Functional diagnostics room. Organization of the work of the department (office) of functional diagnostics

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Introduction

One of the primary tasks of healthcare and medical science is to protect and strengthen the health of the population, increase life expectancy, improve the quality of medical care, and prevent diseases.

A promising form of disease prevention and diagnosis are research methods used in the office functional diagnostics.

In light of new methods of restructuring medicine and the implementation of the national project "Health", the necessary funds have been allocated to equip primary health care and specialized medical institutions for the purchase of high-tech equipment, which is also used in my office.

Over the past three years, the office has received two new devices: the Shiller spirograph and a device for daily ECG monitoring (HM ECG), which has made the work easier and more high-tech.

High demands are placed on functional diagnostic doctors, who must master all modern methods of examining patients, must have knowledge in cardiology, pulmonology, neurology, pediatrics, etc., and must also have computer skills.

The city of Chernogorsk is part of the Republic of Khakassia and is the second largest city in this territory. It covers an area of about 100 square kilometers, its population is 74.8 thousand people, the economically active population is about 42 thousand people.

The leading industries are: coal mining, production building materials, light and chemical industry. On the territory of the city there are 60 enterprises of industry, transport, communications, construction industry, there are about 30 thousand vehicles.

1. Brief description of the medical institution

1.1 The main objectives of the clinic are

provision of qualified specialized medical care to the population in the clinic and at home;

organization and implementation of the complex preventive measures among the population served, workers industrial enterprises aimed at reducing morbidity, disability and mortality;

organization and implementation of medical examination of the population;

organizing and conducting events for sanitary and hygienic education of the population, promoting a healthy lifestyle.

1.2 Organizational structure clinics

The organizational structure of the clinic consists of the following divisions:

Registry.

Prevention department: pre-medical reception room, examination room, a room for health education and hygienic education of the population, a room for preventive and medical examinations.

Treatment and prevention departments: medical offices in which appointments are conducted in 18 specialties: therapists, cardiologist, rheumatologist, endocrinologist, infectious disease specialist, oncologist, ophthalmologist, otolaryngologist, neurologist, surgeon, radiologist, functional diagnostics doctor, physiotherapist, pulmonologist, urologist, psychiatrist, narcologist, works day hospital for 63 places.

Auxiliary rooms: clinical and biochemical laboratories, functional diagnostics room, radiology department, physical service, ultrasound room, vaccination room, endoscopic room, room for rheoencephalogram.

Cabinet for decoration medical documentation, issuing certificates of incapacity for work.

Office of accounting and medical statistics.

Administrative and economic part.

2. Operation of the functional diagnostics room

The functional diagnostics room is equipped with modern equipment:

Electrocardiographs:

Single-channel: EK - 3m - 01 - RD 1 pc.;

Multichannel:

a) cardiovit At - 1 “Schiller” 3-channel 1 pc.;

b) cardiovit At - 1 “Schiller” 6-channel 1 pc.;

c) Mac 1200 VE6-channel 1 pc.

Spirometer "Microlab" MZ 3500 MK - 5-1 pcs.

Spirometer "Shiller" - 1 pc.

EEG "Neurospectrum" - 1 - 1 pc.

- "Cardiotechnics 4000" - HM ECG - 1 working recorder

Medical pulse oximeter "ARMED" - 2 pcs.

Table 1

The following examination methods are carried out in the office:

Electrocardiography (ECG) - registration of electrical potentials in the beating heart;

Holter monitoring ECG (HM ECG) - daily recording of an electrocardiogram;

Spirometry (SG) - study of function external respiration;

Pulse oximetry (PSM) - determination of blood saturation O2;

Electroencephalographic (EEG) - study of brain functions with functional tests;

Rheoencephalography (REG) - hemodynamics of cerebral vessels with functional tests.

2.2 Main indicators of the functional diagnostics room

table 2

Dynamics of the number of studies in the functional diagnostics room for 1990-2012. G.

The increase in the number of studies per 100 outpatient visits is associated with increasing requirements for the examination of patients and the introduction of new projects. Specific gravity reduction special studies without an ECG, due to the lack of equipment.

The number of studies has increased 2.6 times since 1990.

