RU2493887C2 - Pharyngeal sieve for basal tracheobronchial secretion - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine and biology, and may be used in morphological, physiological study of the ultrastructural characteristics of tracheobronchial cell suspensions. A sieve comprises a flat working surface and a handle. The handle is directed to the flat working surface at an angle. The flat working surface makes one piece with the handle in the form of a plastic glossy slide 30*24*1 mm. The handle has a size of 105*10*2 mm; it is provided with a matt or granular surface and curved so that a main portion of the handle designed for the user's hand is inclined at an angle of 20 degrees to the working surface. Between the handle and the working surface, there is a perforation to separate the handle and the working surface. A 1 mm wide junction is 5 mm away from a narrow part to be widened up to 2 mm from the main portion of the handle.

EFFECT: sieve enables avoiding the substrate drop transfer onto the slide and specifying the cytomorphological, cytophysiological, cytochemical measurements of the cell elements as parts of respiratory biological media.

3 dwg

Description

The invention relates to medicine and biology and relates to a morphological, physiological study of ultrastructural characteristics of cell suspensions of tracheobronchial secretion.

A pharyngeal trap device is known (Pat. RF No. 2363505, publ. 08/10/2009), including the upper and lower plates and the handle, the lower plate being a protective shield for the upper plate and has an end bent at an angle of 15 ° that can be fixed the root of the tongue when installing the lower plate opposite the entrance to the larynx, the handle is spring-loaded with the ability to extend the upper plate when you press the handle and return the upper plate to its original position in the absence of the handle, and the upper plate represents battle surface to collect tracheobronchial secretion. This design allows you to get high-quality drugs with a monolayer of tracheobronchial secretion cells, without contact with saliva. The disadvantage of this device is that it transfers the droplets of the substrate onto a glass slide from the top plate.

The proposed device eliminates this drawback and allows you to clarify the results of cytomorphological, cytophysiological, cytochemical studies of cellular elements contained in the biological environment of the respiratory system.

The design of the device is shown in FIG. 1: a) view of the device from the top, b) side view of the device, c) close-up view of the notch zone.

The device is a plastic slide with a handle, made as a single part. Structurally, the device consists of a flat working surface - a glass slide 1, which is an analogue of a glass slide, 30 mm * 24 mm * 1 mm in size, passing into the handle 2 with a size of 105 mm * 10 mm * 2 mm. Between the handle and the working surface of the device there is a "notch" 3, intended for the convenience of separating the handle from the working surface after using the device. 5 mm from the "cut-out" is the transition zone 4, which has a width of 1 mm narrow part, which thickens up to 2 mm of the main part of the handle. For ease of use, the handle has a bend 5 located so that the main part of the handle, which should be in the researcher’s hand, is located at an angle of 20 ° degrees to the working surface of the device. The working surface of the device should be glossy, as subsequently, it will serve as a slide, the handle, on the contrary, can be made with a matte or fine-grained surface.

Figure 2, 3 presents photographs of the device.

Obtaining tracheobronchial secretion using a pharyngeal trap is as follows:

1) The patient rinses the oral cavity with boiled water

2) In a sitting or standing position, opens the mouth where a pharyngeal trap is introduced. The position of the patient depends on the severity of the disease.

3) The patient is asked to produce a few strong coughing strokes so that the tracheobronchial secret gets on a glass slide

4) The device is removed from the oral cavity.

5) The slide is detached from the handle.

A slide with a smear of secretion is dried in air at room temperature. Then the drug is fixed in formalin vapors, methyl alcohol, stained with cytological dyes or carried out cytochemical reactions.

In the proposed device, the application of a small volume of a suspension of cells on the solid surface of a plastic slide, combined with a pharyngeal trap, is carried out at the time of coughing the patient, which distinguishes it from the prototype.

Using the proposed pharyngeal trap allows you to prepare high-quality preparations with a monolayer of cells contained in a minimum amount of tracheobronchial secretion, which avoids contact with saliva and does not require transfer of the secret to a glass slide, as it immediately falls onto it. An advantage is that the device is the subject of a single (individual) use, does not require sterilization after use. The fence of the secret device is also atraumatic. It is assumed that the device can be manufactured industrially from colorless (transparent) polystyrene or a similar polymeric material by the method of HPD (injection molding) by using a mold.

Example.

Using the original pharyngeal trap, we obtained basal tracheobronchial secretion in patients with acute pneumonia.

