The method of medical treatment of oncological diseases of the human body
(57) Abstract:The invention relates to medicine, namely to Oncology, and is used for treatment and angiographic diagnosis of oncological diseases with separate flow. The invention consists in the fact that the affected cancer process, the body is completely isolated in a part of its blood supply, a certain amount away from isolated vessels of the venous blood, give it dosed chemotherapy and contrast the preparation and return pressure in naturereserves artery of the affected organ. The proposed method provides improved drug exposure by 30 - 50%, reduce side effects and substantial savings of drugs. 1 Il. The invention relates to medicine, namely to Oncology.The method is used in medical treatment of cancer through effects on cancer cell cytotoxic drugs and other chemotherapeutic drugs that they usually accompany.The known method described in "Handbook of endovascular interventions in Oncology, the authors Fisher, M. E., and others, the Institute of Oncology and m is Yat dosed introduction into an artery of the affected organ chemotherapeutic drug, mainly cytostatic and other concomitant medications.The disadvantages of this method are that the cytostatic quickly washed away from the affected organ, most of the cytostatic not interacting with tumor tissue and passing through the capillaries and enters the venous system in an unmodified form. Once in the systemic circulation, cytostatic, not having a selective effect on the tumor, oppressing the whole body, which significantly limits the possibility of increasing its concentration. It also requires a significant amount of expensive cytostatic drug to saturate them with tumor cells, saturation which occurs simultaneously with the saturation of all cells of the body. Attempts to restrict the connection of the vessels of the affected organ with total circulatory system did not lead to success, because the disruption of blood flow caused further intoxication by products of metabolism.The known method does not provide the ability to monitor changes in the concentration of the cytostatic agent directly to the tumor tissue, and selectively increasing the concentration of the cytostatic agent directly in the hearth of the This problem is solved in the proposed method of medical treatment of oncological diseases of the human body, including the identification of the localization of cancer hearth catheterization his bravopadma and cravotta vessels, restricting their connection with the General terms of circulation, drug effects on catheterized body is injected into the blood of chemotherapy drugs, which limit communication amazed cancer process body with a wide range of circulatory perform after percutaneous catheterization by complete isolation of blood flow in catheterized vessels, what is it used for Winternitz catheter with inflated cuffs, from catheterized venous vessels divert the entire flow of blood, obsolet allotted blood flow in a specific physical volume, saturated with oxygen, is introduced into this volume dosed chemotherapy drug, mainly cytostatic him and concomitant chemotherapy drugs, and diagnostic radiopaque liquid, and then judge the uniformity of distribution of its concentration and rate of leaching of the cytostatic agent from the body, then assigned the bloodstream podvodyat closed, isolated from atmosphere device, the control over the location of the catheter within the lumen of the vessels is carried out by means of the electron-optical system for visual observation, while the procedure takes 2-3 hours, once a month, then do a month long break and the course if necessary, repeat.Next, a method will be described in more detail based on the device, which is also described for a better understanding of the invention.The drawing shows an exemplary block diagram of the device used to implement the method.The device for implementing the method has a set of intravascular Winternitz catheters 1, 2 cuffs, and a discharge pipe 3, a dosing unit 4, block oxygenation (oxygenator) 5, the pumping unit and the transfer unit 6, and a discharge tube of the catheter venous vessel 7, is connected to the input of the metering unit 4 dispenser 8, the mixing chamber (9), the output of which is connected to the inlet of the oxygenator 5, in exchange chamber 10 which contains oxygen, and the output is connected to a pumping unit 6, the output of which is connected to Winternitz the catheter with cuff 2, placed in the artery lumen 11 of the affected organ is e.g. (not shown).Further, the method described in more detail based on the examples of its implementation, and drawing.In a patient with cancer determine the localization of the tumor, choose the vessel to isolate the blood flow supplying the body with blood, namely determine which artery and vein will be used in the future.Gynecological tumors, it is advisable to use a percutaneous puncture of the femoral artery and vein by the Seldinger method (1) catheterization of vessels Winternitz cuffed catheters over the guidewire under the control of the x-ray television.During the implementation of the method set Winternitz catheter 1 with the sheath into the lumen of the internal iliac vein. When expanding a cuff last, expands and closes the lumen of the vessel, blocking blood flow. To this end produce percutaneous puncture of the femoral vein by the Seldinger needle (1) with an outer diameter from 1.6 to 2.05 mm Catheter 2 is installed in the lumen of the internal iliac artery with rentgenologicheski control. If the body krovosnabzhayut paired vessels, it is better to install it from destruction by the tumor. For this purpose, is injected contrast