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SAINT-PETERSBURG – 2010 - page 32 / 128





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According to the literature, only 50% patients with tumors of peripheral nerve trunks of extremities had correct preoperative diagnosis. In this connection correct and full diagnostics of this pathology is very important for clinical physicians. In the literature, despite of variety of diagnostics methods, the complex of examination for patients with peripheral nerve tumors (PNT) of extremities is not so clear.

Research objective: to analyze advantages and disadvantages of various methods used for examination of patients with peripheral nerve tumors and to offer an optimum complex of examination of patients with this pathology.

Materials and methods: The complex of examination of patients with this pathology offered by RNHI named after professor A.L.Polenov, is based on comprehensive examination and treatment of 284 patients with PNT of extremities and includes: clinical-neurological, electrophysiological examination (electric diagnostics, electromyography), ultrasonic examination (USE), magnetic resonant imaging (MRI).

Research results and discussion: The clinical-neurologic examination included careful history taking, paying attention to the fact of occurrence of pain symptoms, moment of origin of the space-occupying process feeling (palpation), difference which occurred between these two facts. Visual examination and palpation of patients in order to identify this localized pain, sense of new growth, its mobility, displaceability to the poles and palpatory determination of the limits of the tumor and its consistence, Tinel’s sign [2,3,7].

In order to determine a degree of disorder of conductivity of nerve trunks affected by the tumor, we have used: classic electric diagnostics, study of "intensity-duration" curve, electromyography, stimulation electromyography, diaphoresis assessment, in order to determine the local blood flow, wee have determined skin temperature, tachooscilography and reactive hyperemia.

Nowadays the following methods - diaphoresis assessment, local blood flow assessment, determination of skin temperature, tachooscilography, reactive hyperemia are not in use at the branch due to significant labor input, out-of-date equipment, insufficient informativity and ambiguous interpretation of the results.

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