SU1648361A1 - Method for diagnosis of neuromuscular affections of the diaphragm and appliance for carrying same into effect - Google Patents

Abstract

The invention relates to medicine and can be used in pulmonology. The method allows to increase the accuracy of localization of damage to the diaphragm, which is achieved by inserting a probe with an electrode at the working end through the biopsy channel of the thoracoscope into the pleural cavity, inserting a needle electrode into selected areas of the diaphragm and recording its electrical activity. The needle electrode 5 is located at the working end 3, which is made with a bevel at an angle of 45 ° C. on a tube fitted with a spring 2 and forming a telescopic connection with the second tube 1, this allows less damage to the diaphragm, which is constantly in motion, when the device is operating. 2 sec. f-ly, 1 ill.

Description

The invention relates to medicine and can be used in pulmonology.

The aim of the invention is to improve the accuracy of localization of the lesion.

The method is carried out as follows.

A patient is placed in a sitting or lying on its side, under local anesthesia in the V-VI interstitium in the mid-axillary line, a thoracoscope is inserted into the pleural cavity according to a known technique. A device (probe) is inserted into the pleural cavity through the biopsy channel of the thoracoscope. Using the optics of a thoracoscope, they visualize the diaphragm and select the areas of the diaphragm necessary for the study. The needle electrode of the probe is inserted into the selected areas and at the same time the electrical activity is recorded. After registration of the electrical activity of selected areas of the diaphragm, the thoracoscope, together with the probe, is removed from the pleural cavity, and the air from the pleural cavity is actively aspirated.

The electrical activity of the diaphragm is recorded in the following mode:

Time constant 0.01-0.03

Band pass

frequency 200 Hz

Sensitivity 10µV / mm

Draw speed

tape 7.5-60 mm / s.

The drawing shows a device for the diagnosis of neuromuscular diseases and diaphragm, a general view.

A device for diagnosing diaphragm diseases by recording electrical activity contains a probe in the form of a telescopic system of two coaxially arranged rigid tubes 1, cylindrical 4 00

s about

spring 2, the working end 3 of the probe, the base 4 of the electrode, the bipolar needle electrode 5, the connecting wires 6.

The device is a telescopic system and consists of two coaxially arranged rigid tubes, the diameter of the outer tube being 5.0 mm, and the inner diameter being 40 mm. The probe tubes are interconnected by means of a coil spring, which is located in the cavity of the probe outer tube. Probe length 400.0 mm. The working end of the probe has a sharpening angle of 45 degrees. At the working end there is a bipolar needle electrode consisting of two needle-shaped chlorine contacts mounted on the base of an electrically insulating material. The electrode contacts have a length of 2.0 mm and a distance between them of 3.0 mm. The contacts of the electrode through the cavity of the probe are connected to the measuring device.

During the implementation of the diagnostic method, the device is inserted into the pleural cavity with the working end 3 in the direction of the diaphragm. The working end 3 of the probe is pressed against the test section of the diaphragm, while the bipolar needle electrode 5 is located on the electrically insulating base 4 and is inserted into the test section of the diaphragm. During the contact of the bipolar electrode located at the working end of the probe with the surface of the diaphragm, the working end 3 performs reciprocating movements along with the constantly moving diaphragm due to the cylindrical spring 2 located in the cavity of the outer tube of the probe. The outer tube of the probe thus plays the role of a handle and remains stationary with respect to the diaphragm and the inner tube of the probe. The signal from the probe electrode is transmitted to the measuring device via the connecting wires 6.

Example, sick 3., 56 years. The patient was hospitalized due to severe closed chest trauma with severe respiratory failure.

During the examination there was a discrepancy between the presence of detected morphological lesions (only a chest contusion was diagnosed — without pneumogeometrax).

and disorders of the skeleton of the chest, as well as without lung injury) and the presence of severe respiratory failure. In connection with the suspicion of damage to the right dome of the diaphragm, the patient underwent thoracoscopy, however, no morphological damage was detected. In connection with possible traumatic functional disorders, electrical activity was investigated in the diagram.

the right dome of the diaphragm by the proposed method. Low-amplitude electrical activity was detected in all parts of the right dome of the diaphragm, and in the anterolateral regions there was a complete lack of

electrical activity, which is characteristic of bruising the diaphragm. Subsequently, repeated studies of the electrical activity of the right dome of the diaphragm revealed the gradual restoration of its

function to normal values during treatment.

Claims (2)

1. Method for the diagnosis of neuromuscular diaphragm diseases by recording and analyzing electrical activity, characterized in that, in order to improve the accuracy of localization of lesions, the registration is performed through a biopsy channel, 2. A device for diagnosing neuromuscular disorders of the diaphragm, containing a probe in the form of a tube with a bipolar electrode at the working end, characterized in that. that, in order to improve the accuracy of localization of lesions during thoracoscopy, as well as to reduce the traumatic ™, the probe is equipped with an additional coaxially positioned tube installed with longitudinal movement and fitted with a spring, while the working end of the probe is made with a bevel at an angle of 45 degrees, and the electrode is made needle. For iMerite dny at the device