SU1607808A1 - Method of treating cardio-humero-thoracal syndrome of miocardial infarction patients - Google Patents

Abstract

The invention relates to medicine, namely to physiotherapy and cardiology. The purpose of the invention is to relieve pain syndrome, increase resistance to exercise in patients with myocardial infarction in the recovery phase complicated by cardiopulmonary thoracic syndrome, increase the effectiveness of treatment. The goal is achieved by the appointment of electrosleep and exposure of the left subclavian microdism, the clavicle, the subclavian microbial zone and the left shoulder joint area with ultrasound in a continuous mode, with an intensity of 0.4-0.6 W / cm ² , through a layer of 2% nitroglycerin ointment during the last 10 minutes of electrosine, when the frequency of its pulses reaches 70 Hz, the electrosine procedures begin at 50 Hz and an exposure time of 10 minutes and increase each subsequent procedure of 10 Hz to 70 Hz, and the exposure for 10 minutes to 60 minutes, after which these values are kept attained level until the end of the course of treatment.

Description

This invention relates to medicine, in particular to physiotherapy and balneology.

The purpose of the invention is to increase the therapeutic efficacy of the relief of pain and increase the tolerance of patients to exercise.

The method is carried out as follows.

1st day - an electrosound with a frequency of 50 Hz is assigned for 10 minutes, the current is selected individually in the threshold, the sensation is in the range of 0.2-4 mA.

2nd day - a 60 Hz electrosleep is assigned for 20 minutes.

3rd day - an electro-electric frequency of 70 Hz is prescribed for 30 minutes, during the last 10 minutes an ultrasound of 0.4-0.6 W / cm is prescribed (selected individually) through a layer of 2% nitromasy, the method is labile, - the left supraclavicular bone, clavicle, subclavian bone, area of the left shoulder joint.

4th day - the 70 Hz electrosleep is prescribed for 40 min., During the last 10 min, phonophoresis of 2% nitromasi is prescribed, as on the 3rd day.

5th day - a 70-Hz electroscope is assigned for 50 minutes; during the last 10 minutes, 2% nitromasi phonophoresis is prescribed, as on previous days.

6th day - the 70 Hz electric motor is assigned for 60 minutes, during the last 10 minutes the electric switch is assigned

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phonophoresis of 2% nitromasi, as in the previous days.

All subsequent days are prescribed the same procedures as on day 6. And in a similar way to the 12-15th day.

Example 1. Sick A., 60 years old. Diagnosis: ischemic heart disease, myocardial infarction, anterior-lateral sections of the left ventricle, atherosclerosis of the aorta and coronary arteries, atherosclerotic cardiosclerosis, NK-0, hypertensive disease II stage, cardiocerebral variant.

Complaints at admission to rehabilitation: stabbing, aching pain in the left half of the chest, shoulder girdle, radiating to the shoulder blade, of a permanent nature and not stopped by the use of validol or nitroglycerin.

Anamnesis of the disease. For the first time, pain in the heart region occurred 2 days before the development of myocardial infarction. Hospitalized.

The above pains occurred at 3-4 weeks of illness.

Objective research: wet, pink colored visible mucous membranes. Pulse 84 beats per minute, rhythmic, satisfactory filling and stress. The boundaries of relative cardiac dullness are extended to the left. Heart activity is rhythmic, muted tones, accent II tones over the aorta. HELL 160/100 mm Hg Art. From Stotava, they are exposed to ultrasound in a continuous mode with a power of 0.4 W / cm through a layer of 2% nitromasi.

4th day of treatment. Electrosleep was assigned a pulse frequency of 70 Hz, an exposure time of 40 minutes. From the 30th to the 40th minute of the electrospin, ultrasound with a power of 0.4 W / cm was applied through a layer of 2% nitromasi on the subclavian ICU, the clavicle, the supraclavicular ICU, and the area of the left shoulder girdle.

5th day of treatment. Electron was administered by a pulse frequency of 70 Hz (this frequency remains in all subsequent procedures), an exposure time of 50 minutes. During the last 10 minutes of electrosleep, ultrasound has been assigned to the left subclavian ICU, the clavicle, the supraclavicular ICU and the left shoulder joint area of 0.4 W / cm in continuous mode through a 2% nitromasis layer.

6th and all subsequent days of treatment. 0 Appointed by the electric frequency of 70 Hz, exposure 60 min. During the last 10 min, electrosleep was exposed to ultrasound in a continuous mode with a power of 0.6 W / cm through a layer of 2% nitromasi on the left subclavian dorsal arch, clavicle, supraclavicular dorsal cavity and the left shoulder joint.

