Electromyostimulation in the treatment after thrombosis. Treatment of osteochondrosis of the spine with the help of myostimulation

Research Institute of Emergency Medicine. N.V. Sklifosovsky, Moscow

Increasing the efficiency of treatment of patients with chronic obliterating diseases of the arteries lower extremities remains an important issue. Along with drug treatment, there are non-pharmacological methods, such as training (dosed) walking. However, not all patients, especially IV degree, in the presence of trophic disorders in the affected limb, pain at rest, etc., training walking can be applied in full. As an alternative, a method has been proposed to stimulate the muscles of the lower extremities by means of electrical impulses. In this work, a preliminary study of the effectiveness of electrical impulse myostimulation in complex treatment obliterating atherosclerosis in patients with chronic ischemia of the lower extremities.
Keywords: obliterating atherosclerosis, training walking, electrical impulse myostimulation.

Electrical pulse muscle stimulation for complex treatment of obliterating atherosclerosis in lower limbs

I.P. Mikhailov, E.V. Kungurtsev, Yu.A. Vinogradova

N.V. Sklifosovsky SRI for Emergency Care, Moscow

Improvement of treatment for chronic obliterating diseases of lower limbs arteries belongs to current clinical issues. Besides medications, there are non-pharmacological methods such as training (dosage) walk. However, not in all patients, especially at the IV stage of the process, presenting trophic damages, pain at rest, and so on, walk training can be applied in full. As an alternative, electrical pulse muscle stimulation method was proposed. In this paper, a preliminary study of electrical miostimulation effectiveness for lower limb atherosclerotic lesions has been described.
keywords: obliterating atherosclerosis, training walk, electrical pulse muscle stimulation.

Introduction

Chronic arterial insufficiency of the lower extremities affects 2–3% of the population, among which 80–90% of obliterating atherosclerosis of the arteries accounts for. Every year, this disease causes amputation of limbs in 35 thousand patients. The social significance of the problem of treating these patients is determined not only by the prevalence of this pathology, but also by a significant number of people of working age among these patients and their disability.

Treatment of patients with chronic ischemia of the lower extremities is largely determined by the existing risk factors for the onset and development of the disease. Insufficient physical exercise- an extremely important risk factor for the occurrence and progression of chronic obliterating diseases of the arteries of the lower extremities (HOZANK). Lack of physical activity exacerbates the violation of the blood lipid spectrum and, accordingly, contributes to the progression of atherosclerosis. In addition, hypodynamia complicates the process of adaptation of impaired peripheral circulation - both microcirculation and macrohemodynamics - to a new hemodynamic situation.

Along with drug therapy may be a promising non-pharmacological treatment approach. This, in particular, applies to the so-called "training (dosed) walking" (i.e., the work of the leg muscles) in case of damage to the arterial vessels of the lower extremities.

A training walking program is seen as a necessary part, especially on initial treatment patients with intermittent claudication. It consists in walking for 40–60 minutes 4–5 times a week at a speed of 4–5 km/h. This technique is aimed at the development of collateral vessels, as a result of which there is an improvement in blood supply in the ischemic tissues of the lower extremities. The use of training walking in clinical practice in patients receiving complex conservative therapy or as monotherapy improves clinical manifestations diseases (the possibility of walking increases), as well as micro- and macrohemodynamics.

It has been proven that during training walking the best results were obtained in patients with a predominant lesion of the femoral-popliteal and popliteal-tibial segments of the arterial bed.

Unfortunately, concomitant diseases, the presence of trophic disorders in the affected limb, pain syndrome do not allow it to be carried out in full in 50–70% of patients.

In this regard, attempts were made to find an alternative to "training walking" in the form of stimulation of the muscles of the lower extremities by means of electrical impulses, contralateral compression, etc.

