| 摘要 |
FIELD: medicine.SUBSTANCE: invention relates to medicine, namely to clinical diagnostics. Following clinical signs are determined and appraised by points: two and more thromboembolia cardiac and/or respiratory and/or neurological symptoms typical for pulmonary artery - causeless cough, shortness of breath, feeling lack of air, heart rhythm disorder, syncopal condition of unknown genesis, cardialgia - such symptoms are awarded 3 points. If the medical history of a patient contains diseases that can be "masks" of non-massive pulmonary artery thromboembolia - pneumonia, pleuritis, pericarditis, neurocirculatory dystonia, bronchitis, chronic obstructive pulmonary disease - such diseases are awarded 2 points. Proved use of combined oral contraceptives is awarded 3 points. If the electrocardiogram of the patient shows the signs of pulmonary artery thromboembolia, 1 point is awarded. If X-ray examination shows the signs of non-massive pulmonary artery thromboembolia, 1 point is awarded. If doppler echocardiography shows the signs of right ventricular dysfunction, 2 points is awarded. Occurrence of chronic venous insufficiency and thrombophlebitis of veins of lower extremities after taking combined oral contraceptives is awarded 2 points. Hereditary or acquired hemostatic disorders hyperhomocysteinemia, antiphospholipid syndrome, detection of d-dimer marker of thrombosis, hypercoagulation syndrome, increase of thrombocyte aggregation are awarded 2 points. Smoking - 3 points. Presence of one or more risk factors - surgeries, catheterization of main and peripheral vessels, postoperative period, prolonged immobilization, bed rest, travelling by plane, nephrotic syndrome, malignant neoplasms, knee and hip joint prosthetics, injuries, burns, state accompanied by increase of blood viscosity, Crohn's disease, vasculitis, acute myocardial infarction, heart failure, endocarditis, heart rhythm disorders, diabetes mellitus, obesity - is awarded 2 points. Absence of any of the following clinical signs is awarded 0 points, then the total score is calculated. If the total score is more than 14, clinical probability of thromboembolia of pulmonary artery is high; if the total score of 7-13, clinical probability of thromboembolia of pulmonary artery is moderate; and if total score is less than 6, clinical probability of thromboembolia of pulmonary artery is low.EFFECT: method enables more accurate detection of non-massive thromboembolism in female patients taking combined oral contraceptives.1 cl, 2 dwg, 3 tbl |
