Method direct endolymphatic ozone

 

(57) Abstract:

The invention relates to medicine, surgery may be used in endolymphatic ozone. Allocate the lower pole of the right superficial inguinal lymph node. Allocate the upper pole of the left superficial lymph node. Resetinput the pulp of the lymph node. Kateteriziruyut lymph node truncated half subclavian catheter. The edge of the proximal end of the catheter upravlyaut flame. Injected through the catheter to 20.0 ml of ozonated ringer's solution, the rate of infusion of 20 ml/h ozone Concentration of 2.0-2.5 mg/L. the Introduction is carried out 4 times daily for 8-12 days. The method allows to increase the efficiency and quality of direct endolymphatic ozone.

The invention relates to medicine, in particular to surgery.

The known method antegrade endolymphatic infusion by exposure of the surface of the inguinal lymph node resection of the lower pole and remove the pulp of the lymph node, introducing and fixation of the catheter, infusion, removal of the catheter (see ed. mon. USSR N 645984, class A 61 B 17/00, 1968).

For reasons that impede the achievement of specified following technical result when using the known method, the second pole of the lymph node, which leads to difficulty performing resection and catheterization of the left inguinal lymph node right-handed surgeons, because it is run not with hands-operating surgeons.

The closest way to the same destination to the claimed invention on the totality of symptoms is the way antegrade endolymphatic infusion by catheterization of the inguinal lymph node resected pulp (see RF patent N 2012236, class A 61 B 17/00 A 61 B 17/12, A 61 17/22, 1990) prototype.

For reasons that impede the achievement of specified following technical result when using the known method, taken as a prototype, is that in the known method has the following disadvantages.

1. The operation catheterization of the superficial inguinal lymph node is performed under local infiltrative anesthesia. This leads to difficulties in the production of skin incision and subcutaneous fat directly from the selected lower pole of the lymph node due to improper contouring in the infiltrate. Detection of lymph node in infiltration after skin incision is difficult and leads to unnecessary trauma to the lymph nodes and surrounding tissues, as well as the need to increase skin is impotenauses subject to additional trauma to the tissue, that increases the likelihood of avascular necrosis of the tissue at the surgical site. It simultaneously with the chemical effects of the anesthetic solution increases even more the likelihood of avascular necrosis and blockade lymph drainage ways not only catheterizing lymph node, and nearby lymph nodes.

2. When suturing subcutaneous fat and skin over the lymph node after resorption of infiltration from local infiltrative anesthesia may change the relationship between the dissected soft tissue and lymphatic vessels, which in turn can lead to break imposedon and violation lymphocirculation at the surgical site.

3. Used for resection and catheterization of the inguinal lymph node, only the lower pole of the lymph node, which leads to difficulty performing resection and catheterization of the left inguinal lymph node right-handed surgeons, because it is run not with hands-operating surgeons.

4. To impose a purse string suture on the capsule of the lymph nodes after resection of the lower pole and remove the pulp of the lymph nodes, especially of the left inguinal, right-handed surgeons is very difficult and fraught with inconvenience and difficulty of operation. This in most cases leads to the choice for alarmanlage catheter, used for catheterization of the lymph node, and around which impose fibrillogenesis, and it is of great importance as to perform the operation, and postoperative complications.

6. Do not specify the length of the standard PVC catheter, which is used for catheterization of the lymph node, and around which impose fibrillogenesis, and it is of great importance for the development of postoperative complications related to catheter care and accumulation in it "stagnant" lymph.

7. The operation under local anesthesia in inguinal areas associated with more emotional distress and lack of patients, which can lead to failure patients from surgery in the preoperative period.

The task of the invention is the reduction of terms of treatment of patients.

The technical result - improving the efficiency and quality of direct endolymphatic ozone therapy, reduction of terms of treatment of patients.

This technical result in the implementation of the invention is achieved in that in the known method direct endolymphatic Oslo, impose a purse string suture synthetic thread 5/0 with an atraumatic needle into the capsule of the remaining portion of the lymph node at a distance of 2 mm from the intended line of resection its pole at 1/6 of the longitudinal size of the lymph node, resettimeout pole lymph node, perform a partial resection of the pulp lymph node, perform the catheterization lymph node truncated half-tubular length standard subclavian catheter with a diameter of 0.6 or 1.0 mm, the edge of the proximal end of which place truncation upravlyaut flame from a distance of 0.3-0.4 cm from the lateral edge within 1-2 s, injected through the catheter at a rate of 20 ml/h 20,0 ml freshly ozonated of ringer's solution with ozone concentration of 2.0-2.5 mg/l, 4 times daily for 8-12 days, remove the catheter. The peculiarity lies in the fact that the operation catheterization lymph node is performed under General anesthesia.

This ensures high efficiency and quality direct endolymphatic ozone therapy, reduction of terms of treatment of patients.

Thus it is essential the following.