Relevance

The role of stimulation of the calf muscles with an electrical impulse in enhancing venous outflow and preventing thromboembolic complications is known, but this procedure has not been widely used for the time being due to intensive painful sensations in patients during muscle contraction. The situation has changed with the advent of the portable device Veinoplus. The changing configuration of the electrical impulse made the procedure painless and eliminated the appearance of tetanic muscle contractions. When conducting a session of electrical impulse myostimulation (EIMS) with this device, the volumetric blood flow velocity, depending on the level and frequency of stimulation, increases by 12 times, and the peak linear blood flow velocity - by 10 times, while the volume of circulating blood in the limb increases by 7 times. To date, we have not found data on the effectiveness of the use of electrical impulse myostimulation technology in the treatment of patients with chronic arterial pathology of the lower extremities, which was the reason for conducting this study.

Material and methods

The results of complex treatment of 31 patients with varying degrees chronic ischemia of the lower extremities, who were treated in the Department of Emergency Vascular Surgery of the Research Institute for Emergency Medicine. N.V. Sklifosovsky from May to September 2012. All patients were diagnosed with concomitant diseases: coronary artery disease, hypertension, heart rhythm disturbances, etc. Diabetes Type 2 was diagnosed in 5 patients (3 women and 2 men), of which 1 person suffered from type 2 insulin-requiring diabetes. The mean age of patients aged 50 to 84 years was 64.3 years. There were 20 men and 11 women. All patients did not have concomitant venous pathology. Most of the patients were with chronic critical lower limb ischemia (22 patients (70.97%)), 10 (45.4%) of which had trophic disorders, the remaining 9 (29.03%) patients had chronic lower limb ischemia 2Bst . according to Fontaine-Pokrovsky.

The general principle of managing patients included diagnosing vascular pathology, assessing the severity of pain syndrome, the degree of ischemia, monitoring and correcting glycemia if necessary, choosing the optimal surgical tactics, pharmacotherapy (carrying out rational vasodilating therapy, treating neuropathy and angiopathy, using metabolic drugs), dressings and preparations local action in the presence of trophic ulcers, the use additional methods treatment.

All patients underwent conservative vasodilating (trental) infusion, antiplatelet, cardiological and symptomatic therapy, correction of glucose levels. 17 patients were added sessions of hyperbaric oxygenation. In 13 patients, reconstructive surgeries were performed on the main arteries of the lower extremities.

At the same time, in the study group (21 people), electrical impulse stimulation of the muscles of the affected limb with the Veinoplus arterial device was also used: with the maximum disconnection of the limb from axial loads courses of "training walking" were held in bed.

An EIMS session lasting an average of 30 minutes and with individual selection of current strength was carried out during infusion angiotropic therapy (in order to improve the perfusion of drugs in the tissues of the extremities). The frequency of sessions ranged from 2 to 5 times a day. The technique consisted in applying two self-fixing electrodes to the skin of the posterior surface of the lower leg at the border of its upper and middle third, then the mode of the session of electrical impulse myostimulation was set. The strength of the electrical impulse was dosed individually, taking into account the patient's sensations, and amounted to 30–40 conventional units. After the instruction, the patients used the apparatus independently. In the presence of trophic changes in the area of ​​the proposed application of electrodes, the latter were displaced higher (upper third of the lower leg), or superimposed on the thigh along the anterior and posterior medial surfaces, thereby triggering the muscle pump of the thigh.

This technology should be used with caution in "parchment skin" in patients with systemic long-term hormone therapy for underlying diseases. There were no such patients in our study.

Contraindications for electrical impulse muscle stimulation were the presence of a pacemaker, embolism of the arteries of the lower extremities, acute thromboses arteries of the lower extremities of embologenic etiology, non-sanitized focus in the foot, extensive necrosis of the foot and/or lower leg.

results

Stimulation of the musculo-venous pump of the leg was carried out using the apparatus Veinoplus arterial. The results were evaluated on the 1st, 5th, 10th days from the start of conservative therapy, then every 5 days (in patients after reconstructive surgery on the arteries of the affected limb). The total period of observation and evaluation of indicators was 11 days in patients who underwent only a course of conservative therapy, and 20 days in patients who received conservative treatment, supplemented by reconstructive surgery. The evaluation criterion was the degree of reduction of pain syndrome, increase in pain-free walking distance, reduction of edema of the lower leg and foot (in operated patients), and the size of trophic disorders.