agent, usually urographine, in the amount of 20-30 ml / min net with the second lumen of the catheter, inflate the cuff until the complete cessation of blood flow. Control is carried out by injecting a small amount of contrast medium (urographine).In a similar way kateteriziruyut internal iliac artery (2) from the side of the lesion. In contrast is also used urographine. When you put a catheter in the lumen of the internal iliac artery, inflate the cuff 1 and verify the absence of blood flow in the artery through the introduction of a contrast agent.The catheter 1 is connected through the discharge tube 3 to the input of the mixing chamber 8 of the metering unit 4. In the chamber 9 passing blood gets from dosing the dose of the drug, which is mixed with the blood goes to the input of the oxygenator 5, in which the blood is enriched with oxygen. The oxygenator 5 may be made in the form of isolated membranes, washed on one side separated by the blood, and on the other hand gaseous oxygen. After the oxygenator 5, the flow enters the transfer unit 6, the output of which is connected to Winternitz the catheter 2 cuff, and directed into the internal iliac artery 11.This provides a closed process of saturation of the tumor tissue cytostatic without harmful effects on the uniformity of dispensing of fluid, the rate of leaching of cytostatics and its actual distribution in the tissues. In addition, it is possible when the observation density consistency diagnostic fluid to maintain a constant concentration, and to allocate and provide areas where it is possible to increase the concentration by approaching this area of the holes of the catheter, feeding cytostatic (this is true, for example, when selecting a location for sighting sum of cytostatic).The method may be applied to prostate cancer, kidney cancer, liver and in some other cases.The inventive method allows by endovascular observation of the vascular structure of the tumor to control the dynamics of its development or regression under the influence of chemotherapy, to choose and to plan future courses of chemotherapy, to judge the comparative effectiveness of drugs.Here are some examples of the practical application of the method.Example 1.Patient Krisina Nina I., 47 years.History: N - 3033, 1997.Diagnosis: C-r hemangioma T-2 N-1 M-0, post operative treatment in 1995NS in paleo/P> P., I. - 22134-43 Squamous orogovevshi cancer.Given the prevalence of the cancer process, in order to reduce tumors and creating the conditions for radical surgery, solved in the preoperative period to undergo a course of chemotherapy.Given the low effect of chemotherapy carried out by known methods in cancer of the vulva, decided to undergo chemotherapy, as described in the claimed method. To this end, the patient was catheterized internal iliac vein and artery by the Seldinger method. Krovoobrashenie was separated and made controlling the position of the catheter in the vascular bed. System reserved flow connected to the dosing and feeding cytostatic block. In this case introduced Platinum in the amount of 100 mg Next blood mixed with cytostatic, were presented in a block oxygenation, where Bogomils oxygen and using a pumping unit under pressure was introduced into the iliac artery.Prevention of thromboembolism patient entered heparin 25 thousand unitsFor prehydrate patient entered 2000 ml of 5% glucose solution intravenously. The patient has satisfactorily undergone the course of chemotherapy, the tumor umenshenia declared chemotherapy radically in full planned amount.Example 2.Patient Grigoryants Margarita G., 72 years.History: N - 1823, in 1997, he entered the Oncology Department with a diagnosis of C-r hemangioma T 3 N 1 M 1, condition after surgical treatment (in the anamnesis extended vulvectomy in 1996) NS - 2 CL gr.Given the prevalence of the process and radioresistance of the tumor and the lack of a source of fast neutrons (the most effective radiation treatment for common tumors of the vulva), radiation treatment is not recommended.The patient performed the requested chemotherapy. To this end produced catheterization iliac vein and artery using the Seldinger by percutaneous puncture of the femoral vein and artery. In the iliac artery and vein installed Winternitz catheters with cuffs. After controlling the position of catheters made off blood flow and control off circulation. System reserved flow is connected to the dosing unit and the feed solution of the cytostatic agent. Next, the blood, mixed with the cytostatic agent, are fed to block oxygen, after which the oxygenated blood is delivered to the pumping system (roll and tip the pump) and served in the lumen of the catheter, the R heparin at a dose of 25-30 so unitDose of drugs was: Platydema 100 mg, Adriblastina 50 mg Solution of cytostatics were submitted in physiological solution in quantities of 1000 ml.For prehydrate intravenous entered 2000 ml of 5% glucose solution. Introduction glucose is started simultaneously with the introduction of the cytostatic agent.Patient underwent a course of chemotherapy satisfactorily, the phenomenon of dyspeptic disorders (nausea and vomiting) were observed in the weak form.The marked decrease of tumor size (recurrent tumor in the postoperative scar with deep infiltration of underlying tissues), about 30-40% decrease in the area of the tumor, there was a decrease of pain syndrome, decreased effects of cancer intoxication. There was a long remission.Example 3.Patient Mironov Evdokia S., 65 years.History: N - 2217, 1997, was Admitted to our Department with a diagnosis of C-r hemangioma T-C N-1 Mx, infiltrative edematous form 2 CL gr.P., I. N - 16752 - squamous orogovevshi cancer.Given the