SU1202561A1 - Method of treatment of stenocardia - Google Patents

Description

one

The invention relates to medicine and is intended for the treatment of the variant (spontaneous) form of Priuzmetal angina without occlusive restriction of the coronary arteries, as well as other forms of angina pectoris, with a pronounced vasospastic component.

The aim of the invention is to reduce treatment rates and reduce the morbidity of the treatment.

The method is carried out as follows.

The patient is treated with the skin in the interscapular region with an antiseptic solution. An anesthesia is carried out along the midline in the sagittal direction between the spinous processes of the C-O of the thoracic vertebrae, for example, with a 0.25-0.5% solution of novocaine, skin, subcutaneous tissue, and a puncture needle mandrin having a hole on the side and the diameter of the internal channel to 1 mm. Mandrin is removed, a syringe with a local anesthetic solution is attached to the needle, and, anesthetized the tissue, the needle is slowly advanced into the epidural space. Then the syringe is disconnected, the needle is turned around the long axis so that its lateral opening is cranial, and under the control of the X-ray screen, an elastic X-ray contrast catheter is led through the needle into the epidural space so that its end is in the region of the TT-1 segments. Holding the catheter, remove the needle, fix the catheter to the skin and put the patient on his back. Attach a syringe to the catheter and insert the syringe into it, for example, 3-5 ml of 1.5 to 3% aqueous solution of trimekine. After 15–30 minutes, the patient has a feeling of warming, and for I BM, skin sensitivity and numbness in the upper half of the chest and upper extremities decrease. After that, through the catheter, moving it under the control of the X-ray screen, successively at the exit points of the pellets Td. Tj- is injected with up to 2 ml of a neurolytic mixture consisting of 96-100% ethyl alcohol, phenol and glycerin, taken in a ratio of 3: 2: 15. Remove the catheter, closure12025612

Puncture aperture with a gauze ball and leave the patient in a supine position for two to four hours, after which he can remain on the regular mode.

Example. Patient R., 1932, diagnosis: ischemic heart disease, Priuzmetal angina pectoris, atherosclerotic and postinfarction cardiosclerosis. Sick about three

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years, complaints of sharp paroxysmal pain in the heart and behind the sternum, especially at night, take up to 10 tablets of nitroglycerin per day, blood pressure 140/80 mm Hg. There is no indication of a history of myocardial infarction.

Conducted ECG: sinus rhythm, 60 beats per minute with single extrasystoles, heart position uncertain. Bicycle energy showed that the tolerance to the load is 50 3 min.

Coronary angiography: left ventricular normokinesis, balanced type of coronary circulation, narrowing of the mouth of the circumflex branch of the left coronary artery, less than 50% of the lumen, other coronary arteries passable throughout. With the introduction of a contrast agent, a sharp spasm is noted in all parts of the circumflex branch of the left coronary artery with the appearance of electrocardiographic signs of myocardial ischemia. After two or three minutes, the spasm disappears spontaneously, and the ECG is normalized only after taking one nitroglycerin tablet.

According to the results of the survey, direct indications are established for heart sympathization according to the described method .. A rolitic mixture is introduced into the epidural space at the level. 12 hours after the injection, the patient notes a significant improvement in the general condition, the cessation of painful attacks. He stopped taking nitroglycerin and other drugs. Bicycle ergometry shows that load tolerance increases and is 120x5 min, and electrocardiography reduces myocardial hypoxia. The patient was discharged in good condition under the supervision of a physician.

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five

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five

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five

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five

years, complaints of sharp paroxysmal pain in the heart and behind the sternum, especially at night, take up to 10 tablets of nitroglycerin per day, blood pressure 140/80 mm Hg. There is no indication of a history of myocardial infarction.

Conducted ECG: sinus rhythm, 60 beats per minute with single extrasystoles, heart position uncertain. Bicycle energy showed that the tolerance to the load is 50 3 min.

Coronary angiography: left ventricular normokinesis, balanced type of coronary circulation, narrowing of the mouth of the circumflex branch of the left coronary artery, less than 50% of the lumen, other coronary arteries passable throughout. With the introduction of a contrast agent, a sharp spasm is noted in all parts of the circumflex branch of the left coronary artery with the appearance of electrocardiographic signs of myocardial ischemia. After two or three minutes, the spasm disappears spontaneously, and the ECG is normalized only after taking one nitroglycerin tablet.

According to the results of the survey, direct indications are established for heart sympathization according to the described method .. A rolitic mixture is introduced into the epidural space at the level. 12 hours after the injection, the patient notes a significant improvement in the general condition, the cessation of painful attacks. He stopped taking nitroglycerin and other drugs. Bicycle ergometry shows that load tolerance increases and is 120x5 min, and electrocardiography reduces myocardial hypoxia. The patient was discharged in good condition under the supervision of a physician.

Claims (1)

METHOD FOR TREATING ANGENICA, including atimatization of the atria, aortic arch, and ethanol hollow with the help of the fact that, with a shorter treatment time, more traumatic treatment, catheterization of the epidural space in the upper thoracic catheter is inserted into the thoracic and exit points of buds, forks T _t - T ₅ to 2 ml of a mixture of 96-100% ethyl alcohol, phenol and glycerol in a ratio of 3: 2: 15. SS ω yu o