In the comparison group, on the 1st day of conservative therapy, there was clinically some improvement in blood circulation in the affected limb. On the 5th day, patients noted a decrease in pain at rest and with minimal walking, an increase in the distance of pain-free walking by an average of 50 m. On the 10th day, 8 patients noted a positive effect: the absence of pain at rest in the affected limb - 3 patients, an increase painless walking distance up to 100 m - 6 patients; up to 200 m - 3 patients, up to 300 m - 1 patient, a decrease in the size of trophic disorders was noted in 1 patient. 8 patients from the comparison group underwent reconstructive surgery due to the insufficient effect of conservative therapy, the threat of developing ischemic gangrene of the lower limb (Fig. 1).

In 5 cases, femoral-popliteal prosthesis was performed; in 3 patients, endarterectomy was performed with plastic surgery of the arteriotomy opening with a synthetic patch.

In the study group, on the 1st day of the started conservative treatment with the simultaneous use of the apparatus, there were no visible differences with the comparison group. On the 5th day, 14 (66.6%) patients noted a decrease in pain when walking and at rest, an increase in the distance of pain-free walking by an average of 100 m. On the 10th day, 19 (90.48%) patients noted a positive effect: absence of pain at rest in the affected limb - 8 patients, increase in pain-free walking distance up to 300 m - 14 patients, up to 500 m - 5 patients, decrease in the size of trophic disorders - 5 patients. In two patients, the use of the device had to be discontinued due to poor tolerance of electrical impulse stimulation by the patients themselves. Reconstructive operations on the arteries of the lower extremities due to the insufficient effect of conservative treatment were performed in 5 patients (23.81%) (Fig. 2). 1 patient underwent femoral-popliteal prosthetics, 4 patients underwent endarterectomy with plasty of the arteriotomy opening with a synthetic patch).

In operated patients, the degree of reduction of leg and foot edema on the revascularized limb was assessed. It was noted that in the study group, in all 5 operated patients, the edema decreased on the 1st day by 40%, on the 5th day - by 50%, on the 10th day the edema was stopped, and no relapses of edema were detected. In the comparison group, on the 1st day, puffiness persisted, on the 5th day, puffiness decreased by 30%, on the 10th day, pastosity of the leg and foot persisted in 5 patients (Fig. 3).

conclusions

The obtained results of complex treatment of chronic ischemia of the lower extremities with the use of electrical impulse myostimulation can be considered encouraging. Improving venous outflow, electrical impulse myostimulation also enhances the inflow arterial blood, improving oxygen perfusion in the tissues of the foot and lower leg, as well as the local effectiveness of the applied medicines in the body - "target".

Against the background of the application of the technique of electrical impulse myostimulation in conjunction with drug treatment, a decrease in pain syndrome, an increase in the distance of pain-free walking, a rapid relief of edema in the operated limb, an improvement in hemodynamics in the area of ​​trophic disorders, and an improvement in tissue oxygenation were noted, which ultimately positively affects the overall results of complex treatment of patients. with obliterating atherosclerosis of the arteries of the lower extremities and, as a result, a decrease in the degree of ischemia.

Conclusion

In this work, we tried to evaluate the conservative treatment of patients with obliterating atherosclerosis of the arteries of the lower extremities using electrical impulse myostimulation, to determine the category of patients for whom this technique is most effective. The apparatus for electrical impulse myostimulation should be used in the complex treatment of patients with chronic ischemia of the lower extremities, especially in patients with critical ischemia (III-IV degree according to Fontaine-Pokrovsky). The use of electromyostimulation using the Veinoplus device in the treatment of arterial pathology in patients with chronic ischemia enhances the effect of classical methods of therapy (vasodilating infusion therapy, hyperbaric oxygenation) and promotes faster formation of collaterals. The portability, simplicity and safety of the technology allows Veinoplus to be used in an outpatient setting. I would like to emphasize that positive results is possible only with the complex use of this technique and with an individual approach to the treatment of each patient. The use of electrical impulse myostimulation with the Veinoplus arterial device in patients with chronic arterial pathology of the lower extremities requires further clinical studies.