Patient O., 23 years old, was admitted to the pulmonary department with complaints of: cough with yellow sputum, fever up to 39 degrees, chills, sweating, pain on the front surface of the chest on the right, intensifying with a deep breath, shortness of breath with little physical exertion.

Anamnesis of the disease: considers himself sick after the moment of hypothermia, the temperature rose to 38.5 ° C degrees, he took antipyretics. She noted a short-term decrease in temperature to 37 ° C. Two days after acute hypothermia, pain appeared on the front surface of the chest on the right, subfebrile condition persisted, and the increase in temperature was accompanied by chills. The patient was hospitalized in the pulmonology department.

From the anamnesis of life it is known :, smoking experience of 6 years, does not abuse alcohol. An allergic history is not burdened. Botkin's disease, tuberculosis denies. Objectively: general state of moderate severity, clear consciousness. The constitution is normosthenic. Visible mucous membranes are clean, physiological in color. The skin is wet to the touch. Body temperature 38 ° degrees. Peripheral lymph nodes are not enlarged, painless. In the lungs, vesicular breathing, in the lower parts of the right moist small bubbling rales. Respiratory rate 22 per minute. For other organs and systems without features.

To diagnose the disease, we used our invention. Using a pharyngeal trap, a basal tracheobronchial secret was obtained. Then the cytological preparation was fixed in formalin vapors, stained according to the Romanovsky-Giemsa method. A tracheobronchial secretion of the patient reveals a cytological picture characteristic of inflammation: squamous epithelium - 16%, stab neutrophilic leukocytes - 44%, segmented neutrophilic leukocytes - 36%, lymphocytes - 4%, cell destruction index - 70%, large accumulations of microorganisms are found in the smear - streptococcus.

Laboratory data confirm the results of a cytological study of basal tracheobronchial secretion: in the clinical analysis of blood leukocytosis up to 11 * 10 ⁹ liters, accelerated ESR up to 43 mm / hour; in a biochemical blood test hyperfibrinogenemia up to 5.6 g / l. Reduced saturation to 92%, determined using an OX-700 pulse oximeter (Japan). X-ray: on a review radiographs of the chest organs in two projections, a decrease in transparency in the middle sections on the right due to lung tissue infiltration is determined, on the left without focal infiltrative changes. Conclusion right-sided lower lobar pneumonia. On the basis of complaints, medical history, instrumental data, the diagnosis was made: community-acquired acute right-sided lower-lobe pneumonia, moderate severity, phase of heat. DN I.

The patient received treatment: iv sumamed 500 mg, arbidol 2 g 4 times a day, heparin through a nebulizer 2 times a day. During treatment, a positive trend was noted: cough decreased, dyspnea, body temperature was normal, there was no pain in the right half of the chest. General condition is satisfactory. In the lungs, vesicular breathing, no wheezing. Respiratory rate 18 per minute. We used our invention to evaluate the effectiveness of the treatment of the disease. A tracheobronchial secretion of the patient reveals a cytological picture characteristic of reducing inflammation: squamous epithelium - 42.9%, stab neutrophilic leukocytes - 0%, segmented neutrophilic leukocytes - 52.1%, lymphocytes - 5%, cell destruction index - 15%, smear there are no large accumulations of microorganisms. In this case, stabilization of laboratory parameters of peripheral blood is detected: leukocytes 6 * 10 ⁹ liters, ESR 9 mm / h, fibrinogen 3.5 g / l.

Saturation - 97%. Radiologically positive dynamics.

Thus, our invention is important for the study of tracheobronchial secretion under the influence of adverse environmental factors on the human body and in the case of pathology of the respiratory system.

Claims (1)

A pharyngeal trap for a basal tracheobronchial secretion containing a flat work surface and a handle oriented at an angle to the flat work surface, characterized in that the flat work surface is made with the handle as a single part, in the form of a glossy plastic slide with a size of 30 × 24 × 1 mm, while the handle has dimensions 105 × 10 × 2 mm, is equipped with a matte or fine-grained surface and is bent so that the main part of the handle, made for the researcher’s hand, is located at an angle of 20 ° to the working surface surface, and between the handle and the working surface there is a notch for separating the handle from the working surface, and 5 mm from the notch there is a transition zone 1 mm wide from the narrow part, which thickens up to 2 mm of the main part of the handle.

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