3. Dynamic performance indicators of the functional diagnostics room

Table 3


Total number of people examined


Incl. in the clinic and at home
Of the total number of people surveyed and over working age
Incl. in the clinic and at home
Total research
Incl. in the clinic and at home
Children under 17 years old
persons over working age






Ultrasound of the heart
Day hospital at a health care facility

As can be seen from the table, the number of office studies increases every year.

A decrease in REG is associated with a breakdown of the device and its write-off. I don’t do ultrasounds of the heart, since I started doing HM ECG.

Table 4 Structure functional studies (%)





Ultrasound of the heart

The structure of functional research in the office remains at the same level, since new equipment arrives very rarely and in small quantities.

4. Practical part

My work in the functional diagnostics room of the State Budgetary Healthcare Institution of the Russian Federation" City Hospital No. 1 Chernogorsk", the outpatient department is conducted in the following areas:

Work according to methods:

Description of ECG.

Carrying out and interpreting the results of HM ECG.

Evaluation of spirometry results.

Carrying out functional tests (with physical activity, drug tests).

Sanitary educational work.

Civil defense.

Training.

In my work I am guided by Order No. 283 of November 30, 1993. Ministry of Health of the Russian Federation "On Improving the Functional Diagnostics Service in Healthcare Institutions of the Russian Federation."

Electrocardiography is a method of accurate information about the state of the myocardium. An ECG is a waveform with periodically repeating oscillations, various shapes, frequency, direction.

A normal ECG consists of positive and negative waves, segments and intervals, which are designated by Latin letters and have their own shape, size and length.

In the presence of pathology, changes occur: teeth, segments, intervals. After analyzing the ECG, an electrocardiographic report is given.

4.1 Wolff-Parkinson-White syndrome

1.Shortening the PQ interval< 0,12

2. QRS widening > 0.11

3. Pathological initial part QRS complex, due to the D wave. D wave (+) or (-).

4. The change in ST and T is discordant with the leading wave of the QRS complex.

5. The total duration of the complex from the beginning of P to the end of S is normal; with blockades it increases.

6. Increased VVO.

Atrial flutter

1. Absence of the P wave.

2. Presence of wave F.

3.Lack of isoline.

4.AV blockade to varying degrees expressiveness.

5. The QRS shape is normal if there is no initial blockade of the legs.

6.RR can be equal or RR = RR depends on A-B conductivity. The number of F waves ranges from 220-350.

Complete AV block

Independent behavior of the P wave,

P at different places of the ECG curve in relation to QRS.

Intervals RR = RR are increased, greater than one (RR > l.00).

PP # PP within respiratory arrhythmia.

Myocardial infarction

An ECG can determine the presence of myocardial infarction, its stage, location, and depth.

4.2 Myocardial infarction on back wall(acute stage)

In II, III, A VF, the ST segment is highly elevated above the isoline of the concordant shape and turns into a high positive T wave.

In opposite leads V2 V3 V4, the ST segment is below the isoline with an arc downward, the T wave is weakly expressed (+).

Myocardial infarction on the anterior wall (in the subacute stage)

In V2, V3, V4, A, J there is a deep, wide Q wave; R is small, ST is raised above the isoline and turns into (-) coronary T.

In III, II AVF the ST segment is slightly below the isoline, T is high, coronal.

In addition to cardiology, the ECG technique is used by general practitioners, narrow specialists, as well as pediatricians, sports doctors, teenagers during medical examination and examination of conscripts in the GVK. We perform ECGs on seriously ill patients at home.

When recording an ECG, 12 electrocardiographic leads are recorded, plus additional leads:

according to Slapak,

posterior leads (V7-V9),

extreme right leads (V3R-V4R),

leads 2 ribs above and 2 ribs below,

third standard lead during inspiration.

In the structure of functional diagnostic studies, ECG studies with pharmacological tests are carried out:

1. Nitroglycerin test - for diagnosing coronary heart disease. The drug relieves coronary spasm and, when used sublingually, reduces ST segment depression and T wave inversion. In this case, the test is considered positive.

2. Atropine test - to identify the genesis of rhythm and conduction disturbances that can be caused by increased tone parasympathetic system or associated with pathological changes in the myocardium.