Literature

1. Obolensky V.N., Yanshin D.V., Isaev G.A., Plotnikov A.A. Chronic obliterating diseases of the arteries of the lower extremities - diagnosis and treatment tactics. breast cancer. 2010; 17:1049–1054.
2. Sinyakin K.I. Dynamic physical activity in complex therapy obliterating atherosclerosis of the arteries of the lower extremities: Ph.D. dis. cand. honey. Sciences. M.: 2009; 145.
3. V. M. Koshkin, L. V. Dadova, P. B. Kalashov, and K. I. Sinyakin, Russ. Conservative treatment chronic diseases of the arteries of the extremities. Abstracts of the All-Russian Scientific and Practical Conference. Novokuznetsk, October 12–13, 2006; 120–121.
4. Koshkin V.M., Sinyaki O.D., Nastavsheva O.D. Training walking is one of the priority directions in the treatment of obliterating atherosclerosis of the arteries of the lower extremities. Angiology and vascular surgery. 2007; 2:110–112.
5. Leval B.Sh., Obolensky V.N., Nikitin V.G. The use of electrical impulse myostimulation in the complex treatment of patients with diabetic foot syndrome. Clinical trials of Veinoplus.
6. Sapelkin S.V., Volkov S.K. Experience in the use of myostimulation using the Veinoplus apparatus in patients with angiodysplasia in the early postoperative period. Clinical trials of Veinoplus.
7. Bogachev V.Yu., Golovanova O.V., Kuznetsova A.N., Shekoyan A.O. Electromuscular stimulation new method treatment of chronic venous insufficiency. Phlebology. 2010; 4:1:22–27.
8. Griffin M., Nicolaides A.N., Bond D., Geroulakos G., Kalodiki E. The efficacy of a new stimulation technology to increase venous flow and prevent venous stasis. Eur J Vasc Endovasc Surg. 2010; 40(6): 766–71.

The procedure is indicated for paresis and paralysis various genesis(post-stroke syndromes inclusive), fluctuations blood pressure, atrophy of muscle tissue, varicose veins, obesity. Electrical stimulation is widely used in complex therapy schemes, as well as preventive and rehabilitation measures.

The role of electromyostimulation in the treatment of vascular pathologies

The technique is notable for the absence of a wide range of contraindications, painlessness, relative safety and effectiveness.

During the electromyostimulation procedure, pulsed currents of different frequencies are used, selected according to the parameters human body. The correct electrical effect, calculated according to individual needs and parameters, allows you to bring the patient into stable remission in severe chronic diseases, relieve pain, enrich blood flow, stabilize interstitial metabolic processes, form a stream of impulses entering the central nervous system. With the help of the technique, symptomatic treatment is often carried out, as a result of which edema, muscle tension, and inflammation are eliminated.

Electromyostimulation has a beneficial effect on blood vessels: it normalizes their tone and elasticity, increases the gaps in occlusive lesions, and regulates blood pressure.

The procedure provides the following effects:

• Maintaining muscle contractility;
• Restoration of motor functions of the limbs by regulating the flow of nerve impulses to the central nervous system;
• Removal of edema, inflammation, congestion in tissues;
• Prevention of the development of atrophy of muscle tissue;
• Regulation and stabilization of blood pressure;
• Improving tissue nutrition by activating blood supply and enriching blood flow;
• Optimization of blood rheology;
• Relief of pain syndrome of various etiologies and severity;
• Resorption of body fat (including visceral fat);
• Normalization of metabolic processes in cells and tissues;
• Regeneration skin and structures of the musculoskeletal system (protection from the destruction of joints and cartilage in inflammatory and degenerative lesions, tissue repair in post-traumatic complications);
• Gradual physiological cleansing of blood from toxic substances;
• Activation of immune functions;
• Feeling better.

