SU1428381A1 - Method of treatment of traumatic injures of nerves of the extremities - Google Patents

Abstract

This invention relates to neurology. The purpose of the invention is to reduce the time it takes to restore nerve function. After surgery, patients are prescribed - penicillamine, vitamin Wb, furosemide, muscle electrostimulation, paraffin-nocheritis applications, massage, exercise therapy. The method allows the motor, sensory and vegetative functions of the nerve to be fully restored.

Description

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The invention relates to medicine, namely to neurologology and neurosurgery, and can be used to treat traumatic injuries of peripheral nerves after neurosurgical interventions (neurolysis, neurotraphy, nerve transplantation).

The purpose of the invention is to reduce the time it takes to restore nerve function by inhibiting the growth of connective tissue.

This goal is achieved in that according to the method of treating traumatic injuries of the nerves of the extremities, including stitching the ends of the nerve and using drugs directly after the operation, patients are additionally prescribed osteolatirogea D-penicillamine daily for 30-35 days.

The method of treatment is carried out as follows.

/ Z-nenicillamine is prescribed to patients with traumatic injury of peripheral Ki | x nerves after surgery {neurorafi, autotransplantation) from the 1st d | b1 after surgery according to the following scheme: 1 week - 300-400 mg / day - 1.5 times tablets once a day 1 hour before meals; 2 weeks - 750 mg / day - 1 tablet 3 times a day; 3 and 4 weeks - 750-900 mg / day - 1.5 tablets 3 times a day 1 hour before meals, reducing to 4 tablets 1 week 3 times a day, and then I tablet 2 times and 1 tablet 1 per day. At the same time, patients receive conventional treatment: immediately after surgery, vitamin B, furosemide, after 3-4 weeks, electrical stimulation of the muscles, paraffin-osokerithe application, massage, exercise therapy.

: Example Patient X, age 33 years. Diagnosis: traumatic rupture of the right median nerve in the lower third of the forearm. There are no complaints about the impossibility of bending 1-3 fingers in the right hand, opposing the first finger, feeling of numbness on the palmar surface of 1-3 fingers, pain in the right hand. 05/28/85 a glass m. Received incised wound.

Neurological status: in the region of the scar in the lower third of the right forearm, the painful neuroma is palpated, radiating to the area of the fingers. There is no palmar flexion of 1-3 fingers, opposing the first finger. The diagnosis is 1-3 fingers, dry skin in the area of the affected nerve. Hypesthesia of the palmar surface of 1-3 fingers of the right hand.

According to the classic electrodiagnosis. sticks: complete reaction of the degeneration of the right median nerve. Electromyography: during stimulation of the right median nerve, no M-response was obtained.

06/19/85 was operated on: the suture of the right median nerve.

06.20.85, the treatment with the proposed method was initiated: D-pencylamine was prescribed after 150

to the following scheme: 1 week - 300-400 mg / day - 1.5 tablets I once a day 1 hour before meals; 2 weeks - 750 mg / day - 1 tablet 3 times a day; 3 and 4 weeks - 750-900 mg / day - by

1.5 tablets 3 times a day for 1 hour before a meal, reduced on the 4th week to 1 tablet 3 times a day, then 1 tablet 2 times and I tablet 1 time a day.

In addition, the patient underwent physiotherapy treatment 3 weeks after the operation: electrostimulation of the muscles of the first finger raised on the UEI-1 apparatus with an exponential current with a pulse duration of 100 ms and a frequency of I Hz, 5–8 contractions per minute with a 3-minute interruption 5-8 hours daily. A total of 30 treatments per course. Paraffin-peroxo- tic ants of the scale on the region of the affected limb at 40–42 ° C for 25–30 min each day were electrostimulated. A total of 30 treatments per course.

0 The patient was discharged 27.06.85, continues treatment on an outpatient basis.

Examined on August 19, 1985 (2 months after the operation): the patient has palpal flexion of 1-3 fingers of the right

 hands and contrasting of the first finger, increased muscular strength, trophic disorders disappeared, a slight hypesthesia is revealed: 5 and with hyperpathy on the palmar surface of 1-3 fingers.

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With thumb muscles

At the moment of maximum movements of active movements, the electromyogram of type 1 was registered by Yu. S. Yu. Yusevich. The threshold of the M-response for styling the proximal point is 150 V, the distal one is 135 V. The latent period for styling the proximal point is 12.4 ms, the duration of the M-response is 8.4 ms, the maximum amplitude is 430 µV, S.PI on the right sredinno.m nerve 31.4. M / s.

After 2 months after surgery and treatment of patient X, he began work in his specialty, Gurezhny.

Repeated examination 1 1.1 1.85 g .: the motor, sensitive and autonomic functions of the right median nerve are clinically fully restored.

The threshold of the M-response when stimulating the proximal point is 92V, the latent period is 9.6 ms, the duration of the M-response is 12.0 ms, the maximum amplitude is 1020 μV, the SPI in the right median nerve is 42.8 m / s.

Clinical trials have shown that the proposed method of treating patients with traumatic injuries to the nerves of the extremities makes it possible to significantly reduce the duration of treatment as compared with the known methods of treatment.

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Claims (1)

Invention Formula A method for the treatment of traumatic nerve damage to the limbs, including: 1428381 54 the ends of the nerve, followed by the introduction of a nerve by inhibiting the growth of a compound in the damage zone of the medicinal tissue, the patient is additionally treated with drugs, characterized in that, in order to allow D-penicillamine in pharmacopoeial shortening of the terms of functional dosages and regimen.