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INVENTION
Patent of the Russian Federation RU2278615
METHOD OF DIAGNOSIS OF INTESTINAL HELMINTHESES
The name of the inventor: Vasilkov Alexander Fedorovich (RU); Astakhin Alexander Vladimirovich (RU); Levitan Boleslav Naumovich (RU)
The name of the patentee: Vasilkov Alexander Fedorovich
Address for correspondence: 414000, Astrakhan, ul. Baku, 121, Astrakhan State Medical Academy, patent engineer S.A. Golubkina
Date of commencement of the patent: 2004.07.06
The invention relates to medicine, gastroenterology, parasitology and roentgenology and can be used to diagnose intestinal helminthiases. Irrigoscopy is performed under conditions of artificial hypotension of the large intestine, using a single-stage double contrasting of the large intestine, which is carried out by introducing a fine-dispersed peptized water-barium cocktail heated to 36 ° C, having the following composition: water 100 ml, sodium citrate 1.5 g, sugar 8 G, barium sulfate - 200 g, carboxymethyl cellulose - 0.5 g, raw chicken eggs - 2 pcs; After the introduction of said cocktail, irrigoscopy is repeated after 24 hours and intestinal helminthiasis is detected upon detection of ribbon-like shadows. This invention makes it possible to determine with great certainty the shape and localization of the helminth even in the case of a negative coprologic and serological examination.
DESCRIPTION OF THE INVENTION
The invention relates to the field of medicine, namely to gastroenterology, parasitology and roentgenology, and can, in particular, be used to diagnose three classes of helminths: round, tapeworms and flukes.
From the practice of medicine, there are traditional methods for diagnosing helminthoses, such as co-proskating and serological.
However, the known methods have significant drawbacks. The diagnostic value of these methods is low because of the lack of specificity and sensitivity, and the frequent absence of helminths and their eggs in the fecal material. In the early stage of the disease, in the absence of sexually mature helminths, and in the case of invasions caused by larval forms, parasitological diagnostics based on coproscopy is extremely difficult, and often impossible (Ozeretskovskaya NN, Zalnova NS, Tumolskaya NI Clinic And the treatment of helminthiases - Moscow, 1985. - P.19-21). On the territory of Russia, low-intensity invasions predominate, especially with geogelmintoses, therefore it is necessary to use methods of enrichment (methods of Füllbörn, Kalantaryan), which further complicates the procedure (Menshikov VV, Delektorskaya LN, Zolotnitskaya RP et al. Laboratory methods of research in the clinic - Moscow .- Medicine, 1987. - P.83).
Known and widely used is a method for diagnosing helminthiases of the gastrointestinal tract, as a serological study with specific antigens.
However, the known method has a number of significant drawbacks. First of all, high cost and insufficient information, high frequency of false positive reactions. In addition, it does not allow to determine the location of the helminth.
The aim of the present invention is to increase the efficiency of diagnostics of large intestine helminthiases.
The objective of the invention is achieved by carrying out irrigoscopy under conditions of artificial hypotension of the large intestine using simultaneous double contrasting of the large intestine by introducing a finely dispersed peptized water-barium cocktail heated to 36 ° C and having the following composition: water 100 ml, sodium citrate - 1.5 g, sugar 8 g, barium sulfate 200 g, carboxymethylcellulose 0.5 g, raw chicken eggs 2 pcs; After the introduction of the cocktail and the irrigoscopy, the X-ray of the large intestine is repeated after 24 hours and intestinal helminthiasis is detected upon detection of ribbon-like shadows.
The claimed method of diagnosing helminthiases of the large intestine is new and has not been described in the literature.
The proposed method achieves the following positive effect: increasing the efficiency of diagnostics of large intestine helminthiases, saving forces and means. The method is simple in execution, does not require the use of special equipment and expensive medications. The method makes it possible to determine with great certainty the form and localization of the helminth. Moreover, it often proves effective even in the case of a negative coprological and serological study. The method is based on the detection of tape-like enlightenments in the large intestine or helminth body when it absorbs a peptized, radiocontrast barium suspension. The developed technique is recommended to be used when identifying representatives of three classes of helminths: roundworms, tapeworms and flukes.
The proposed method is carried out as follows.
After careful preparation of the patient for the study, one-stage double contrasting of the large intestine (UDC) is carried out, the procedure is carried out according to the orders of the Ministry of Health of the Russian Federation No. 129 and No. 132. It is mandatory to use the original finely dispersed peptized water-barium cocktail and artificial hypotonia of the large intestine. Relaxation of the large intestine is achieved with the help of medications (2-3 tablets of aeron or 100 mg of pinaverium bromide (ditsitel) for 15-20 minutes before the study). The contrasting water-barium cocktail has the following composition: water 100 ml, sodium citrate 1.5 g, sugar 8 g, barium sulfate 200 g, carboxymethyl cellulose 0-5 g, raw chicken eggs 2 pcs. The mixture is prepared on an electric mixer for 5-6 minutes. For one study, 150-200 ml of solution is sufficient. To optimize the research process and better absorb the contrast cocktail helminths it is recommended to preheat to 36 ° C.
After the irrigoscopy for the purpose of visualization of helminths, a repeated fluoroscopy of the large intestine is necessary after 24 hours. In order to confirm and analyze the ribbon-like shadows, targeted x-rays are made on a 24 × 30 cm film with subsequent examination of the abdominal cavity after 24 hours.
