E.T. NURMUKHAMETOVA, M.E.SHLYAPNIKOV

Medical University “Reaviz”, 227 Chapaevskaya Str., Samara, Russian Federation, 443001

 Nurmukhametova E.T. – postgraduate student of the Department of Obstetrics and Gynecology, e-mail: nurelm@yandex.ru, ORCID ID 0000-0002-4529-6920

Shlyapnikov M.E. – D. Sc. (medicine), Professor, Head of the Department of Obstetrics and Gynecology, e-mail: shme@samtel.ru, ORCID ID 0000-0002-4725-4310

Objective. With the use of laser Doppler flowmetry (LDF) to assess the state of peripheral blood flow in patients before and after uterine artery embolization (EMA) in the treatment of uterine fibroids.

Material and methods. Depending on the severity of the postembolization syndrome (PS), 81 patients were divided into 3 groups: mild severity (n = 36) — group I, moderate degree (n = 30) — group II, severe (n = 15) — III group. Using the LDF method, occlusion tests were performed to record microblood flow rates in each group before and after EMA.

Results. A marked increase in the intensity of blood flow in group III studied by 32% (p <0.05), associated with an increase in the metabolic needs of the body, and an increase in KV by 20% statistically significant (p <0.001), which characterizes the increase as active (inflow) and passive (outflow) mechanisms of modulation of tissue blood flow.

Conclusion. In patients of group III in the postoperative period is developed a compensatory hyperemic pathological type of blood flow, characterized by an increase in all types of blood flow modulations, an increase in the number of functioning capillaries, an increase in perfusion and vascular wall penetration, and an increase in arterial blood flow in the microvasculature.

Key words: microcirculation, uterine artery embolization, postembolization syndrome, laser Doppler flowmetry, occlusive test.

(For citation: Nurmukhametova E.T., Shlyapnikov M.E., Diagnostic utility of assessing the state of peripheral blood flow after uterine artery embolism. Practical Medicine. 2018)

REFERENCES

1. Adamyan L.V. and the group of authors. Uterine fibroids: diagnosis, treatment and rehabilitation. Clinical recommendations (treatment Protocol), 2015. 50 p. (in Russ.)
2. Strizhakov A.N., Davydov A.I., Pashkov V.M., Lebedev V.A. Benign diseases of the uterus. GEOTAR, 2011. 312 p. (in Russ.)
3. Dobrokhotova J.E., Khachatryan A.S., Ibragimov, M.D. Uterine Fibroids. Modern questions of pathogenesis and drug reduction therapy. Doctor.ru. Gynaecology, 2013, №7(85), pp. 29-32.(in Russ.)
4. Uterine artery embolization. Under ed. J.E. Dobrokhotova. SPb: Ecten Medi-Kal. 2013. 112 p. (in Russ.)
5. Tikhomirov A.L., Lubnin D.M. Uterine artery Embolization in treatment of fibroids Mat-CI. Questions of gynecology, obstetrics and Perinatology, 2002, no. 2, pp. 83-85. (in Russ.)
6. Kapranov S.A., Dobrokhotova J.E., Bobrov B.Yu., Alieva A.A. Postembolization syndrome in endovascular treatment of uterine fibroids. International interventi district journal Cardioangiology, 2005, no. 7, 24 p. (in Russ.)
7. Spencer E.B., Stratil P., Mizones H. Clinical and Periprocedural Pain Management for Uterine Artery Embolization. SeminInterventRadiol, 2013, №30 (4), pp. 354-63.
8. Pron G., Bennett J., Common A., Wall J., Asch M., Sniderman K. Ontario Uterine Fibroid Emboli-zation Group Collaboration. The Ontario Uterine Fibroid Embolization Trial. Part 2. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids Fertil Steril, 2003, vol.79, no.1, pp.120-127. doi: 10.1016/S0015-0282(02) 04538-7
9. Krupatkin, A.I., Sidorov, V.V. Functional diagnostics of the state of microcirculatory-tissue systems: oscillations, information, nonlinearity: hands — in for doctors. Moscow: Librokom, 2013. 496 p. (in Russ.)
10. I. Kozlov, G.A. Azizov, O.A. Gurova, F.B. Litvin. Laser Doppler flowmetry in the assessment of the state and disorders of blood microcirculation. Methodical assistance of ore. Moscow, 2012. 32 p. (in Russ.)
11. Prokofieva T.V., Polunina O.S., Yatsenko M.K., Maklakova N.V. Occlusion test in patients with stable angina III functional class in the process of inpatient treatment in LDF-testirovanie. Advances in modern natural science. 2007, no. 12-1, pp.129-131. (in Russ.)
12. Hock M.M., Levitan B.N., Bredikhin M.V., Ivannikov V.V., Umerov A.R. Hemodynamic types of skin microcirculation according to laser dopplerometry in chronic hepatitis and liver cirrhosis. Russian journal of gastroenterology, Hepatology, Coloproctology. 2008, vol. XVIII, no. 5. 185 p. (in. Russ.)
13. Vasiliev N., Streltsova N.N. Laser Doppler flowmetry in the assessment of skin microcirculation in patients with arterial hypertension and its combination with type 2 diabetes mellitus. Russian journal of cardiology, 2015. pp. 20-26. (in. Russ.)
14. Kade E.A., Eliseeva L.N. Investigation of the state of the microcirculatory bed in patients with rheumatoid arthritis. Advances in modern natural science, 2006, no. 10, pp. 106-107.
15. Azizov G.A. Functional tests in the assessment of disorders of microcirculation in the assessment of diseases of vessels of lower extremities. Regional blood circulation and microcirculation and Deposit, 2006, vol. 5, pp. 37-43. (in. Russ.)
16. Zavalko A.F., Nurmukhametova E.T., Antipov E.V. Dynamic indices of micro-circulation in women after embolization of vessels of the uterus. Vestnik of medical Institute «Reaviz»: Rehabilitation, Doctor and health. 2017. №6 (30), pp. 154-158. (in. Russ.)
17. Ananchenko M.N., Chuyan E.N. Skin microcirculation under functional load in subjects with different typological features under the influence of low-intensity millimeter radiation. Scientific notes of  Tauride national University. V. I. Vernadsky. Series «Biology, chemistry». vol 24 (63). 2011, no. 2, pp. 30-49.