The pains that worried about admission ceased on the 9th day of treatment.

The patient took 15 procedures, transferred 5

respiratory organs, digestive organs, supports

and movement of the urinary system without pathology. General blood and urine tests, coagulogram within normal limits. ECG: sinus rhythm, 85 per minute, the deviation of the EOS to the left, the blockade of the anterior branch of the left leg of the Guiss bundle. Signs of ischemia and scar in the high parts of the anterior and lateral walls of the myocardium of the left ventricle.

Indicators of bicycle ergometry prior to the prescription of the proposed treatment method: load threshold 25 W, work done 125 J, double product 129.1 sr. units, FC-IV.

The patient was assigned to treatment by the proposed method. During electrosleep, a drowsy state first arose, and then a shallow sleep.

1st day of treatment. Electric wiring with a frequency of 50 Hz, exposure time 10 min. The strength of the current was chosen individually on the threshold of sensation in the form of tingling around the sockets - 1 mA. The duration of the pulses on the 1st and on all subsequent days is constant and equal to 0.5 ms.

2nd day of treatment. An electric motor was assigned with a pulse frequency of 60 Hz, an exposure of 20 minutes.

3rd day of treatment. An electric motor was assigned with a pulse frequency of 70 Hz, an exposure of 30 minutes. During the last 10 minutes of electrosleep, i.e. after the 20th minute, on the left subclavian ICU, the clavicle, the supraclavicular ICU and the area of the left brachial neck

n the bridge is good.

After taking the course of treatment with the proposed method, the final ECG is marked by the restoration of repolarization processes in the lateral wall of the left ventricle.

Bicycle ergometry indicators: threshold load 75 W, work done 450 J, double product 183.6 sr. units, FC-1P.

According to the personal data, the remission lasted 8 months.

Example 2. Patient G., 61 years old. Diagnosis: ischemic heart disease, anterior-widespread myocardial infarction, angina pectoris stress (FK-1), atherosclerosis of the aorta and coronary arteries, atherosclerotic cardiosclerosis, NK-0.

Complaints for admission to rehabilitation: recurrent, squeezing pain behind the sternum, appearing during exertion, arrested by nitroglycerin; constant aching pains of fuzzy localization in the left half of the chest, shoulder joint and left hand, which are not relieved by the use of medicines; psycho-emotional excitability and pain associated with it in the region of the piercing heart.

Anamnesis of the disease. For the first time, pain such as angina pectoris appeared 4 days 5 before the development of a heart attack. On the day of hospitalization for acute myocardial infarction, prolonged bouts of angina pectoris developed twice. During the period

five

inpatient treatment, exacerbations of angina pectoris, corresponding to the first functional class, aching pains appeared on the 4th week of the disease. . From the anamnesis of life: renal stone disease 13 years.

Objective research: wet, pink colored visible mucous membranes; pulse 78 beats per minute, rhythmic, satisfactory filling and voltage. The boundaries of relative cardiac dullness are extended to the left by 0.5 cm. Heart rate is rhythmic, tones are muffled, systolic murmur on the upper tip. HELL 150/80 mm Hg. Art. Palpatsi in the area of supra- and subclavian moc, pressure on the clavicle is painful. Respiratory, digestive, musculoskeletal system without pathologies. Complete blood count, urine, coagulogram, serum lipid concentration within normal limits.

ECG: sinus rhythm, 81 beats per minute, EOS deviation to the left. Signs of ischemia and scar in the anterior-septal and apical-lateral sections of the left ventricle, and ischemia in the posterior wall.

Indicators of bicycle ergometry prior to prescribing the proposed treatment method: load threshold of 75 W, total work done 60 J, double product 135 conv. units

The treatment was carried out by the proposed method.

1st day of treatment. Electronum was set at a pulse frequency of 50 Hz, with an exposure time of 10 minutes. On this and further days of treatment, the pulse duration is 0.5 ms. The strength of the current was chosen individually on the threshold of sensation in the form of tingling around the sockets - 0.8 mA.

2nd day of treatment. Electronum was set at a pulse frequency of 60 Hz, with an exposure time of 20 minutes.

3rd day of treatment. Electronum was set at a pulse frequency of 70 Hz, with an exposure time of 30 minutes. During the last 10 minutes of electrosleep, the left subclavian ICU, the clavicle, the supraclavicular ICU and the left shoulder joint area were sonicated in a continuous mode with a power of 0.4 W / cm through a layer of 2% nitro-ointment.