1. The method is quite simple and easy to use.

2. The method is reliable in practical use.

3. The method does not require any d and subcutaneous fat directly from the selected pole lymph node due to its good contouring when performing catheterization of the superficial inguinal lymph node under General anesthesia. Lymph node detects immediately after skin incision and subcutaneous tissue, and it does not cause excessive trauma to the lymph nodes and surrounding tissues, as well as the need to increase skin incision to locate the poles of the lymph node. The probability of avascular necrosis of the tissue at the surgical site is negligible. No is the chemical effect of the anesthetic solution in the surrounding lymph node tissue that does not lead to aseptic necrosis and the blockage of lymph drainage ways.

5. The method does not break imposedon and violation lymphocirculation at the surgical site during the closure of subcutaneous fat and skin over the lymph node, since it does not change the relationship between the dissected soft tissue and lymphatic vessels due to the fact that you do not apply local infiltrative anesthesia.

6. The way leading to difficulty in performing resection pole and catheterization of the inguinal lymph node of the right-handed surgeons using for resection of the lower pole of the lymph node for catheterization of the right inguinal lymph node and the upper pole of the lymph node for catheterization of the left inguinal lymph node, because it is run with a hands-operating surgeons.

7. G lymph node prior to resection of his pole and partial removal of the pulp of the lymph node.

8. The use of standard subclavian catheter creates good conditions for infusion through it and facilities maintenance. Truncation standard subclavian catheter half its tubular length does not lead to the development of postoperative complications related to catheter care and accumulation in it "stagnant" lymph due to the characteristic structure of the subclavian catheter and a small length (about 6 cm) and diameter. Melt the edges of the proximal end of the truncated standard subclavian catheter reduces the trauma to them the inner surface of the partially pumpless lymph node.

9. The method does not lead to a failure patients from surgery in the preoperative period, because the operation under General anesthesia in inguinal areas not associated with more emotional distress and lack of patients.

10. Time is reduced by 30% compared with the known method of operation of an exposure, resection pole and intranazalnoe pulp, catheterization of the lymph node, because it does not apply local infiltrative anesthesia, simplified technique of resection and percutaneous lymph node.

11. The method saves partially intranodal bullets is therapy through the use of ozone, which has a strong bactericidal effect and has a high reactive power. If this does not occur in the resistance of the microflora to ozone. Appropriate instead of antibiotics use ozonated ringer's solution.

13. The way potentiates the effectiveness of the primary therapy, has an immunomodulatory effect, improves microcirculation and stimulates reparative processes, anti-inflammatory, antibacterial, anti-stress, analgesic, antifungal activity.

14. Is closed lavage of the lymphatic system by introducing into the lymph stream of ozonized solution of ringer.

15. Improve patient outcomes by reducing the possibility of complications.

16. Reduces lymphogenous intoxication.

17. The method can be used in the treatment of various diseases, there is shown holding antibiotic therapy in combination with antiviral and antifungal therapy.

18. Reduces the treatment time of patients due to the efficiency of the method.

19. Does not require special skills of the surgeon to perform the method.

20. Obta and effectively can be used in patients with viral hepatitis and acquired immunodeficiency syndrome and their combination.

This ensures efficiency and quality of direct endolymphatic ozone.

Conducted by the applicant's analysis of the prior art, including searching by the patent and scientific and technical information sources and identify sources that contain information that has allowed to establish that the applicant had not found a source that is characterized by signs, identical to all the essential features of the claimed invention. The definition from the list of identified unique prototype as the most similar set of features analogue has allowed to establish the essential towards perceived by the applicant to the technical result of the distinctive features in the proposed method, set forth in the claims.

Therefore, the claimed invention meets the condition of "novelty."

To verify compliance of the claimed invention the term "inventive step", the applicant conducted an additional search of the known solutions to identify signs that match the distinctive features of the prototype of the characteristics of the claimed method. The search results showed that the claimed invention does not follow for a specialist t the influence provided the essential features of the claimed invention transformations to achieve a technical result. In particular, the claimed invention does not provide for the following conversions:

- addition of known means of any known part (s), attached (connected) to it according to certain rules, to achieve a technical result, in respect of which it is the effect of such additions;

- replacement of any part (s) of the other known means known part to achieve a technical result, in respect of which it is the effect of such a change;

- the exclusion of any part (element, action) means while the exclusion of its functions and the achievement of a result of such exclusion (simplification, weight, material consumption, increase reliability, reduce process time, etc);

- increase the number of homogeneous elements of actions for enhancing the technical result due to the presence in the vehicle of such elements, actions;

- execution of a known drug or its part (s) of a known material to achieve a technical result due to the known properties of this material;

- creating the well-known rules, recommendations and achievable technical result is due only to the known properties of the parts of this tool and the relationships between them.

The described invention is not based on the change of the quantitative characteristic (s), the submission of such evidence in the relationship or change its appearance. This refers to the case when the known fact of the influence of each of these features on the technical result, and the new values for these characteristics or their relationship could be obtained from the known dependency relationships.

Therefore, the claimed invention meets the condition of "inventive step".

Information confirming the ability of the invention to provide the above technical result.

