| 摘要 |
FIELD: medicine.SUBSTANCE: invention relates to medicine, urgent vascular surgery, radionuclide diagnostics with assessment of blood supply of soft tissues, ischemia degree, identification of zones of aseptic muscular necrosis (AMN) in patients with acute thrombosis of main arteries of lower extremities. Three-phase scintigraphy with radiopharmaceutical preparation (RPP) 99Tc-pyrphotech is performed in order to visualise main blood flow in phase of main blood flow and detection of focuses of RPP hyperfixation or zones where RPP accumulation is absent in tissue (TP) and bone (BP) phases. Index of RPP washout (IW) from shin muscular tissue and index of ratio (IR) of RPP accumulation in muscle and accumulation in shin bone in BT are determined in zones of diffuse RPP distribution in muscles of shin of either extremity separately. IR equals ratio of average impulse count in shin muscle in TP (N,) to average count of impulses in muscle in BT (N): IR=C·C/N, where C is coefficient, taking into account 99Tc, decay, decay constant ?=0.00192 min, and correction to coercion of IR value to 180 min interval between tine of examination in TP and BP: C=e·180/t, where t is time in min between TP and BP. IR equals ratio of average impulse count in shin muscle in BP (N) to average impulse count in shin bone in BP (N): IR=N/N. Degree of ischemia is stated: I-IIA at IW=1.54±0.17, IR=0.68±0.04 and non-detection of AMN focuses and zones of blood supply absence; IIB - at IW=1.36±0.18, IR=0.88±0.06 and non-detection of and focuses and identification of blood supply absence in TP; IIC at IW=0.93±0.27, IR=0.93±0>14 or is not identified, detection of AMN and zones of absence of blood supply in TP; IIIA at IW=0.82±0.18, IR=0.93±0.04 or is not identified and detection of AMN focuses and zones of absence of blood supply in TP and BP.EFFECT: method makes it possible to determine level of arterial occlusion in said group of patients, ischemia degree, AMN zone, state of either extremity microcirculation to confirm and specify clinical diagnosis and optimise treatment tactics.2 ex, 1 tbl |
