THE APPLICATION OF WAVE BIOMECHANICAL THERAPY FOR THE COMBINED TREATMENT OF THE PATIENTS SUFFERING A SNAKE (VIPER) BITE DURING THE REHABILITATION PERIOD


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Abstract

We have undertaken the comparison of the results of the treatment and the changes in the laboratory characteristics of 25 patients that suffered a viper bite and were given the combined treatment either with the application of wave biomechanical therapy (WBMT) (10 patients comprising the study group), and without it (15 patients making up the control group). During the rehabilitation period, all the patients exhibited the common symptoms of intoxication including fever, shortness of breath, dizziness, nausea, dilated pupils, and rapid heartbeat as well as the local changes (burning sensation, redness of the skin at the site of the bite, decreased skin sensitivity, swelling, bruising, and blisters); other pathological conditions documented in the association with the snake bite included lymphangitis, lymphadenitis of the regional lymph nodes, and extensive swelling of the extremities with severe pain which were collectively responsible for the significant prolongation of the duration of hospitalization and required an additional treatment. The laboratory studies have demonstrated the multidirectional disorders of the hemorheologic patterns and of the cellular component of toxemia, such as deviations from the normal values of practically all hemorheological characteristics, mostly in the upward direction, moderate leukocytosis, and the increase in the amount of the dead white blood cells, as well as the significant enhancement of the indicators of endotoxemia including the leukocyte index of intoxication, and the coefficient of endogenous intoxication (a 1.8-5.7 times elevation, respectively). The application of the WBMT technology gave rise to positive clinical and laboratory dynamics (more pronounced in the patients of the study group than in those of the group of comparison) in the form of the reverse development of the general manifestations of intoxication and, especially, such local changes as reduced swelling, skin redness, bleeding, feelings of pain, normalization of body temperature and heart rate, restoration of skin sensitivity. The use of WBMT was accompanied by a full and pronounced correction of hemorheological disorders (viscosity and aggregation), and the 1.5-fold higher frequency of their effective correction in the treatment group compared with that in the control patients. There was an apparent tendency towards the normalization of endogenous intoxication and higher overall contents of the blood fractions of medium molecular weight peptides (MMP) (with the 1.2 and 1.4 times reduction in the levels of the MMP254 and MMP280 fractions, respectively) while leukocyte index of intoxication showed a statistically significant fall by a factor of 3.5 in comparison with its initial value. It is concluded that the introduction of WBMT in the combined therapeutic modality makes it possible to decrease the duration of hospitalization of the patients by 1.5 times (33%) on the average.

About the authors

A. V Badalyan

Federal state budgetary educational institution of additional professional education «Russian Medical Academy of Postgraduate Education», Ministry of Healthcare of the Russian Federation

Email: drbadalian@mail.ru
канд. мед. наук, зав. отд. острых отравлений ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского» Департамента здравоохранения г. Москвы, 129090, Москва 127994, Moscow, Russian Federation

V. A Shchetkin

Federal state budgetary institution «N.V. Sklifosovsky Research Institute for Emergency Medicine», Moscow Healthcare Department

129090, Moscow, Russian Federation

Yu. S Goldfarb

Federal state budgetary educational institution of additional professional education «Russian Medical Academy of Postgraduate Education», Ministry of Healthcare of the Russian Federation

127994, Moscow, Russian Federation

N. V Borovkova

Federal state budgetary institution «N.V. Sklifosovsky Research Institute for Emergency Medicine», Moscow Healthcare Department

129090, Moscow, Russian Federation

E. A Chukina

Federal state budgetary institution «N.V. Sklifosovsky Research Institute for Emergency Medicine», Moscow Healthcare Department

129090, Moscow, Russian Federation

E. E Bitkova

Federal state budgetary institution «N.V. Sklifosovsky Research Institute for Emergency Medicine», Moscow Healthcare Department

129090, Moscow, Russian Federation

E. V Klychnikova

Federal state budgetary institution «N.V. Sklifosovsky Research Institute for Emergency Medicine», Moscow Healthcare Department

129090, Moscow, Russian Federation

E. V Tazina

Federal state budgetary institution «N.V. Sklifosovsky Research Institute for Emergency Medicine», Moscow Healthcare Department

129090, Moscow, Russian Federation

Yu. V Andreev

Federal state budgetary institution «N.V. Sklifosovsky Research Institute for Emergency Medicine», Moscow Healthcare Department

129090, Moscow, Russian Federation

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