SU946525A1 - Method of treatment of tromboses of lower limb deep veins - Google Patents

Description

(54) METHOD OF TREATMENT OF THROMBOSIS OF DEEP VEINS OF THE LOWER LIMBS

The invention relates to medicine, in particular to methods for treating thrombosis.

There is a method of treating deep vein thrombosis of the lower extremities by intravenous administration of medicinal substances 1.

However, when injecting drugs into the veins distant from the thrombosis zone, the drugs are rapidly inactivated and in order to achieve a high concentration of drugs in the zone of the thrombus, they must be given in a large dose, which significantly increases the risk and risk of bleeding.

When applying a tourniquet or elastic compression proximal to the site of introduction of medicinal substances, the desired effect of treatment is not achieved, since compression of the tibia with a tourniquet cannot last more than 10-15 minutes (a longer compression contributes to the appearance of new thrombosis), which limits It is knownj that the treatment of thrombosis can be effective with the continuous intake of drugs into the veins for 2-3 days or more.

The purpose of the invention is to create a high concentration of medicinal substances in the pathological focus and maintain it for a long time.

The goal is achieved by the fact that when implementing the method of treating deep vein thrombosis of the lower extremities by intravenous

10 injecting drugs, injecting a catheter in the distal direction into the superficial vein of the back foot or at the inner ankle of the lower leg; further relaxation of the lower leg and

20, the administration of drugs is stopped, and the procedure is repeated at a frequency of 28-32 alternations per hour.

The process is carried out in the following manner.

25

In the superficial venous network of the lower extremity in the area of the foot or ankle of the lower leg is inserted in the distal direction of the catheter, connected with a tube with a sterile

Claims (1)

30 tank containing medicinal substance. A pneumatic harness is applied to the limb just above the location of the catheter in the vein a. The limited area is connected to the pressure source by a hose. From the pressure source, through the connecting hose, a pressure of 40-42 mm Hg is periodically supplied to the pneumatic harness. During the period of compression of the limb by a cord with a duration of 15 to 60 s, 0,60-0,62 ml of diluent containing medicinal substances under a pressure of 50-53 mm Hg is delivered through a catheter from the revolver. The flow follows iz-superficial in, n lower extremities. through the systems of the connective veins into the deep veins. During a period of no pressure, which lasts from 105 to 60 seconds, no medicinal substances enter the superficial venous network of the extremity. PRI m e jS. Sick H, Diagnosis: gastric cancer, total lesion, infiltrative-link form. Produced extirpation of the stomach. In the postoperative period, thrombosis of the deep veins of the right tibia occupying the upper third of the tibia and disseminated into the popliteal vein was detected on the basis of clinical signs and radioindication with fibrinogen 3. Produced phlebography, the diagnosis was confirmed. Started the treatment of thrombosis by the proposed method. A skin incision was made on the right tibia in the area of the inner ankle, a large saphenous vein was cut out, which is incised on the front surface and inserted into its lumen and extended in the distal direction by 3.0 cm a thin polyethylene catheter. tibia sutured with two silk seams. Above the insertion point of the catheter, a 2.5 cm elastic cushion with a height of 3.0 cm and covering the entire leg (in the form of a hoop) is superimposed. The cuff is connected to a device creating intermittent pneumatic pressure, and the catheter is connected to a reservoir containing medicaments for treating thrombosis. The device for supplying pressure to the cuff is turned on, the pressure in it has risen to 42 mm Hg. and held at this level 61 s. At this time, from the reservoir to the catheter in the vein, under a pressure of 51 mm Hg. 0.61 ml of the solution containing medicinal substances is given. After the end of the compression period of the limb with the cuff, the pressure in it decreased to 0 and the flow of medicinal substances into the vein stopped. Then the cycle is repeated. The following medicinal substances were used to treat the patient (for 24 hours): 0.9% sodium chloride solution 440 ml, 60.000 units. fibrinolysin, 30,000 units heparin. Every 24 hours a medicinal mixture of the same composition was prepared. The treatment by the proposed method continued continuously for three days and was discontinued due to the fact that the thrombosis ceased to be determined by phlebographic examination, the patient's condition improved significantly, the body temperature returned to normal, the pain and swelling of the right tibia disappeared. Subsequently, the patient received 5,000 units of heparin four times a day. Discharged home 18 days after surgery in a satisfactory condition. The proposed method for the treatment of thrombosis of the deep veins of the lower extremities in comparison with the known one allows to create a high concentration of medicinal substances in the thrombosis zone and maintain it for a long time. Creating an elevated concentration of medicinal substances in the pathological focus and maintaining it for a long time is due to the fact that medicinal substances with directed flow and the shortest way get from the superficial vein of the lower leg to the deep, directly to the location of the thrombus. The proposed method can be carried out throughout the entire time of treatment of thrombosis, as this method does not disturb venous hemodynamics. Claims of treatment of deep, venous thrombosis of the lower extremities by intravenous administration of medicinal substances, characterized in that, in order to create a high concentration of medicinal substances, a catheter is introduced in the distal direction for a long time into the superficial vein of the rear the feet or at the inner ankle of the lower leg, then above the catheter insertion site, a tourniquet is applied and the lower leg is compressed under pressure equal to the venous pressure, and simultaneously introduced through drug catheter 59465256 substances, further sources of information, relaxation of the lower legs and cease to be taken into account in the examination of the introduction of medicinal substances, at -1. Chazov V.I. Thrombosis and embolism than the procedure is repeated with frequency in the clinic of internal diseases. 28-32 alternations per hour. Moscow-Warsaw, 1966, p. 210-212.