The technique is often used for post-stroke complications and associated physical inactivity. It proved to be excellent in the treatment of systemic polyetiological symptom complexes, including vegetovascular dystonia (VVD).

Indications for electromyostimulation

The appointment of the procedure must be obtained from the treating or supervising specialist. Self-treatment to the technique is fraught with deterioration and progression of existing diseases. The selection of physiotherapy and its technical features (current frequency, frequency of use, duration of the course) is carried out in strict accordance with the patient's indications, individual characteristics body and goals of treatment. Do not forget about the presence of contraindications to electromyostimulation.

Electromyostimulation is used for such diseases:

• Vegetovascular dystonia (neurocirculatory dystonia);
• Syndrome of the vertebral artery;
• Phlebeurysm;
• Disturbances in the blood supply to the brain;
• Consequences of strokes (paresis and paralysis);
• Hypertension and hypotension;
• Metabolic disorders (including hypercholesterolemia in atherosclerosis);
• Occlusive vascular diseases (acute and chronic), including progressive atherosclerosis;
• Lymphostasis;
• Vascular insufficiency (arterial or venous).

Electromyostimulation, like other physiotherapy, is not an independent method of treatment. Specialists use it in combination with conservative or surgical therapy. In some cases, the patient is prescribed additional physiotherapy.

Especially well the technique manifests itself in rehabilitation and preventive measures.

Principles of the electromyostimulation procedure

The procedure is performed by a qualified physiotherapist. At the same time, the therapy protocol agreed with the treating specialist (cardiologist, phlebologist, vascular surgeon, neurologist, etc.) is observed. The implementation of electromyostimulation takes place on an outpatient basis in the corresponding office. We strongly do not recommend that you turn to such manipulations "at home" with incompetent persons.

Electromyostimulation does not require specific preparatory measures. During its implementation, anesthesia is not used.

Conventional electromyostimulation is carried out by applying electrodes that conduct current to certain parts of the body. They are adhesive (equipped with a conductive gel) or reusable (located on the skin over hydrophilic pads). There is another type of procedure called interstitial electrical stimulation. It is more invasive because it inserts thin electrode needles under the skin. It is considered more effective than classical electromyostimulation.

The process of conducting physiotherapy consists of the following steps:

1. The patient is comfortably positioned on the couch, taking the desired position
2. Electrodes are applied to the skin at certain points of the body, which set the direction of the impulses;
3. The specialist selects the necessary treatment time on the device, and also sets specific parameters for the intensity and frequency of the electric current transmitted to the tissues (the characteristics directly depend on the indications and goals of the procedure);
4. The equipment is put into action;
5. The average duration of a session is 20-30 minutes.

During the procedure, you will not feel severe pain or discomfort. On the contrary, most patients note that electromyostimulation is pleasant to the body. At about 10 minutes, endorphins, “hormones of joy,” begin to be actively produced in the blood, which is the reason for the analgesic and relaxing effect of the method.

The average frequency of procedures for a full course of classical electromyostimulation is 15-20 sessions. For treatment with interstitial electrical stimulation, 3-8 sessions are sufficient, depending on the dynamics.

It is acceptable to combine the procedure with manual therapy and exercise therapy.

Contraindications to the procedure

Electromyostimulation has absolute and relative contraindications. If there are relative restrictions, the physiotherapist selects short courses and carefully monitors the patient's well-being.

Contraindications to the procedure:

• Hypertension of the third degree (with frequent hypertensive crises);
• Atrial fibrillation;
• Transverse heart block;
• Rheumatism in an active form;
• Extensive trophic ulcers limbs, open wounds, abscesses and fistulas;
• Coagulation disorders (hereditary and acquired);
• The presence of an intrauterine device in women;
• Renal and liver failure;
• oncological diseases and benign tumors unknown genesis;
• Progressive thrombophlebitis;
• Use of a pacemaker;
• Cholelithiasis;
• Increased muscle electrical excitability;
• Epilepsy and epi-syndrome
• Acute viral and infectious diseases;
• Mental disorders;
• Pregnancy in any trimester.

