RU2266037C1 - Method for predicting post-operational disorders in cardiac rhythm in patients suffering pulmonary cancer after performing radical operation - Google Patents

Abstract

FIELD: medicine, functional diagnostics.

SUBSTANCE: in post-operational period it is necessary to carry out conjunctival videobiomicroscopy to calculate the size of varicosis of post-capillary venules. At varicoses being 23.3 mcm and more one should predict the development of affected cardiac rhythm at early post-operational period. The innovation suggested enables to conduct prophylaxis of affected cardiac rhythm both in intra- and post-operational periods due to detecting the signs of these disorders in pre-operational period.

EFFECT: higher accuracy of prediction.

2 ex

Description

The invention relates to medicine, namely to functional diagnostics, and can be used to predict heart rhythm disturbances in patients with lung cancer after radical operations with an uncomplicated history of cardiac arrhythmias.

Methods for predicting heart rhythm disturbances in patients with lung cancer after radical surgery are not described in the literature.

The invention is aimed at solving the problem: the ability to predict the development of cardiovascular complications in patients with lung cancer in the postoperative period.

The essence of the method is to use the method of video biomicroscopy of the conjunctiva of the eye to predict heart rhythm disturbances in patients with lung cancer in the postoperative period by calculating the size of varicose veins of post-capillary venules. With a value of varicose expansion of 23.3 μm (0.0233 mm) or more, the development of heart rhythm disturbances in the early postoperative period is predicted.

The method is as follows.

In the preoperative period, a sitting patient undergoes video biomicroscopy with a picture of the microcirculatory bed of the conjunctiva of the eye on a video monitor of a personal computer, followed by morphometric processing of the resulting photograph. In this case, one of the calculated indicators is the size of varicose veins of the postcapillary conjunctiva of the eye.

With a value of varicose veins of postcapillary venules of 23.3 μm or more, the development of cardiac arrhythmias is predicted in the early postoperative period with standard patient management in the intensive care unit. If the value of varicose veins of postcapillary venules is less than 23.3 microns, the absence of cardiac arrhythmias is predicted in the postoperative period with standard patient management in the intensive care unit.

The study is carried out with a slit lamp ShchL-2G, equipped with a video adapter manufactured by Zagorsk Optical and Mechanical Plant OJSC, Zagorsk. GOST 12.2.025-76; TU 3-3.2438-91.

The advantage of the method lies in the possibility of predicting heart rhythm disturbances in the early postoperative period in patients undergoing radical surgery for lung cancer with a history of cardiac arrhythmias.

Examples of specific performance.

Example 1. Patient CWR, 51 years old. Diagnosis: moderately differentiated squamous cell adenocarcinoma of the upper lobe bronchus on the right. T ₂ N ₂ M _x . On October 22, 2003, video biomicroscopy was performed: the value of varicose veins of postcapillary venules was 56.2 μm, that is, the patient has an unfavorable prognosis for the development of cardiac arrhythmias in the postoperative period. 10.24.2003, a standard pulmonectomy was performed on the right under endotracheal anesthesia. Intraoperative period without complications. 10/27/2003, with a smooth course of the postoperative period and standard therapy, cardiac arrhythmias of the type were noted: atrial fibrillation, tachysystolic form, ventricular contraction rate - 120-130 per minute.

Example 2. Patient BAE, 68 years old. The diagnosis of moderately differentiated squamous cell adenocarcinoma of the upper lobe bronchus on the left. T ₃ M ₀ M ₀ . On June 26, 2003, video biomicroscopy was performed: the value of varicose veins of postcapillary venules was 28.5 μm, that is, the patient has an unfavorable prognosis for the development of cardiac arrhythmias in the postoperative period. 06/27/03, an extended pulmonectomy was performed on the left without features. The course of anesthesia is smooth. 06/30/03, with standard therapy, tachysystolic atrial fibrillation was noted, the frequency of ventricular contractions was 112 per minute.

Example 3. Patient KAYA, 58 years old. Diagnosis: moderately differentiated squamous cell adenocarcinoma of the intermediate bronchus on the right T ₃ N ₃ M ₀ . On March 10, 2004, video biomicroscopy was performed: the value of varicose veins of postcapillary venules was 18.7 μm - the patient has no data on the development of cardiac arrhythmias in the postoperative period. 03/11/04, an extended pulmonectomy on the right without features was performed. The course of anesthesia is smooth. The postoperative period was uneventful.

Using the proposed method allows to predict heart rhythm disturbances in patients with lung cancer in the postoperative period, which shows a radical operation, and to prevent arrhythmias in the intra- and postoperative period.

Claims (1)

A method for predicting postoperative cardiac arrhythmias in patients with lung cancer after radical surgery, characterized in that the size of varicose veins of the postcapillary conjunctiva of the eye conjunctiva is calculated in a patient with lung cancer, and if it is greater than 23.3 μm, heart rhythm disturbances are predicted in the early postoperative period .