The method of selective catheterization
(57) Abstract:The invention relates to neurosurgery, in particular to selective catheterization of the spinal canal and intervertebral holes and local endolyumbalnye pharmacophobia in the treatment of diseases of the nervous system affecting etiology, and can also be used for intravascular manipulations for the dosed administration of medication directly into the lesion. When catheterization produce tougher outer conductor, the promotion of it and the vertebral canal to the lesion epidural catheter, with nested inside the inner conductor. Before attachment to the catheter distal portion of the inner conductor set corresponding to the location of the affected area deviation from the axis of the conductor and return to its original position. The catheter with the wire moving through the outer conductor and the vertebral canal before the adoption of the inner conductor, and with him and a catheter into the affected area previously specified deviations, and when catheterization carry out the lateral deviation of the distal portion. The method allows to avoid damage to the epidural bag at the puncture and catheterization, to avoid slouching the x drugs injected epidurally. 2 Il. The invention relates to neurosurgery, in particular to selective catherization the spinal canal and intervertebral holes and local endolyumbalnye pharmacophobia in the treatment of diseases of the nervous system affecting etiology, and can also be used for intravascular manipulations for the dosed administration of medication directly into the lesion.Diseases of the nervous system affecting etiology, in particular sciatica, are in the overall structure of diseases of the peripheral nervous system up to 80%, are associated with prolonged disability and often lead to disability. It is therefore evident that the search and improve the methods of treatment of this pathology sufficient relevant.With the development of new medical technologies has developed a wide variety of methods of treatment of these diseases, and more recently, minimally invasive, which improves the quality of life of patients. The abundance of different ways indicates that one of them is not sufficiently effective and versatile and has its positive and negative sides.There is a method of treatment of vertebr is NCCI lower sacral foramen and the introduction of large amounts of drugs through a needle and syringe (B. K. The novels. Treatment of radiculitis epidural injection of medicinal substances. HP: Medicine, 1971, S. 59 - 5).There is also known a method of multiple precision needle injection drug mixtures through a needle and syringe directly into the area of irritation of the spine under the control of the computer tomograph (David J. Allison, H. Peterson, A. Hemmigway Interventinal Radiology The NICER Year Book 1994, p. 236), which applies only when formiranih lesions.The closest attainable goals is the way catheterization of the patent of the Russian Federation 2074010, MKI 6 A 61 M 25/08, publ. 27.02.97, bull. N 6, which allows for the manipulation of multiple wires at the proximal section of the inner conductor to provide a deviation managed the distal section of the catheter 360oaround the axis of the tool to advance the catheter through curved sections of vessels and branches.The objective of the proposed technical solution is to provide a method for selective catheterization at the location of the area of the lesion in the spinal canal and intervertebral holes, which avoids damage to the dural SAC at the puncture and catheterization, to avoid accidental introduction of medical prepare.The problem is solved by introducing a rigid outer conductor, the path to the affected area epidural catheter before the catheter into the affected area a predefined deviation. With the catheter in advance include inner conductor with extra soft distal part, which before attachment set corresponding to the location of the affected area deviation from the axis of the conductor and return to its original position. After that, the catheter with the wire moving through the outer conductor and the spinal diseased vertebral holes. Further rotation of the proximal part of the inner conductor to move its distal part, with the possibility of penetration of the catheter into besprovodnikovy hole to a predetermined depth.Introduction external hard conductor through the lower sacral hole and use the walls of the spinal canal as a continuation of the outer conductor when promoting soft epidural catheter inserted in his inner conductor with extra soft distal part gives an opportunity to hold the catheter through the lower sacral foramen at the level of any of the affected spinal segment.What pervoe deviation from 0 to 360ocorresponding to a pre-identified location of the affected area, and return to its original position, allows a precise move the catheter to the affected area, located in mesozonal the hole, to improve the quality of life of the patient.The set