Attend sessions only if you feel consistently satisfactory. Refuse treatment for a sudden illness (for example, influenza or SARS) and continue the course after recovery.

Refuse to take alcoholic beverages for the duration of electromyostimulation. Consult with a physiotherapist beforehand regarding other adjustments in lifestyle and routine.

We strongly do not recommend that you turn to self-treatment with the help of unscrupulous specialists. Be sure to visit a cardiologist, phlebologist and therapist before turning to electromyostimulation. Do it only with an experienced physiotherapist.

Today, the procedure of myostimulation is gaining more and more popularity.

The advantage of myostimulation is its ability to stimulate the most inaccessible muscle groups. It is necessary to pay attention to the fact that the procedure does not affect cellulite. The condition of the skin improves due to improved tissue nutrition, disposal of toxins and muscle training. Myostimulation will help in the transformation appearance abdomen, thighs and buttocks.

The principle of myostimulation is based on the use of current, which causes muscle fibers to contract. After the procedure, the muscles and skin become toned. To get rid of excess fat and cellulite, the procedure is used only in combination. The procedure is carried out only by specialists and on professional equipment. Myostimulation can also be carried out at home by purchasing a device designed for use at home.

Myostimulators

The best equipment for myostimulation is made by European, Israeli, American and Japanese manufacturers. Devices from Russia are not worse than them in quality, but they are inferior in terms of design and convenience. Equipment made in Korea and Taiwan is not as reliable, but more affordable.

Myostimulation using devices for home use will not give great results. But if they are used in combination with other methods, then you can count on a positive result.

Myostimulation can affect all muscle groups. During the procedure, sensory and motor nerves are activated, blood circulation improves. Myostimulation prepares muscles for constant loads, promotes recovery after injuries, operations and diseases. But still, replacing the gym with myostimulation will not give great results, since it must be used in combination with physical activity.

The procedure consists in impulses applied through electrodes to the nerve endings, as a result of which the muscles contract. As a result, the muscles come in tone, the muscles increase in volume, their strength increases. Reduces body fat and cellulite. Myostimulation is not used as the main way to deal with excess body fat cellulite.

Current characteristics

During the electrical stimulation procedure, the shape and frequency of the current pulses are selected and their amplitude is regulated. The pulse duration is from 1 to 100 ms.

The current strength for the muscles of the hand and face is 3-5 mA, and for the muscles of the shoulder, lower leg and thigh - 10-15 mA. The main indicator of the correct impact of pulsed current is painless muscle contraction when exposed to the current of the smallest strength.

Contraindications and indications

Myostimulation is indicated for those who want to tone their muscles and correct their figure. There are many contraindications for this procedure. Myostimulation is contraindicated in people with diseases of the heart and blood vessels, thyroid gland, diseases of the blood, kidneys and liver, varicose veins.

Often, patients show intolerance to electric current, this must be taken into account during treatment. Pregnant women, as well as during menstrual cycle myostimulation is contraindicated. The procedure is prohibited for various kinds of inflammation and tumors, as well as for cysts and myomas.

Myostimulation: pros and cons

The main advantage of myostimulation is the work of muscles without physical stress. When you do physical exercises- only certain muscles work, during myostimulation all muscle groups are involved. For example, it is possible to tighten the muscle of the inner thigh, which is very difficult to load under normal conditions.

Upon completion of the procedure, the elasticity of the weakest muscles also increases. The effect of myostimulation can persist for a very long time. After the procedure, the body does not hurt like after a workout. Myostimulation helps to reduce excess weight.

The disadvantage of the myostimulation procedure are multiple contraindications.

The procedure will not give good results if it is not used in combination with various diets and additional procedures. The procedure is painless, but the feeling of muscle contraction under the influence of current can cause discomfort.

With a thick layer of fat on the patient's body, even with regular procedures, myostimulation will not give good results.

The effect after the completed course of treatment will not keep you waiting: as a result, the patient will be able to get increased muscle and skin tone, a relief structure of the body and get rid of the annoying “orange peel”. But in order to consolidate the result, you should pay attention to fitness and any other physical exercises. You need to choose a light diet to reduce calorie intake.

