SU1698775A1 - Method for diagnosing the degree of seriousness of septic state in children - Google Patents

Abstract

This invention relates to medicine. The aim of the invention is to improve the diagnostic accuracy and speed up the method. To do this, during clinical and laboratory examinations, infrared spectroscopy of dried capillary blood is additionally performed, and in the presence of an absorption band with a maximum at 1095-1105, presepsis is diagnosed, at 1080 - a slight form, at 1040 cm - an average yellow form and at 1010 cm - t desired form.

Description

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The invention relates to medicine and concerns methods for the diagnosis of septic conditions in children.

The purpose of the invention is to improve the accuracy of diagnosis and acceleration of the method.

The method is carried out as follows.

Two drops of capillary blood are taken from the patient, the blood is dried on a glass that is specimen or optically transparent in the range of 800–1300 infrared spectrum. In the case of using optics that are transparent in the infrared spectrum, a window with a dried smear of blood is placed in the instrument's beam and the spectrum is recorded in the range of 800-1300. When using a glass slide, the dry substance removed from it is thoroughly ground with a filler that is transparent in the above infrared range.

spectrum. The resulting mixture is in the form of a compressed tablet, if the filler is solid, or in the form of a suspension, if the filler is liquid, is placed in a beam spectrometer and the infrared spectrum is recorded. In the presence of a band, absorption with a maximum at 1095-1105 is diagnosed with a presepsis, at 1080 cm - a mild form, at 1040 cm - an average yellow form and at 1010 cm - a heavy form.

PRI me R 1. baby B. 9 days. She gave birth to a 36-year-old mother with a history of gynecological and obstetric history. The birth is premature, with stimulation, an anhydrous period of 9 hours. The umbilical cord disappeared on the 9th day. On admission, the child is weak, adynamic, reflexes are quickly exhausted, pale yellow skin, the act of sucking is broken, painful cry, shortness of breath, tachycardia, umbilical

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ring tight with purulent-serous compartment.

Clinical analysis of blood Er - 4.7-10 2 / l, Lake - 10, {"109 / l, hemoglobin - 90 units, ESR - 4 mm / h, C-30, E - 2, MY - 6, Lymph - 60. On the basis of the clinical picture and anamnestic data, there was a need for a differential diagnosis between the risk of intrauterine infection, the initial stage of sepsis and umbilical sepsis in a mild form.

When determining the content of acid-soluble blood components (CRC), their level was 0.220 units, and the index IL-1.17, which indicates the absence of a septic condition in a child. To record the infrared spectrum, 1 drop of blood was taken from the heel and dried at 56 ° C on a glass slide. The dry substance is thoroughly ground with potassium bromide and compressed into a tablet at a pressure of 50 t / cm2. In the infrared spectrum recorded from this tablet, it was observed on the absorption band with a maximum of 1100 cm. On the basis of this, as well as clinical data, a diagnosis was made: perinatal encephalopati of hypoxic genesis, acute period, severe form, neuro-reflex excitability syndrome, prematurity of I degree, conjugation jaundice, omphalitis, prepsis. Generally prescribed advanced antiseptic therapy has been prescribed. The patient was discharged at the clinic in a satisfactory condition.

Example 2. Child H, 6 days. I gave birth to a 39-year-old mother, from the 1st of pregnancy, occurring with toxicosis of the 2nd half. Childbirth premature, anhydrous period of 6 hours. Diagnosis on admission: intrauterine pneumonia, severe form, conjugative jaundice, omphalitis, perinatal encephalopathy of hypoxic genesis, depression syndrome, prematurity II.

In view of the severe condition of the child, it became necessary to make a differential diagnosis between pneumonia and sepsis. However, clinical and laboratory data did not allow us to state exactly that there is no sepsis. To clarify the diagnosis, the CRC index and infrared blood spectrum were examined.

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The CRC indicator was equal to 0.300, which indicated presepsis. An absorption band with a maximum at 1100 cm was detected in the infrared spectrum, which also confirmed this diagnosis. In this case, there is a coincidence of the clinical diagnosis with findings made on Q based on spectroscopic studies in the ultraviolet and infrared regions.

Example 3. Child P., 3 days. Born to a 28-year-old mother,. The birth is swift. In the birth traumatic brain injury. Diagnosis at admission: perinatal encephalopathy of hypoxic-traumatic genesis, acute period, moderately gland, suspected heart disease, pyoderma. On the skin pustules.

In order to clarify the diagnosis, the CRC level was determined, which amounted to 0.790 units, which is evidence of sepsis. Since the clinical and laboratory data did not confirm the diagnosis of sepsis, the blood of the child after appropriate processing and preparation of the tablet with excipient was subjected to infrared spectroscopy. An absorption band was found with a maximum in the 1120 cm region, i.e. The diagnosis of sepsis was not confirmed.