The proposed method was clinically tested for 520 patients who were on treatment in various departments and polyclinic of AM OKB No. 1 of Astrakhan from 1999 to 2004. Below are the results of approbation.
520 patients were examined. Indications for X-ray examination for the presence of helminths were: anemia of obscure gesne, recurrent allergies, irritable bowel syndrome, chronic colitis, partial intestinal obstruction, eosinophilia, subfibrillitis of unclear etiology. In parallel, all patients underwent a co-proskating study (feces for eggs of worms). In 162 cases, ribbon-like shadows in the enlarged lumen of the large intestine, characteristic of helminths, were visualized, only in 48 patients of this group the diagnosis was confirmed with a three-time co-transrectional study, in 15 patients with endoscopic examinations and surgical interventions.
As an illustration, we give the following clinical observations:
Example 1. Patient B., 51 years old. I entered the surgical department of AM OKB No. 1 with complaints of obstinate constipation, weight loss, weakness, fatigue, malaise. During examination, attention was drawn to the expressed pallor of the skin. To clarify the causes of anemia and partial intestinal obstruction, the patient undergoes irrigoscopy under conditions of artificial hypotension of the colon with the use of a one-stage double contrasting of the large intestine performed by introducing a fine-dispersed peptized water-barium cocktail heated to 36 ° C, having the following composition: water 100 ml, sodium citrate - 1,5 g, sugar - 8 g, barium sulfate - 200 g, carboxymethylcellulose - 0.5 g, raw chicken eggs - 2 pcs. Irrigoscopy: the exophytic formation with irregular contours is defined in the splenic corner (3x6 cm), covering the whole lumen of the gut with suprastenotic expansion. After the introduction of the cocktail and the irrigoscopy, the radiograph of the large intestine is repeated after 24 hours: a lot of ribbon-shaped shadows are determined in the splenic corner and the descending section of the colon.
Conclusion: the obstruction of the colon, caused by a conglomerate of helminths.
Example № 2. Patient M., 24 years old. For a long time, he suffers from recurrent allergies. At the next hospitalization in the pulmonology department of AM OKB No. 1, anemia of mixed genesis (B12 and iron deficiency) was detected. An in-depth examination of the patient was carried out, including irrigoscopy followed by examination of the large intestine after 24 hours (see Example No. 1). In the left sections of the colon, ribbon-like shadows, characteristic of helminths, are revealed. Conclusion: Helminthiasis.
Example No. 3. Patient S., 38 years old. For 4 years he was on the "D" account for iron deficiency anemia. Twice I underwent in-depth examination, including irrigoscopy, performed according to a traditional three-stage procedure. The causes of anemia remained unclear. At the next hospitalization in the hematological department of AM OKB No. 1, an X-ray examination of the large intestine was performed according to the proposed procedure. In the transverse-colon, splenic and descending sections of the colon, multiple ribbon-like shadows are revealed. Conclusion: Helminthiasis.
Example № 4. Patient K., 43 years old. Entered the gastroenterology department of AM OKB No. 1 with complaints of aching pain in the peri-oophoric region, frequent, loose stools with an admixture of blood. In order to clarify the diagnosis, an irrigoscopy (UDC) was performed with a colon examination after 24 hours. In the elongated sigmoid and transverse colon, a number of ribbon-like shadows were identified. Conclusion: Helminthiasis.
Example number 5. Patient V., 36 years old. For a long time I suffered from chronic constipation. At the examination in the polyclinic at the place of residence, iron deficiency anemia was detected. The last 5 years have not been carried out irrigoscopy or colonoscopy. The examination in the clinic AM OKB No. 1 was performed. Irrigoscopy (UDC) according to the suggested method: a lot of contrasting ribbon-like shadows were revealed in the splenic corner and descending section of the colon. Conclusion: Helminthiasis.
Analysis of clinical approbation shows that our proposed method of radiation visualization of intestinal helminthiases, based on the conduct of irrigoscopy in conditions of artificial hypotension of the colon with the use of one-stage double contrasting of the large intestine, carried out by introducing a fine-dispersed peptized water-barium cocktail heated to 36 ° C, having the following composition: Water 100 ml, sodium citrate 1.5 g, sugar 8 g, barium sulfate 200 g, carboxymethylcellulose 0.5 g, raw chicken eggs 2 pcs; After the introduction of the cocktail and the irrigoscopy, the X-ray of the large intestine is repeated after 24 hours and intestinal helminthiasis is detected upon detection of ribbon-like shadows; Significantly expands the diagnostic capabilities of the clinician, opens new prospects for conducting etiological therapy.
The proposed method for diagnosing intestinal helminthiases can be used in practical gastroenterology, parasitology and roentgenology and recommended in clinical practice.
CLAIM
A method for diagnosing intestinal helminthiases, characterized by carrying out irrigoscopy in conditions of artificial hypotension of the colon with the use of a one-stage double contrasting of the large intestine carried out by introducing a finely dispersed peptized water-barium cocktail heated to 36 ° C, having the following composition: water 100 ml, sodium citrate 1 , 5 g, sugar 8 g, barium sulfate 200 g, carboxymethylcellulose 0.5 g, raw chicken eggs 2 pcs; After the introduction of the cocktail after 24 hours, irrigoscopy is repeated, and when intestinal helminthiasis is detected, ribbon-like shadows are diagnosed.
print version
Date of publication 06.01.2007gg
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