presence of infiltrative edematous forms of vulvar cancer, surgical treatment the patient was denied (this form of surgical treatment is not showing myotherapy the claimed method. To this end, the method of the Seldinger produced by the puncture of the femoral artery and vein, installed Winternitz cuffed catheters into the lumen of the internal iliac arteries under the control of AO. The accuracy was tested by introducing into the bloodstream of contrast (urographine). The catheters were connected to the mixing chamber of the dispenser. Next, selected blood flow was directed into the mixing chamber of the dispenser, where he mixed with the solution of the cytostatic agent. Next, the flow of blood was sent to the block oxygenation, where, abogadas oxygen, blood through the pumping unit was supplied into the internal iliac artery.Prevention of thromboembolism patient entered 25 thousand units of heparin. As cytostatic introduced the Bleomycin at a dose of 60 mg.The patient has satisfactorily undergone chemotherapy. The tumor decreased in size, slept swelling, pain decreased.In a satisfactory condition the patient was discharged home.The method in accordance with the invention allows for a high concentration of the cytostatic agent in the body with minimal impact on other self.The use of the claimed method allows to reduce the dose rate of Dragostea the RA treatment varies 10-12000 USD).In the proposed method the cost of the necessary quantity of the drug does not exceed 2500-3000 USD, i.e. provides a five-fold saving chemotherapy drugs.According to the proposed method of use of the method was performed by the author 9 operations with satisfactory result.The method may be applied at any location of the cancer, but especially his action will be effective in the localization of the affected organ with blood from one or two vessels. Especially effective this method can be applied in kidney cancer, liver, and with the defeat of the limbs. The method of medical treatment of cancer, including the identification of the localization of cancer hearth catheterization his krovatyami and crovetti vessels, drug effects on catheterized body is injected into the blood of chemotherapeutic drugs, characterized in that the spending limit communication amazed cancer process body with a big circle of blood circulation by complete isolation of blood flow in catheterized vessels, what is it used for Winternitz catheter with inflated cuffs, from Katamari the lead dosed chemotherapy drug mainly cytostatic him and concomitant chemotherapy drugs, and diagnostic radiopaque fluid to control the position of catheters in blood vessels, then assigned the bloodstream serves under pressure in catheterized isolated artery of the affected organ, and this whole operation is performed under the control of the electron-optical system for visual observation, when this operation is performed with a duration of 2 to 3 hours, once a month, then do a month long break and chemotherapy necessary, repeat.
FIELD: medical engineering.
SUBSTANCE: device has catheter having the first end open and additional tubes. The catheter lumen is 2.0-5.0 mm and wall thickness is 1.0-2.5 mm as large. The catheter has cup seal mounted on lateral surface near the first open end, the second rounded dead end and lateral openings for attaching additional tubes near the second dead end. The additional tubes are manufactured as additional ureteral drains. Lumen space near the first end and lumen space near the lateral openings located aside of the middle portion of catheter are manufactured to receive adapters for connecting a system for collecting urine. Middle portion of the catheter is curved as spiral coil having external diameter not more than 7 times as large as external catheter diameter. It is strengthened with thread brought through catheter lumen, the thread having ends taken out through catheter wall under the cup seal. Lateral draining openings equal or unequal to each other in size equally or unequally spaced on the internal coil side.
EFFECT: improved device interaction with surrounding tissues.
3 cl, 2 dwg
SUBSTANCE: method involves applying intracoronary phosphocreatine introduction into infarction-responsible artery when carrying out coronary angioplasty. Phosphocreatine solution is injected after reperfusing the infarction-responsible artery at constant volume rate of 0.1-4 ml/s with introduced phosphocreatine dose being equal to 0.5-4 g.
EFFECT: reduced myocardium necrosis zone; prevented cardiac insufficiency and cardiac rhythm disorders.
FIELD: medical equipment.
SUBSTANCE: inflatable balloon can be used for making catheters which have carrier axial polymer tube with inflatable working medium through hole in wall of tube by balloon dispose at one end and with valve unit for keeping working medium, disposed at the other end. Device is intended for curing detachment of retina by means of blocking rupture of retina under effect of wave of impression generated by inflated balloon. Inflatable balloon has end tubular taps for fastening to carrier axial tube and central inflatable part, which can take shape of sphere, or ellipse either cylinder of the balloon. Walls of balloon are made of three layers of internal and external layers of silicon rubber to have intermediate layer of polyorganosiloxane. Walls are made of three layers of internal and external layers of silicon rubber to have intermediate layer of polyorganosiloxane. According to the second version, tubular sections of silicon rubber are disposed concentrically onto surface of ends of inflatable part; the sections are integrated with the surface of tube. The sections are made for widening at balloon's bulge.