In patients with surgical pathology, which have surgery under General anesthesia and which shows direct endolymphatic ozone therapy in the preoperative period to receive authorization to perform operations on the underlying disease and catheterization of the inguinal lymph node. In parallel with the operation for the underlying disease perform an operation catheterization lymph node. Their sizes are adults from 8 x 16 10 x 18 mm Under General anesthesia longitudinal slit length of at least 2.8 cm in the projection of this surface of the inguinal lymph node and selected for resection pole cut through the skin and subcutaneous fatty tissue, flag pole lymph node. It is important that emit lower pole of the right or the upper pole of the left inguinal lymph node.

Further impose a purse string suture synthetic thread 5/0 with an atraumatic needle into the capsule of the remaining portion of the lymph node at a distance of 2 mm from the intended line of resection its pole at 1/6 of the longitudinal size of the lymph node, and then perform the resection of the selected pole lymph node, by cutting with a scalpel pole lymph node. Next, a small spoon Volkmann carefully partially resetinput the pulp of the lymph node. Then take the standard subclavian catheter for single use with a diameter of 0.6 or 1.0 mm, truncate its tubular part with a scalpel half its tubular length, the edge of the proximal end of which place truncation upravlyaut flame from a distance of 0.3-0.4 cm from the lateral edge within 1-2 with, check the patency of standard heparin solution, and proximal the and of 4 mm and fasten purse string suture. Injected into the catheter standard 5000 UNITS of heparin solution in a volume of 1 ml and check the tightness of the seam on the truncated catheter. Suture the skin and subcutaneous tissue, the catheter is fixed to the skin. Then not earlier than 3 h after catheterization lymph node, observing all the rules of asepsis and insertion through the tube subclavian catheter injection needle is injected through the catheter at a rate of 20 ml/h 20,0 ml freshly ozonated of ringer's solution with ozone concentration of 2.0-2.5 mg/L. then into the lumen subclavian catheter and lymph node enter standard 5000 UNITS of heparin solution in a volume of 1.0 ml procedure is given 4 times daily for 8-12 days, and then remove the catheter.

Us in this way treated 12 patients with pancreonecrosis and 14 patients with peritonitis.

Example 1. Patient K., 23 years. Did the clinic peritonitis. Operated. Operations revealed diffuse serous-fibrinous peritonitis of appendiceal origin. Performed appendectomy with drainage of the abdominal cavity and catheterization of the right superficial inguinal lymph node on the proposed method. On conservative therapy in the postoperative period, treatment was fighting stopped, disappearance of the signs of intoxication. Discharged on 10-e day from the operation.

Example 2. Patient Z., 22 years. Did the clinic peritonitis. Operated. Operations revealed diffuse fibrinous-purulent appendicular peritonitis origin. Performed appendectomy with drainage of the abdominal cavity and catheterization of the right superficial inguinal lymph node on the proposed method. On conservative therapy in the postoperative period started the treatment by the proposed method. The patient's General condition improved quickly: temperature normalized on the third day, no signs of intoxication. Issued on the 11th day from the operation.

Example 3. Patient B., 49 years old, operated on for acute mixed pancreatic necrosis and peripancreatic infiltrate. Performed under General anesthesia surgery and rehabilitation, drainage stuffing bags and abdominal surgery catheterization of the left superficial inguinal lymph node on the proposed method. In the postoperative period to conservative therapy was conducted endolymphatic introduction through the catheter at a rate of 20 ml/h 20,0 ml freshly ozonated rastvoryennogo catheter. The patient was discharged from hospital in satisfactory condition under outpatient supervision of the surgeon on the 23rd day from the operation.

When analyzing the application of the method in control group consisted of 12 patients and a comparison group of 12 patients.

Comparative data on the use of the method according to time intervals as follows. The traditional way of catheterization of the inguinal lymph node elapsed time 8,51 of 0.68 min, while offer - of 5.89 0,44 min (p < 0,05). The coefficient of efficiency of application of the method 30,8%.

The expediency of application of the method are obvious.

Thus, the presented data suggest the implementation of the use of the claimed invention (method) the following cumulative conditions:

the tool embodying the claimed method in its implementation, is intended for use in industry, namely, in medicine, in particular in surgery;

for the inventive method, it is described in the independent clause sets out the claims, confirmed the possibility of its implementation using the steps described in the application or known before the priority date tools and methods.

Therefore, staticheskoi ozone by catheterization of the inguinal lymph node resected pulp, characterized in that under General anesthesia emit lower pole of the right or the upper pole of the left superficial inguinal lymph node, place a purse string suture synthetic thread 5/0 with an atraumatic needle on the capsule remaining part of the lymph node at a distance of 2 mm from the intended line of resection its pole at 1/6 of the longitudinal size of the lymph node, resetinput pole lymph node, perform a partial resection of the pulp lymph node, perform the catheterization lymph node truncated half-tubular length standard subclavian catheter with a diameter of 0.6 or 1.0 mm, the edge of the proximal end of which place truncation upravlyaut flame from a distance of 0.3 - 0.4 cm from the lateral edge within 1-2 with injected through the catheter at a rate of 20 ml/h 20,0 ml freshly ozonated of ringer's solution with ozone concentration of 2.0-2.5 mg/l, 4 times daily for 8-12 days to remove the catheter.

 

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