So, if SSSS is suspected, a test is considered negative when the heart rate increases by 30% or more from the initial one. The test is considered positive when the heart rate increases by less than 30%, periods of stopping occur sinus node, the appearance of second degree SA block, identification of foci of ectopic activity.

If atrioventricular conduction is impaired, elimination of first degree AV block suggests (according to most authors) its functional origin.

An ECG is taken every 15 minutes after administration of 1 ml of 0.1% atropine solution for an hour.

3. In our office, we use a test with dynamic physical activity of 20 squats in adolescents undergoing medical examination, persons of military age and contract soldiers as prescribed by doctors of the city military registration and enlistment office.

Table 5 Number of studies using functional tests for 2010 - 2012

When comparing the indicators, we can conclude that the level of ECG studies in the office is excessively high and is constantly increasing.

Table 6 Structure of pathology detected during electrocardiography for 2010 - 2012. G. (%)


	Specific gravity	Specific gravity	Specific gravity
Newly diagnosed myocardial infarction
Atrial fibrillation and flutter
Paroxysmal tachycardia
WPW syndrome
Bundle branch blocks and AV blocks

5. Study of external respiration function

The study of external respiration function is carried out in our office using the Microlab and Schiller apparatus using the modernized spirography technique. Spirometry is a method of graphically recording changes lung volumes when performing various breathing maneuvers.

Spirometry assesses:

1. Pulmonary volumes and capacities;

2. Indicators of bronchial patency;

3. Some indicators of pulmonary ventilation.

Spirometry as a research method is quite simple, accessible, and has the most developed methodological standards, standards and criteria for assessing deviations from the norm.

Along with the determination of statistical volumes (vital capacity, its components), the spirometric method allows one to obtain information about changes in lung volume over time, that is, about changes volumetric speed breath that makes it high informative method research.

There are no contraindications to spirometric testing.

It must be taken into account that some patients cannot (sometimes do not want) to correctly perform the necessary respiratory maneuvers (mentally retarded or uninterested in the study, as well as patients suffering from severe obesity, cachexia, severe cardiac and pulmonary heart failure, myasthenia, etc.). d.).

The patient's airway is connected to the device via a mouthpiece and a series of breathing maneuvers are asked to be performed. The correctness of the test is monitored along a curve that reflects the subject's breathing. The test is repeated several times until matching results are obtained, followed by selecting the best of them.

The basis of the study is the determination of vital capacity of the lungs (VC), forced expiratory volume in 1 second (FEV 1),

Tiffno index (FEV 1/VC), maximum pulmonary ventilation (MVL).

These indicators contain a fairly large amount of information about the anatomical and functional capabilities of the external respiration apparatus.

Patients are examined in the following areas:

Pulmonologist: for patients (bronchial asthma, chronic obstructive bronchitis and obstructive bronchitis, pulmonary emphysema);

General practitioner;

Teen service and GVK.

Table 7 Dynamics of the number of studies of respiratory function using spirometry for 2010 - 2012

Table 8 Structure of identified disorders of pulmonary ventilation function (%)


	Abs. numbers	Specific gravity	Abs. numbers	Specific gravity	Abs. numbers	Specific gravity
Mixed patients
By obstructive type
By restrictive type
Function is not affected

46% mixed type

32% obstructive type

18% by restrictive type

4% is not violated.

In the structure of morbidity, the leading place is occupied by bronchial asthma and chronic non-obstructive bronchitis.

In persons young(students, conscripts) last years The number of studies on postural disorders is increasing.

In 2011, the Cardiotechnika - 4000 device was transferred from the hospital to the clinic for daily ECG monitoring (HM ECG) - a method of recording ECG from 6 to 20-24 hours or more (72 hours).

Holter ECG monitoring is a method of recording ECG at different time intervals: from 6 hours to 24 hours or more.

However, it is practically important to define both shorter and longer recording periods.

Determination of indications in CM has been the subject of close research since the beginning of the introduction of the method.

In addition to the main medical aspects, this question is extremely relevant for economic justification examinations of patients with diseases of cardio-vascular system. In our clinic, CM is carried out mainly on the direction of a cardiologist, as well as local therapists.