EFFECT: improved mechanical strength; reduced gas permeability.
8 cl, 2 ex, 4 dwg
SUBSTANCE: method involves carrying out fibrogastroduodenoscopy. Flexible tube is introduced into the stomach under fibrogastroduodenoscope control. Distal tube end is tightly connected to balloon manufactured from thin medical siliconized rubber. The balloon is introduced into free abdominal cavity via perforated orifice under fibrogastroduodenoscope control and pumped in dosed way to seal the orifice. The tube is pinched on proximal end and attached to nose wing. Laparotomy or laparoscopy is carried out later when the time required for adequate preoperative preparation to be over. Then the tube and balloon are removed. Surgical defect correction is done.
EFFECT: created favorable conditions for carrying out surgical intervention.
FIELD: medicine, purulent and thoracic surgery.
SUBSTANCE: it is necessary to carry out draining and sanitation of restricted pleural empyema in a patient. Then the drainage should be substituted with a balloon catheter into the balloon of which under roentgenocontrol one should introduce isotonic NaCl solution with water-soluble contrast till complete filling the empyemic cavity and, correspondingly, occlusion of fistula-carrying bronchus. Filled up catheter should be kept for 7 d and then under roentgenocontrol gradually for 14-21 d one should remove the introduced solution. Te quantity of simultaneously removed solution should be determined according to the presence or absence of air drop out of empyemic cavity. After cavitary reduction the catheter should be removed. The innovation enables to provide reduction of pleural empyemic cavity along with occlusion of bronchopleural fistula and, also, prevent aerogenic contamination, stimulate granulation and subsequent cicatrisation of cavitary walls due to the pressure of balloon catheter upon them being filled by the cavitary volume.
EFFECT: higher efficiency of therapy.
3 dwg, 1 ex
FIELD: medicine, cardiosurgery.
SUBSTANCE: the present innovation deals with reconstructing permeability of occluded coronary arteries due to removing occlusion out of affected parts of arteries. So, a coronary guide with a soft tip should be applied to achieve the site of occlusion by not entering a lateral artery. As balloon catheters one should apply two-lumen ones, moreover, the first is designed to be shortened from its distal edge and ends with a balloon segment. The present balloon catheter should be applied up to the site of occlusion onset and simultaneously up to bifurcation region to install it, to be blown up to overlap the mouth of lateral artery. Then a rigid direct guide should be applied along the same balloon catheter - according to its conduit mine after preliminary removing a coronary guide with a soft tip. After directing this rigid guide through occlusion into distal part of occluded main artery and its recanalization with it is important to remove the first modeled balloon catheter and apply the second balloon catheter instead. It should be moved along occlusion to reach the center and dilate the artery. In particular case, one should remove a two-lumen tip by not interrupting the hermetic nature of a balloon catheter. The innovation enables to remove occlusion of the main artery in the site of branching, exclude "falling down" of coronary guide into lateral artery and, thus, provide the disposition of coronary guide especially in the stump in occluded artery and obtain its central position and movement strictly along the center of occlusion avoiding vascular wall traumatism due to subintimal application of coronary guide and, also, avoid arterial perforation in the site of occlusion.
EFFECT: higher efficiency.
1 cl, 7 dwg, 1 ex
SUBSTANCE: method and device can be used for selective treatment of ill parts of tissue or organs of human bodies. Surface of medicinal devices being in contact with mentioned parts of body under pressure of medicinal devices are covered with lypophile, mainly water-insoluble medicinal aids being capable of connecting with any components of tissue, which medicinal preparations effect onto tissue immediately after contact and they effect for very short period of time without making dangerous effect onto adjacent healthy tissue. Device has balloon which surface is connected with lypophile, water-insoluble medicinal preparations being capable of binding with tissue. After contact with tissue is made, medicinal preparations are capable of instant release of biological active matters. Balloon is provided with preformed longitudinal folds. Biological active matter covers parts of balloon hidden by folds.
EFFECT: higher efficiency of treatment.
20 cl, 11 ex
SUBSTANCE: given invention refers to balloon for medicinal equipment, specifically for catheter used within angioplasty containing polyamide copolymer material, characterised by the fact that specified polyamide copolymer material is presented with general formula (I), HO-(PF-OOC-PA-COO-PF-COO-PA)n-COOH, where PA is polyamide segment, PF is diol segment containing dimeric diol and/or corresponding diol polyester with end OH groups and n is number within 5 to 20.
EFFECT: improved plasticity performance.
25 cl, 1 dwg, 3 tbl, 2 ex