OBJECTIFICATION OF THE DEPTH OF LIMB ISCHEMIA DURING MILITARY MEDICAL COMMISSION DURING MARTIAL LAW

Summary. Aim. The optimization of the method of examination of patients with suspected ischemia of the limbs when conducting a military medical commission during martial law. Materials and methods. 46 men (25-59 years old) with suspicion of chronic limb ischemia were examined. Examination of each patient was carried out according to both standard and optimized methods. The standard technique included a survey, physical examination, rheovasography, optimized - instead of the latter, it included photoplethysmography, perfusion index, tests with loading and cooling. Results and their discussion. Chilliness was noted by 14 people, intermittent gait – by 19, pain – by 38. In 7 examined, the pulse on the main arteries was preserved. According to the standard method, ischemia was diagnosed as the leading syndrome in 43 (93.5 %) patients, including compensated – in 18 (39.1 %), subcompensated – in 23 (50.0 %), decompensated – in 2 ( 4.3 %). Alternative pathology was diagnosed in 2 (4.3 %) patients. In 1 (2.2 %) patient, ischemia was assessed as a non-conducting syndrome. According to the optimized technique, ischemia was diagnosed as the leading syndrome in 36 (78.3 %)* patients, including compensated – in 19 (41.3 %), subcompensated – in 13 (28.3 %)*, decompensated – in 4 (8.7 %). Alternative pathology was diagnosed in 6 (12.8 %) patients. In 4 (8.7 %)* patients, ischemia was assessed as a non-conducting syndrome (* – differences are significant). Photoplethysmography, perfusion index, tests with loading and cooling made it possible to more objectively determine the degree of impaired blood flow and functions, which is the main criterion (according to Order No. 402) for determining the degree of suitability for military service. Conclusion. When conducting VLC in persons with suspicion of chronic limb ischemia, the perfusion index should be used as an objective (quantitative) criterion of the degree of regional blood flow disturbance, in particular, when evaluating the results of functional tests with exercise and with cooling.