6. Indications for use of HM ECG

Complaints that suggest cardiac arrhythmias (such as palpitations, loss of consciousness, dizziness).

Assessment of life-threatening arrhythmias in patients without complaints with:

a) hypertrophic cardiomyopathy;

b) recent myocardial infarction complicated by heart failure or rhythm disturbance;

c) short QT syndrome.

Efficiency mark antiarrhythmic treatment.

Evaluation of the work of IVR.

Assessment of ischemic changes in the myocardium:

a) if Prinzmetl’s angina is suspected;

b) after myocardial infarction to determine treatment tactics for the patient;

c) for ischemic heart disease to determine the treatment strategy for the patient.

In reality, indications for chemotherapy cover almost all categories of patients with diseases of the cardiovascular system.

There is a tendency to expand the indications for chemotherapy in Lately. This is due, first of all, to the qualitative expansion of the method’s capabilities and the introduction of additional options for analyzing the circadian rhythm of the heart. Only a comprehensive analysis of two components of the circadian rhythm - the electrocardiogram and heart rate variability in adults - brings CM to a leading place among non-invasive methods in electrocardiology, diagnosis, prognosis and evaluation of the effectiveness of antiarrhythmic therapy.

HM is not only a long-term ECG recording, but also a study, the results of which reflect the features of the daily (circadian) biorhythmological organization of the heart rhythm.

In our office, Holter monitoring is carried out using the Cardiotechnika system through three working channels. The system has 1 working recorder and 1 set of electrodes. Leads V4, J, V6 are recorded. The system provides computer decryption with medical correction. CM is of great importance in the diagnosis of syncope.

The most dangerous are arrhythmogenic syncope, which is the most significant risk factor for sudden cardiac death.

Syncope can be caused by:

1. Violations sinus rhythm SA blockade and sinus node failure.

2. AV block of the third or second degree.

3. Ventricular tachycardia(episode lasting more than 30 seconds or manifestation of hemodynamic disturbances).

I identified patients with pauses of more than 3 seconds against the background of SSSS (tachy-bradycardia). Behind last year cases of SSSU were identified, which amounted to 1% of general pathology, identified during CM.

Patients with this pathology are referred to cardiac centers for IVR.

When analyzing the operation of the IVR, no cases of dysfunction of the stimulator associated with a malfunction in the IVR itself were identified.

Monitoring the effectiveness of antiarrhythmic treatment plays an important role in the work. The performance indicators are:

Reduction in the number of extrasystoles by more than 75%.

Reducing the number of paired extrasystoles, type R extrasystoles on T by more than 90%.

Complete disappearance of episodes of ventricular tachycardia.

4. Reducing the number of polymorphic types of extrasystoles to a maximum of 2.

I have been directly involved in monitoring since 2011. In June 2008 completed a specialization in chemical engineering in Krasnoyarsk.

The identified pathology in CM is various violations rhythm and conductivity, ischemic changes in the myocardium, as well as disturbances in the functioning of pacemakers.

Table 9 Pathology detected during Holter ECG monitoring

7. Priority national project in the field of healthcare "Health"

The priority national project in the field of healthcare “Health” is of great importance in my work as a doctor in the functional diagnostics office.

Activities of the priority national project in the field of healthcare

The main goals of the national healthcare project:

Strengthening the health of the Russian population, reducing the level of morbidity, disability, and mortality.

Increasing accessibility and quality of medical care.

Strengthening primary health care, creating conditions for increasing the volume of provision medical services at the prehospital stage.

Development of preventive healthcare.

Meeting the population's needs for high-tech types of medical care.

Main directions of the priority national project:

Development of primary health care, which includes the following activities:

Training and retraining of general (family) practitioners, local physicians and pediatricians;

Increase wages primary care medical workers, paramedic-midwife stations and ambulances;

Strengthening the material and technical base of the primary medical care diagnostic service and emergency medical care;

Prevention of HIV infection, hepatitis B and C, identification and treatment of HIV patients;

Additional immunization of the population within the framework of national calendar vaccinations;

Introduction of new screening programs for newborn children;

Additional medical examination working population;

Providing medical care to women during pregnancy and childbirth and state and municipal institutions healthcare.