Prescribed conventional treatment adequate to the presence of pyoderma. The main therapeutic measures were aimed at combating traumatic brain injury. Further observation confirmed the correctness of the diagnosis based on the results of infrared spectroscopy. Apparently, the increase in CRC was due not to sepsis, but to a head injury.

Example 4. Child Sh., 5 days. On admission, he was diagnosed with omphalitis, pneumonia, perinatal encephalopathy of hypoxic-traumatic genesis, acute course, Mediol – 0, each form, depression syndrome,

conjugation jaundice, prematurity II degree.

A blood test: Er - 5 4 ,, Lake - b, 2 “107 / l, hemoglobin - 100%, ESR - 8 mm / h, C - 45, U - 1, P - 2, E 2, Moi - 6 , Lymph - 40.

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According to clinical and laboratory data there is no sepsis.

In the study of blood using infrared spectroscopy detected absorption at 1080. On the basis of IR-spectroscopy diagnosed slsis, easy form.

Later, in the dynamics, there was a slow increase in body weight, the temperature was 36.7 ° C, occasionally 37.1 ° C, the skin color was pale gray, symptoms of intoxication increased, there was regurgitation, unstable stool, began to suck, appeared moderate shortness of breath and tachycardia. In the clinical blood analysis, an increase in the number of leukocytes to 9, a decrease in the level of hemoglobin to 80.0% was revealed. Treatment with ampicillin did not produce any effect; on day 8, cecephine was also administered intravenously. The final clinical diagnosis: sepsis, mild form, purulent omphalitis, pneumonia, perinatal encephalopathy of hypoxia of traumatic genesis, acute course, moderate form, depression syndrome, conjugation jaundice, prematurity II degree.

Example 5. Child S., 16 days. Diagnosis at admission: prenatal sepsis, septicopyemia, acute course, severe form. Felonus I, I, and III fingers, suspected spinal necrotizing enterocolitis, pneumonia, mixed form, perinatal encephalopathy of hypoxic-traumatic genesis, acute course, severe syndrome, depression.

CBC: Air - 3.6, ,, Lake - 11.8-109 / l, hemoglobin - 85%, ESR - 14 mm / h, C - 32, E - 3, P - 2, Moi - 8, Lymph - 62, anisocytosis.

According to clinical and laboratory data - sepsis, moderately or severely.

In the infrared spectrum of the blood studied, absorption was observed at 1040. Diagnosis: moderate sepsis.

In the dynamics - a flat weight curve, temperature 37.2-37.4 ° C, skin color pale gray with yellowness, ery- givan, vomiting, sucks poorly, does not suck the norm, symptoms of intoxication are retained, pronounced tachycardia and shortness of breath. Leukocytosis increased to 12.6 "109 / l, hemoglobin level decreased

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up to 78%. After the course cefamisin replaced by ristomycin.

The final clinical diagnosis: sepsis, septicemia, acute course, medium form, panarcium 1, II and III fingers, pneumonia, displaced form, perinatal encephalopathy of hypoxic-traumatic genesis, acute course, depression, oppressive syndrome.

Example 6. Child P., 26 days. Diagnosis at admission: sepsis, septicemia, acute current, form and ma - ulcer neurotichesky enterocolitis, perinatal form, prematurity II degree. From the intestine, the pseudomonagus is sown.

Blood count: Er - 3.0.10 (2 / l, Lake - 16 YU9 / l, hemoglobin - 38%, ESR - 30 mm / g, C - 39, U - 3, P - 4, E - 4, Mon - 12, Lymph - 41.

When examining a child’s blood using infrared spectroscopy, an absorption band with a maximum at 1010 cm is present in the spectrum, indicating a severe form of sepsis.

Further clinical observation confirmed this conclusion.

The final clinical diagnosis: sepsis, septicemi, acute course, severe form, purulent omphalitis, purulent conjunctivitis. neural necrotic enterocolitis, perinatal encephalopathy, acute period, severe form, prematurity of II degree.

Thus, when using the rapid method of infrared spectroscopy of blood to diagnose septic processes in children entering a hospital, there is a possibility of an early reliable diagnosis of this disease. The accuracy of diagnosing septic conditions when using the proposed method is 100%.

Claims (1)

Invention Formula A method for diagnosing the degree of severity of a septic condition in children by clinical and laboratory examination, characterized in that, in order to improve the accuracy and speed up the method, infrared spectroscopy of dried capillary blood is additionally carried out in the presence of an absorption band with a maximum 716987758 at 1095–1105 cm, preori 1040 cm –– is diagnosed with moderately severe sepsis, with 1080, with a mild form, and with 1010 cm –– with a heavy form.