METHODS OF DIAGNOSTICS AND TREATMENT OF CLOTTED HEMOTHORAX BY AY MALCHIKOV Russian patent published in 2009 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular to chest therapy and can be used for removal of blood clot from pleural cavity in case of clotted hemothorax. Essence of method lies in daily analysis of patient's health condition, carrying out X-ray chest examination in case of aggravation of symptoms of general and local inflammation, puncturing of pleural cavity from several points in case if massive X-ray shadow is detected in injured half of chest, with displacement towards healthy side, installation of drainages, removal contents through them with determination of its volume and colour, repeated X-ray examination, producing conclusion about presence of clotted hemothorax by results of contents volume and colour evaluation. Before puncturing chest tissues are anaesthetised, before puncture upper drainage with outlet valve is installed. Puncture is performed under ultrasonic control of introduction accuracy with preliminary introduction of 0.9% sodium chloride solution in amount 1-1.5 ml before introducing needle into blood clot. Needle is exchanged through conductor for elastic catheter, after which position of patient's body in space is changed, trying to place selected part into the lowest position in pleural cavity. Then equal in volume, heated to 37°C diluting solution, containing 5% of sodium hydrocarbonate and 1.5% of hydrogen peroxide, is introduced into selected shadowed region. After 10 minutes patient's chest region is placed into vertical position, fixed, lowest point of pleural cavity is determined, end of lower drainage tube is introduced into it and used to remove liquid contents from pleural cavity. Repeated X-ray examination is performed. Conclusion about presence of clotted hemothorax is given in case of reduction of lung field shadowing and removal from cavity of increased volume of foamy liquid of red colour. Treatment is carried out by means of regular analogous injections of diluting solution into remaining regions of shadowing until the latter is eliminated from them and all diluted blood is removed through lower drainage. After that by means of drainages pleural cavity is washed with heated to 37°C 0.9% sodium chloride solution until "clean water".

EFFECT: application of claimed invention allows to increase efficiency, safety and reduce traumaticity due to targeted dilution of clots, removal of diluted blood and washing of pleural cavity by means of drainages.

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