Providing the population with high-tech medical care:

Increasing the volume of high-tech medical care;

Construction of new centers of high medical technologies, training of highly qualified doctors and paramedical personnel for these centers.

Since 2006, under the Health project, my office has received new equipment:

Six-channel electrocardiograph AT - 2 "Cardiovit";

Electrocardiograph MAS - 1200 YE;

Spirograph "Schiller";

8. Implementation of the National Project "Health"

In 2012 Working citizens who did not undergo medical examination in 2009-2011 were subject to additional hospitalization, regardless of their field of activity and without age restrictions.

Table 10 Additional medical examination of working citizens

Results of additional medical examination for identified pathology

Table 11 Structure pathological changes identified during DD by ECG method (%)

Pathology is increasing every year. The structure of the identified pathology remains at the same level.

therapeutic diagnostics electrocardiogram heart attack

9. Brief questions and tasks

Besides the main job ECG interpretation, HM ECG, SG, conducting functional tests, I carry out advisory work: I examine diagnostically difficult patients referred from other medical institutions in the city. I conduct ECG classes with local doctors and emergency doctors. I also train nurses to work on ECG machines. Behind reporting period 10 nurses were trained.

As can be seen from the above, my work during the reporting period was quite intense. The number of people examined is increasing from year to year. The number of methods used to examine patients is also increasing. Over the past three years, I have mastered and implemented new devices in my office:

Spirometer "Shiller"

"Cardiotechnics 4000" - for conducting HM ECG

Medical pulse oximeter "ARMED".

began to use more widely functional tests. Thus, from all that has been said, we can conclude that I try to use all possible techniques in examining patients. I pay great attention to improving my qualifications as a functionalist doctor. working on methodological literature, I participate in seminars and conferences on therapeutic topics. She spoke at these conferences with various reports. In the field of diagnostics cardiac diseases did not make any serious mistakes during the reporting period.

I see my task as contributing to the further improvement of medical care for the city’s population at the level of modern requirements for healthcare authorities:

Introduce the latest methods of examining patients using modern equipment.

Make wider use of existing equipment.

Provide practical assistance to young doctors and nurses.

Constantly improve your qualifications (through specialization, improvement, reading specialized literature, participating in medical conferences).

To achieve the acquisition of modern equipment for the office to carry out:

Load test: Bicycle ergometer;

ABPM (24-hour blood pressure monitoring).

In my future work I will put all my efforts into preserving the health and working capacity of the population.

10. Hygiene education population

In addition to treatment and rehabilitation of patients important In reducing morbidity among the population, measures are aimed at preventing diseases and increasing the sanitary and hygienic culture of the population. According to Order No. 15 of January 25, 1993 of the Republic of Kazakhstan “On improving hygienic training of the population and promoting a “Healthy lifestyle””. Health education is mandatory for all health care workers.

At the beginning of the year, a work plan is drawn up at the rate of 4 hours per month. Promotion of medical and hygienic knowledge is carried out taking into account the epidemiological situation, seasonality, as well as according to the list of promotions and information projects. I conduct conversations with patients, give lectures, publish san - bulletins and “health corners”. I give lectures on local radio.

Read during the reporting period:

40 lectures, 25 of them on radio;

Conversations - 45;

San - bulletins - 10;

? "Health Corner" - 5.

The topics are different - this is the prevention of cardiovascular vascular diseases, colds, AIDS prevention, the dangers of alcohol and smoking, about proper nutrition, O healthy life, etc.

I devote myself to sanitary and educational work Special attention because I believe that all diseases are easier to prevent than to treat.

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...

Naumchik Tatyana Ivanovna

Head of the functional diagnostics room. Functional diagnostics doctor highest category. He has scientific publications and is working on his Ph.D. thesis.

The office’s specialists conduct functional diagnostic studies of the musculoskeletal system, central and peripheral nervous system, cardiovascular and respiratory systems(including using stress tests) to determine functional state internal organs and fabrics child's body, identifying risk factors for developing diseases.