4th day of treatment. Electronum was set at a pulse frequency of 70 Hz, with an exposure time of 40 minutes. From the 30th to the 40th minute, ultrasound with a power of 0.4 W / cm is applied through a layer of 2% nitromasy to the left subclavian dorsal cavity, clavicle, supraclavicular dorsal cavity and the left shoulder joint.

5th day of treatment. Electronum was set at a pulse frequency of 70 Hz, with an exposure time of 50 minutes. During the last 10 minutes of electrosleep, ultrasound has been assigned to the left subclavian dorsal membrane, the clavicle, the supraclavicular dorsal cavity and the area of the left humeral girdle.

Tava power of 0.4 W / cm in continuous mode through a layer of 2% nitromasi. On that day, the aching pains in the left side of the chest stopped.

6th day of treatment. Electron frequency of 70 Hz was prescribed at an exposure of 60 minutes. During the last 10 min, electrosleep was exposed to ultrasound in a continuous mode with a power of 0.6 W / cm through a layer of 2% nitromasi on the left subclavian dorsal arch, clavicle, supraclavicular dorsal cavity and the left shoulder joint.

The same effect was applied on the 7th and all subsequent days of treatment.

The patient slept during electrosleep and 5 after the current was turned off. Angina attacks stopped on the 2nd day after the proposed treatment was prescribed, aching pain in the left half of the chest - on the 5th day. The treatment course consisted of 13 procedures. Sick procedures transfer- 0 forces good.

After taking the course of treatment with the proposed method, a decrease in ischemic prosthesis is observed in the final ECG in the posterior and lateral walls of the left ventricle.

Bicycle ergometry indicators: threshold load 100 W, total work done 1050 J, double product 191.4 used units.

According to the results of the survey, the duration of remission was 9 months.

102 patients who received the proposed method of treatment and 84 patients treated by the known method were examined. In the first group of patients there were 30 people with strokes of exertional stress I - II 5 functional class (29.4%), and in the second - 25 such patients (29.8%).

In the group of patients treated with the proposed method, significantly more often (, 001) than in the group treated with a known method, cessation of cardiamia 0 was noted (97% vs. 31%).

Electrocardiogram data showed signs of scar and ischemia in the peri-infarction zone. At the end of the treatment course, the repolarization processes in the peri-infarction zone improved in 75 patients (73.5%) who received the proposed treatment method, and in 43 patients (5.2%) who received the known treatment method (, 05).

The state of the coronary circulation was assessed on the basis of exercise tolerance, determined by bicycle ergometry. The capacity of the performed load increased in 93 (91.2%) patients treated with the proposed method and in 52 (61.9%) patients treated by a known method (, 001). In the group of patients who received the proposed method of treatment, the power of the threshold load increased by 38.8 ± 2.3 W, whereas in patients who received the known method of treatment, this

the increase was only 23.4 ± 1.2 W (, 001). The increase in double product - the indicator of the maximum consumption of oxygen by the myocardium in the group of patients who received

and in the recovery phase, which includes an electropulse, characterized in that, in order to increase the therapeutic efficacy of the relief of pain, the proposed method of treatment is 43.2 ± 6.4 conv. Roma and increased tolerance in patients with units, and in the group of patients who received iz-to-exercise, an additional important treatment method, 24.8 dz6, l cond. units act on the left subclavian MCA. Thus, the proposed method of an occluster, supraclavicular ICU and the region calls for a more pronounced effect on the left shoulder joint by ultrasound in the coronary blood flow in a continuous mode, with an intensity of 0.4-

The application of the proposed method is ensured at a value of 0.6 kHz / cm, through a 2% layer it bakes more pronounced than with primitroglycerin ointment, during the last 10 minutes of operation of the electroscope when the frequency of its pulses reaches 70 Hz, and the electrosine procedures begin with an hour. , 5 tots 50 Hz and exposure 10 min and increase each subsequent procedure

a change in the known method, an increase in the tolerance of patients to physical exertion, a relief of pain, an increase in the effectiveness of treatment.

Claims (1)

Invention Formula 10 Hz to 70 Hz, and exposure for 10 minutes to 60 minutes, after which these values are saved. At the achieved level until the end of the course syndrome in patients with myocar infarction treatment. Yes, in the recovery phase, including an electropulse, characterized in that, in order to increase the therapeutic efficacy, pain relief and tolerance of patients to exercise, additionally affect the left subclavian ICU. the clavicle, the supraclavicular ICU and the left shoulder joint region by ultrasound in continuous mode, with an intensity of 0.4-