of features is new and allows, firstly, to reduce tissue injury that is caused by only one puncture of the spinal canal, to reduce the volume and the dose of the drugs, thereby avoiding General toxic effect of drugs, eliminate damage to the dural SAC and roots, in many cases, to avoid open surgery, to reduce the treatment time, improve the patient's quality of life.The essence of the method is illustrated by drawings, where Fig. 1 shows a diagram of a selective catheterization of the spinal canal, Fig. 2 - scheme catheterization intervertebral holes.In Fig. 1 and 2 the outer conductor 1, an epidural catheter 2, the inner conductor 3.The inventive method is carried out as follows. When the location of the zones in the vertebral canal rigid outer conductor 1 is used to puncture the lower sacral foramen to the spinal canal, the walls to the Oia soft epidural catheter 2 with nested inside the inner conductor 3 (Fig. 1). At the location of the affected area in the intervertebral foramen (Fig. 2) super soft distal portion of the inner conductor 3 specify the lateral and axial deviation from the 0oup to 360ofrom the axis of the conductor corresponding to the detected location of the affected area, and return to its original position. After that, the inner conductor 3 is put into the catheter 2 and the catheter is in the rigid outer conductor 1. Hard outer conductor 1 is introduced into the lower sacral opening up the spinal canal and move it along the catheter with the inner conductor 3 to the affected vertebral hole, then rotate the proximal part of the inner conductor 3 is moved to its distal portion of the catheter. With this movement of the distal portion of the inner guide catheter, getting into the area of the intervertebral foramen, loses a support on the wall of the spinal canal and takes a previously given deviation from the 0oup to 360ofrom the axis of the inner conductor, penetrating into the intervertebral hole to a predetermined depth. The method of selective catheterization by introducing a rigid outer conductor, the path to the affected area epidural catheter before the catheter in the area paratenic with extra soft distal part, which the attachment is set corresponding to the location of the affected area deviation from the axis of the conductor and return to its original position, after which the inner conductor together with the catheter is moved through the outer conductor and the spinal canal to the affected vertebral hole and rotation of the proximal part of the inner conductor to move its distal part, with the possibility of penetration of the catheter into the intervertebral hole to a predetermined depth.
SUBSTANCE: method involves determining required foramen level. Needle is introduced at lumbar, sacral and thoracic segment level in paravertebral way with posterolateral access method and with anterolateral access at the cervical segment level. Tuochi 16-20 needle is applied. The needle is introduced 7-12 cm far from vertebral column median in the direction of intervertebral foramen at an angle of 50-80° to table surface in prone patient position at lumbar, sacral and thoracic segment level. The needle is brought in sliding in lateral direction after it has rested against joint facet. The needle is introduced towards the intervertebral foramen in dorsal patient position. Then, the needle slides from the transverse process in ventral direction. Short-term pain increase being the case, drugs are introduced.
EFFECT: enhanced effectiveness of treatment.
FIELD: medicine, oncology.
SUBSTANCE: the present innovation should be applied at adjuvant chemotherapy in case of tumors of central nervous system. Moreover, while carrying out lumbar puncture it is necessary to perform catheterization of subarachnoidal space. Moreover, one should daily sample liquor at the quantity of 10 ml to be incubated with chemopreparation in vitro for 30 min at 38 C. One should daily introduce chemopreparations upon autoliquor through catheter during the whole period of therapy course. The method enables to choose any mode and duration of endolumbar chemotherapy at its decreased toxicity.
EFFECT: higher efficiency of chemotherapy.
FIELD: oncological diseases.
SUBSTANCE: invention is designed for use in complex treatment of urinary bladder cancer in case of propagation of tumor to sub-epithelium connective tissue. Method comprises transurethral resection and introduction of immune preparations and furacillin solution. Once transurethral resection completed, three-way Foli catheter is transurethrally introduced to patient, through which mixture of standard furacillin solution with 10·106 ME interferon α-2β is injected from the first postoperative day and over following 3-5 postoperative days bringing summary dose of interferon to 50·106 ME.
EFFECT: prevented traumatism of urinary bladder due to single introduction of catheter and assured continuous action of drugs without development of immune complications.
FIELD: medicine, surgery.