Apply modern methods research of cardio-vascular system: electrocardiography (ECG), echocardiography with Doppler analysis of intracardiac flows (Echo-CG), Holter ECG monitoring, 24-hour blood pressure monitoring. Research nervous system include such techniques as: electroencephalography (EEG), including with computer data processing; echoencephalography (Echo-EG) - is used as a screening method for CCMT, which allows pediatric neurologist monitor the effectiveness of dehydration therapy and monitor the patient over time. The EEG technique is also performed for adult patients referred by neurologists and paid patients. Study external respiration functions carried out by spirometry with flow-volume loop analysis. The additional use of pharmacological tests and exercise testing makes it possible early detection“hidden” bronchospasm in children at risk for developing bronchial asthma.

The use of the latest non-invasive research methods is possible thanks to the equipment of the Cabinet with modern diagnostic equipment medical equipment leading global companies. Specialists use a Philips EPIQ 7 ultrasound diagnostic device, a 24-hour ECG and blood pressure monitoring system from Mortara (USA), a Fukuda electrocardiograph (Japan), a Master Screen Pneumo Jaeger spirometer (Germany), an Angiodin-Echo echoencephalograph, and a stationary EEG system 32 channels Nicolet Alliance Works (USA).

Upon the direction of a neurologist, functional diagnostics is carried out in the office electroneuromyography. Modern electroneuromyography is a complex of methods for assessing the condition neuromuscular system, based on recording and qualitative-quantitative analysis of various types of activity of nerves and muscles.

During the study, the electrical potentials of the membranes are recorded muscle fibers, axons that are part of mixed peripheral nerves, as well as the structures of the neuromuscular synapse.
The doctor evaluates both voluntary and stimulation-induced activity of the neuromuscular system.

Doctors work here:

Bozhyev Alexander Mikhailovich- functional diagnostics doctor of the highest category, candidate of medical sciences;
Gribova Svetlana Stefanovna
Naumchik Tatyana Ivanovna- head of the office, functional diagnostics doctor of the highest category;
Serdyuk Olga Alexandrovna- functional diagnostics doctor of the second category;
Sobakinskikh Tatyana Vikentievna- functional diagnostics doctor of the highest category;
Cherkashina Elena Ivanovna- functional diagnostics doctor of the highest category.

The concept of functional diagnostics combines diagnostic procedures, the use of which allows for an objective assessment of the functional capabilities of organs and systems.

In their work, the doctors of our department use diagnostic equipment of the latest models from the world's best manufacturers, thanks to which our specialists have the opportunity to conduct an objective examination of the health status of patients in various areas (cardiology, pulmonology, neurology, otorhinolaryngology, general therapy and others).

Techniques

Our specialists successfully use the following diagnostic techniques in their daily work:

24-hour ECG monitoring (SMECG) (preparation scheme);
(preparation scheme);
Study of external respiratory function, assessment of pulmonary ventilation capacity (PVC) (preparation scheme);
Bicycle ergometry (VEM) (preparation scheme);

Electrocardiography (ECG)

One of the most common and basic diagnostic methods in cardiology. The method consists of recording the electrical activity of the heart and allows one to successfully identify various rhythm and conduction disturbances, assess the functional state of the myocardium, and diagnose myocardial infarction and other ischemic changes. The ECG recording method is absolutely painless and safe for the patient. Modern devices allow not only to conduct research, but also to save previously obtained data in the archive and use them to monitor therapy.

Holter ECG monitoring

A functional diagnostic method that allows you to objectively assess the work of the heart throughout the day. This method is indispensable for assessing heart rhythm disturbances (often only 24-hour monitoring can detect arrhythmia) and diagnosing coronary heart disease. Holter monitoring is used to identify indications for surgical treatment heart, coronary angiography, for correction of drug therapy.

24-hour blood pressure monitoring (ABPM)

Method for diagnosing changes in blood pressure and assessing the effectiveness of the treatment drug correction. Throughout the day, the portable device records blood pressure indicators that occur against the background of the patient’s usual lifestyle. In some cases, it is precisely this technique that makes it possible to exclude arterial hypertension arising due to stress from visiting a doctor, as well as to record prognostically unfavorable nocturnal hypertension.

Echocardiography

A very important informative technique for studying the structure and function of the heart and large vessels allowing to identify congenital and acquired heart defects, assess the structure and function of valves, the thickness and function of the myocardium in coronary heart disease, hypertension and other diseases of the cardiovascular system.

