-2.2 l / min, while the complex therapy system has a gas analyzer for inhaled and exhaled gases, a tonometer, a phonendoscope, a set for tracheal intubation - a laryngoscope, endotracheal tubes, an electric defibrillator, a cardiomonitor, a medical suction device, an ele The spatial placement of ampoules is 2 ml of a 5% solution of Mexidol, 5-60 ml of a 20% solution of Nootropil, 1-30 ml of cerebrolysin, 1000 ml of a 5% glucose solution, 2 ml of a 0.5% diazepam solution, 10 ml of 0.25% droperidol solution, 1 ml of 5% solution of vitamin B-1, 2 ml of 5% solution of ascorbic acid, 2 ml of 5% solution of vitamin B-6, 1 ml of vitamin B-12, 1 ml of 5% solution of vitamin E, 2, 0 ml of a 5% solution of ascorbic acid, phenobarbital tablets 0.1 g each and sterile lines for intravenous infusion of single use, and the patient's placement unit has movable locking elements you. 2. The system according to claim 1, characterized in that the gas supply unit is installed with the delivery of oxygen and inert gas in ratios from 1: 1 to 1: 5.