SUBSTANCE: method involves carrying out an antibacterial therapy and additional administration of curative mixture consisting of one part of dimexide, two parts of 0.5% of novocaine solution with antibiotic eliciting high the bacteriostatic activity against microflora in duct secret. Administration of this curative mixture is carried out by catheter into injured duct directly by course 1-2 times. Invention promotes to topical sanitation of mammary gland duct and reducing time of disease. Invention can be used in treatment of galactophoritis.
EFFECT: improved method for treatment.
FIELD: medicine, ophthalmology, pediatrics.
SUBSTANCE: method involves irrigation therapy (IT) by retrobulbar catheterization. Before carrying out IT the preparation "Ginkgo biloba" in capsules and age dosage and nasal drops "Semaks" by 1-2 drops for 1 month is prescribed to patient. Then in IT is carried out for 10 days in hospital by administration of cerebrolysin, riboflavin, agapurin, taufon and emoxipine in the dose 0.4 ml of each of them. Preparations are administrated successively, by fractional doses with interval for 2 h in combination with laser-pleoptic treatment at wavelength 0.63 mcm using device "SPEKL" for 10 min, by one procedure per a day for 10 days. After treatment in hospital glutamine and lecithin is prescribed by ambulatory treatment in age doses for 1 month. Method provides the prolonged remission of disease and reduced hospital period due to the complex effect of indicated curative factors on metabolism normalization in nervous cells, their resistance to stress injures, improvement of regenerative and microcirculating processes in eye tissues, frequency-contrast characterization of visual analyzer.
EFFECT: improved treatment method.
SUBSTANCE: method involves introducing probe into the stomach via esophagus. Guiding probe in the stomach and intestine is carried out under laparoscopic control. After having placed the working end in the stomach, elastic conductor is introduced via its internal canal. Flexible tube is introduced as far as possible along the external surface into pyloric sphincter and is arranged on the stomach fundus on the greater curvature. Probe with conductor is introduced along the tube via the pyloric sphincter to duodenojejunal curve. The duodenojejunal curve angle is reduced in instrumental way and by turning the patient to the right side. The probe and conductor are brought behind the duodenojejunal curve by applying axial pressure to the external probe end.
EFFECT: enhanced effectiveness of treatment; reduced risk of traumatic complications.
FIELD: medicine; medical engineering.
SUBSTANCE: device has catheter having internal canal, tube arranged in front of distal catheter end and fixing ligature. Reach-through holes are available in catheter wall for connecting the internal canal to environment medium. The fixing tube has reach-through hole in its wall. Intracorporal fixing ligature end is attached to distal end of the fixing tube. Extracorporal end of fixing ligature is introduced into internal canal of the fixing tube via the reach-through hole in fixing tube wall. Ligature is brought out via proximal fixing tube end, drawn through the internal catheter canal and brought out via proximal catheter end having sealing valve. Pusher having connection rod is detachable from the catheter. The fixing tube is shapable as loop holding the catheter in organ cavity. Method involves applying colonoscopy operation. The place intended for setting catheter being reached with endoscope, the fixing tube and catheter are pushed by catheter through instrumental endoscope canal into hollow organ with their distal ends forward. Pusher rod is inserted into proximal catheter end and catheter pushing through the endoscope canal goes on until the fixing tube and distal catheter end exit from endoscope canal into organ cavity. Then, the fixing ligature is pulled in holding the extracorporal end causing the fixing tube to bend as loop in intestine. The so formed loop is brought to the setting place. The loop is pressed against hollow organ wall and the endoscope is carefully withdrawn from the hollow organ. Pushing catheter into hollow organ lumen is kept on with pusher in concurrently slackening ligature out. The proximal catheter end is removed from the endoscope after withdrawing the endoscope from the organ. The pusher is detached from the catheter. Extracorporal fixing ligature end projecting from the proximal catheter end is caught and ligature slack is pulled up. Valve and catheter are attached to external catheter end. The external catheter end is fixed on body.
EFFECT: high accuracy in delivering drugs exactly to pathological focus.
11 cl, 4 dwg