| 摘要 |
FIELD: medicine.SUBSTANCE: invention can be used for diagnostics of thromboembolism of the pulmonary artery (TEPA) and selection of differentiated therapy depending on an occlusion type. Computed tomography with bolus enhancement is carried out. Transverse dimensions of the right (RV) and left (LV) heart ventricles in their saggital projection are determined on the tomograms. Areas of affection located more distally than a thromboembolus are identified with determination of the presence of an occluded vessel or vessels in it. The identified occlusions are given points: occlusion of the segmentary branch of the pulmonary artery (PA) more distally than the embolus is estimated in 1 point irrespective of the occlusion degree; the occlusion of each of the lobe branches in case of affection of the right middle-lobe, left middle- and upper-lobe PA branches - 2 points; the upper lobe branch of PA on the right, the lower lobe branch of PA on the left - 3 points; the right lower lobe branch of PA - 4; the left main PA - 7; the right main PA - 9; both main PA and/or pulmonary trunk - 17 points. The points are summed up and anti-coagulant therapy with heparin is carried out if the sum of points is from 1 to 6 or in case of a combination of the sum of the points from 7 to 10 and value of a ratio of transverse dimensions of RV to LV less than 1.2. Thromboembolytic therapy is carried out if the sum of points is from 7 to 10 and the value of the said ratio of dimensions greater than 1.2 or is the sum of points is from 11 to 17.EFFECT: method provides objectification and promptness of the TEPA degree estimation and the right ventricle insufficiency in conditions of the absence of the time reserve, which leads to timely administration of respective therapy, reduction of a degree of the pulmonary bed affection, and reduction of a risk of formation of chronic post-embolic pulmonary hypertension.6 dwg, 5 ex, 1 tbl |