Electroencephalography (EEG)

This is a method of analyzing the functional state of the brain by recording its bioelectrical activity. In its principle, the EEG method is similar to electrocardiography, only with EEG, sensors are placed not on the heart area, as with ECG, but on the head.
This study is necessary in the diagnosis of many neurological diseases: epilepsy, encephalopathy, tumors, for diagnosing the causes of fainting, etc.
You can undergo these and other functional diagnostic methods in the diagnostic department of our clinic.

Color duplex (triplex) scanning

It is the most modern and informative method for studying blood vessels - arteries and veins; it allows you to directly see the vessels themselves and the tissues surrounding them, as with conventional ultrasound, as well as study blood flow using spectral analysis and color mapping flow based on the Doppler effect.

Our department conducts:

Color duplex (triplex) scanning of the extracranial sections of the brachiocephalic arteries. The method allows you to examine the condition of the vessels supplying blood to the brain, determine the presence of atherosclerosis, the presence and nature of atherosclerotic plaques, degree of stenosis (narrowing) of the lumen of blood vessels, condition vertebral arteries, their course and the presence of compression during cervical osteochondrosis, as well as the state of sleepy and subclavian arteries. The study is carried out for headaches, dizziness, hypertension, various signs disorders of blood supply to the brain.
Color duplex (triplex) scanning of the arteries of the extremities allows you to assess the condition of the arterial walls, the presence of atherosclerotic changes, the degree of stenosis of the lumen, and the nature of the blood flow. The method is indispensable for the diagnosis of obliterating atherosclerosis, Raynaud's syndrome, and surgical interventions on the arteries.
Color duplex (triplex) scanning of veins limbs is the most informative method for varicose veins, it is applied for early diagnosis thrombophlebitis, determining the need for surgical treatment, as well as monitoring the condition of the veins after surgical intervention. The method is indispensable for diagnosing deep venous system limbs, detection of thrombosis. Vein examination lower limbs is mandatory when preparing for abdominal surgery.
Transcranial color duplex (triplex) scanning allows you to assess the state of blood flow in the vessels of the base of the brain.

The high resolution of the modern devices used in our clinic allows us to detect even small changes in blood flow or vessel structure.

As a result, it becomes possible to determine the cause and degree of circulatory disorders in human organs and tissues, as well as more accurate and targeted implementation of therapeutic measures.

What is functional diagnostics? This is one of the branches of medical science that combines a number of diagnostic procedures, which allow us to objectively assess functionality all organs and systems of the human body.

Functional diagnostic methods

Taking an electrocardiogram.
Echocardiography.
Holter monitoring of the electrocardiogram.
Treadmill test (cardiographic study performed under stress).
Color scanning of blood vessels: both duplex and triplex.
Electroencephalogram.
Lung ventilation testing and assessment

The place where they are carried out is the functional diagnostics room. Now let's talk about the various methods in more detail.

Electrocardiography

This method got greatest distribution and fame, moreover, it is one of the main ones in this section of medicine. An electrocardiograph records and records on paper or electronic media indicators of cardiac electrical activity, thanks to which a functional diagnostics doctor can, by deciphering the information received, identify many health problems in the patient, if any. Any conduction and rhythm disturbances are also detected. A specialist can assess how well the myocardium copes with its functions and diagnose various ischemic changes even at the very early stages of development, including such a dangerous pathology as myocardial infarction. The procedure for taking an electrocardiogram does not pose any danger to the patient’s health and is absolutely painless. It is carried out by a functional diagnostics nurse. Modern equipment that records ECG, in addition to actually conducting the study, is capable of accumulating a colossal amount of data in its memory, and also, based on it, carrying out quality control of the courses of treatment completed by patients.

Electrocardiogram with stress

Second title this method- diagnostics. Its peculiarity is that the electrocardiographic study is not carried out in supine position, and while the patient receives physical activity on a special running track.

Using a treadmill test you can obtain the following data:

Hotler monitoring of electrocardiograms

This method is used to evaluate the work of the heart of the person being examined throughout the whole day. Its location is the Department of Functional Diagnostics. With help, you can record any types of arrhythmia (especially those that occur from time to time and do not last long) and identify the early stages of coronary heart disease. Such functional diagnostics are used to determine the presence of indications for surgical intervention on the heart, coronary angiography, correction of drug therapy.