• muscles come to tone;
• muscle mass increases;
• lymph and blood flow is activated;
• fat deposits and manifestations of cellulite are reduced;
• metabolic processes are improved.

Preparation for myostimulation

Before the procedure, you must consult a doctor for advice. Since myostimulation has many contraindications. If the doctor has approved your decision, then it is recommended to perform a scrubbing or surface peeling before the procedure so that dead cells do not interfere with the procedure.

Before the procedure, you need to remove all metal objects from yourself.

Electrodes of different sizes are fixed to the body, fixed with special straps. A special gel is applied to the electrode pad or it is simply wetted with water, after which the electrodes are fixed. In some cases, disposable electrodes are used, which are attached to the skin like a patch. The part of the body that undergoes the myostimulation procedure should be completely relaxed and in a comfortable position so that there are no obstacles for current impulses. The current strength is dosed to a distinct muscle contraction. Soreness of the procedure, as well as the absence of contraction, may indicate an incorrect course of the procedure.

Rules for electromyostimulation

• You need to make sure that you have no contraindications to the procedure.
• The electrodes are installed according to the instructions, individually for each device.
• Good contact is essential during the procedure.
• The procedure begins with a zero amplitude indicator and gradually increases.
• Simultaneous stimulation of antagonist muscles is prohibited.
• During the procedure, it is forbidden to move the electrodes and break the circuit during the operation of the device.
• The duration of the procedure should not exceed 30 minutes.
• During the course, you must follow a diet.
• Upon completion of the procedure, the electrodes are treated with a disinfectant solution.

Possible complications and side effects with myostimulation

After the procedure, in places where the electrodes were applied, reddening of the skin may appear, they quickly disappear. It is also possible allergic reactions organism, associated with the individual characteristics of the organism. Electrical burns may occur if the electrodes are not fully attached.

Prices for the procedure of myostimulation

Myostimulation refers to inexpensive, but effective procedures. Myostimulation procedures can be carried out in cosmetic centers or at home, after purchasing the appropriate device. Myostimulation in the salon on average costs from 800 to 5000 rubles, depending on the level of the clinic and equipment.

INTRODUCTION

Chapter 1. MODERN APPROACHES TO MECHANICAL PREVENTION OF POSTOPERATIVE VENOUS THROMBOEMBOLIC COMPLICATIONS IN SURGICAL PATIENTS

1.1. Epidemiology of deep vein thrombosis and thromboembolism pulmonary artery.

1.2. Features of venous thromboembolism in high-risk surgical patients.

1.3 Blood stasis as the main component of the pathogenesis of venous thrombosis.

1.4.Methods of combating venous stasis in surgical patients.

1.4.1. Methods for accelerating venous outflow and their effectiveness

1.4.1.1. Elevated position of the lower extremities, active muscle contractions, early activation.

1.4.1.2. Elastic compression.

1.4.1.3. Intermittent pneumatic compression.

1.4.1.4. Electrical stimulation of the leg muscles.

1.4.1.5. Combined use.

1.4.2. Significance of velocity parameters of venous blood flow for thromboprophylaxis.

1.4.3. Blood flow velocity and shear stress are factors in maintaining the thromboresistant properties of the endothelium.

CHAPTER 2. CHARACTERISTICS OF MATERIALS AND RESEARCH METHODS

2.1. Characteristics of the experimental part of the work.

2.1.1. general characteristics test subjects.