24-hour blood pressure monitoring

This method of measuring blood pressure is carried out by almost every department of functional diagnostics. It is used to assess how effective the patient’s drug correction of blood pressure is. For this purpose, the patient is connected to portable device, recording how blood pressure levels change against the background of the patient’s normal lifestyle. It is this method that often helps to identify a person’s true A/D level, by eliminating situational hypertension that occurs as a reaction to the stress caused by a person’s visit to a medical facility. In addition, 24-hour monitoring helps to identify such a prognostically unfavorable symptom as nocturnal hypertension.

Echocardiography

This technique has great importance to determine the characteristics of the structure and functioning of the heart and great vessels. This examination is carried out by a functional diagnostics doctor. Echocardiography allows you to:

Identify the presence of both congenital and acquired defects in the structure of the heart.
Evaluate the structure and operation of valves.
Determine the thickness and functioning of the myocardium in patients suffering from coronary heart disease, hypertension and other diseases of the cardiovascular system.

Electroencephalography

This examination makes it possible to assess the condition of the brain based on the determination of bioelectrical activity. Functional diagnostics of this organ is necessary if the presence of various neurological pathologies is suspected, such as:

encephalopathy;
frequent fainting;
oncological diseases;
epilepsy, etc.

Color scanning (duplex and triplex)

This method is the most modern and informative in terms of studying blood vessels sick. It makes it possible to see both the vessels and surrounding tissues, in the same way as with a simple ultrasound, in addition, to study the blood flow using its color mapping and spectral analysis, which are based on

Color scanning (duplex or triplex) includes such functional diagnostic techniques as:

Accurate data about the processes inside the body make it possible to judge its health. The functional diagnostics room of the Diagnostic and Treatment Center on Vernadsky has modern equipment necessary for a thorough examination of patients.

The equipment helps determine the state of the cardiovascular system and identify various pathologies:

heart rhythm disturbance;
heart overload;
extrasystole;
atrial fibrillation;
acute and chronic heart failure;
heart injuries;
disturbances in the blood supply to the heart muscle.

Natalia Varennikova 31.05.2019

Good afternoon :) I express my deep gratitude to the professional doctor with a capital P! Krasnov Sergey Aleksandrovich, you gave health to our knees and ankles! Sergei Alexandrovich prescribed and carried out treatment for me, which brought results! My knees are fit for life and sports again! :) I wish such a doctor great health, so that long years helped people!!!
And also, thanks to everyone attentive girls from the reception, and those who do the MRI!
Sincerely, Natalya Varennikova.

Nikolay 05/14/2018

Guryanova Valentina Andreevna from the Children's Hospital on Vernadsky is a doctor from God! You helped me a lot. I didn't even hope that my problem would be resolved. In the end everything is fine. I am very glad that I had an appointment with you.

Main directions of examinations

The Center carries out diagnostics of blood vessels, brain, bronchopulmonary system.

Patients can undergo the following types of studies:

electrocardiography;
24-hour Holter ECG monitoring;
spirography;
24-hour blood pressure monitoring.

Functional diagnostics can be recommended by the attending physician for a number of diseases, as well as for suspicious symptoms, pain, or deterioration in health. The basis for referral for examination is the medical history and Current state patient. Some types of tests require preparation. The patient is warned about this in advance.

In our medical center in Moscow you can undergo comprehensive functional diagnostics of the body. Services are provided experienced doctors. The cost of examinations allows you to save money.

Functional diagnostics room. Organization of the work of the department (office) of functional diagnostics

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Naumchik Tatyana Ivanovna

Techniques

Electrocardiography (ECG)

Holter ECG monitoring

24-hour blood pressure monitoring (ABPM)

Echocardiography

Electroencephalography (EEG)

Color duplex (triplex) scanning

Functional diagnostic methods

Electrocardiography

Electrocardiogram with stress

Hotler monitoring of electrocardiograms

24-hour blood pressure monitoring

Echocardiography

Electroencephalography

Color scanning (duplex and triplex)

Main directions of examinations

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