2.1.2. Study of regional venous hemodynamics of the lower extremities by duplex angiscanning.

2.1.3. Characteristics of research conditions and methods for accelerating blood flow.

2.2. Characteristics of the clinical part of the work.

2.2.1. General characteristics of patients and methods of examination.

2.2.2. Assessment of risk factors for the development of venous thromboembolism.

2.2.3. Methods for diagnosing venous thromboembolic complications.

2.2.3.1. Ultrasonic angioscanning.

2.2.3.2. Perfusion lung scintigraphy.

2.2.3.3. ECHO-cardiography.

2.2.3.4. Sectional research.

2.2.4. Characteristics of methods for the prevention of venous thromboembolism.

2.2.4.1. Elastic compression.

2.2.4.2. Electromyostimulation of venous outflow.

2.2.4.3. Pharmacological prevention.

2.3 Methods of statistical processing of results.

CHAPTER 3. RESULTS OF THE EXPERIMENTAL STUDY AND THEIR ANALYSIS

3.1. The results of measurements of the diameter of the popliteal vein.

3.2. Results of measuring the peak blood flow velocity in the popliteal vein.

3.3. The results of measuring the volumetric blood flow velocity in the popliteal vein.

3.4. Influence of myostimulation on the sural sinuses and assessment of Doppler curves and myostimulation power.

3.5. Choosing the optimal combination of blood flow acceleration methods based on the data obtained.

3.6 Factors influencing the rate of blood flow during muscle contraction.

CHAPTER 4. RESULTS OF THE "EPIDEMIOLOGICAL" STAGE OF THE STUDY AND THEIR ANALYSIS

4.1. General characteristics of postoperative venous thrombosis.

4.1.1. Localization of the thrombotic process.

4.1.2. The timing of the development of venous thrombosis.

4.1.3. The total number of risk factors and the incidence of thrombosis.

4.2. General characteristics of pulmonary embolism.

4.3. General mortality, causes of death, complications of preventive methods and other characteristics of the study.

4.4. Analysis of the obtained results.

CHAPTER 5. RESULTS OF THE “COMPARATIVE” STAGE OF THE STUDY AND THEIR ANALYSIS

5.1. Results of the use of myostimulation in the pilot group.

5.2. Algorithm for the use of electrical stimulation of the leg muscles as part of the complex prevention of venous thromboembolic complications.

5.3. Efficiency of a comprehensive program for the prevention of venous thromboembolic complications using the technique of myostimulation and graduated compression bandage with increased level pressure.

5.4 Experience of myostimulation in acute thrombosis.

Recommended list of dissertations

• Optimization of methods for the prevention of acute venous thrombosis in surgical patients with a high risk of thromboembolic complications 2014, Doctor of Medical Sciences Viktor Evgenievich Barinov

• Prediction and prevention of postoperative venous thromboembolic complications 2008, doctor of medical sciences Vardanyan, Arshak Vardanovich

• Deep venous thrombosis and pulmonary embolism: diagnosis, risk prediction, early treatment of traumatic disease 2006, doctor of medical sciences Mishustin, Vladimir Nikolaevich

• Complicated forms of chronic venous insufficiency (pathogenesis, diagnosis, treatment, prevention) 2004, Doctor of Medical Sciences Schelokov, Alexander Leonidovich

• Choice of method of surgical prevention of pulmonary embolism (PE) 2004, candidate of medical sciences Korelin, Sergey Viktorovich

Introduction to the thesis (part of the abstract) on the topic "Electromyostimulation of venous outflow in the prevention of venous thromboembolic complications in surgical patients."

Similar theses in the specialty "Surgery", 14.01.17 VAK code

• Features of the pathogenesis of embolic venous thrombosis 2007, Doctor of Medical Sciences Shulgina, Lyudmila Eduardovna

• Prevention, diagnosis and treatment of pulmonary embolism. 2009, Candidate of Medical Sciences Nizhnichenko, Vladimir Borisovich

• Ultrasound diagnostics and evaluation of the results of treatment of patients with thrombosis in the inferior vena cava system 2011, Doctor of Medical Sciences Goldina, Irina Mikhailovna

• Prevention of venous thromboembolism in patients undergoing major orthopedic surgery on the lower extremities 2006, candidate of medical sciences Zinovieva, Irina Evgenievna

• Management of pregnancy, childbirth and the postpartum period in women with diseases of the veins of the lower extremities 2008, candidate of medical sciences Eshalieva, Ainagul Sarpekovna

Dissertation conclusion on the topic "Surgery", Lobastov, Kirill Viktorovich

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