A four probe for enteral nutrition with balloon fixation
The invention relates to medicine, namely to surgery. The probe contains four channels and locking the container in the form inflate the cuff at the distal end. For distal canal to the cylinder a wide channel has additional holes for internal drainage between the stomach and the duodenum. The first narrow channel serves for the introduction of drugs into the lumen of the esophagus and opens holes in the middle of the probe. The second narrow channel for inflating the retention balloon. The third channel is designed for enteral nutrition. The invention allows to extend the functionality, to provide a fixation on a certain level that facilitates insertion of the probe. 2 Il. The invention relates to medicine, namely to surgery.The modern concept of nutritional therapy in the correction of metabolic disorders in patients with surgical sepsis is early intracolonic the introduction of nutrients, nutrients and probiotics. However, the installation of nutrient probe, his fixation on a certain level of ulcer prophylaxis erosive lesions of the esophagus and stomach are conjugate axis for the evacuation of the duodenal stump after resection of the stomach Billroth-2 in the modification of the Comptroller - Finsterer.The prototype of the invention is a dual probe for enteral nutrition and drainage of the stomach . One channel was left gastric contents, according to another opening in the lumen of the jejunum, was enteral nutrition. However, setting this probe was performed intraoperatively, introducing it with the help of an endoscope is connected with certain difficulties: when removing the endoscope often is associated destruction of the probe.In connection with the above, we have developed a four nasointestinal probe for eneraljnogo power with balloon fixation. According to our data the application it is advisable for patients in a critical condition in violation of motor-evacuation function of the stomach, dynamic intestinal obstruction to stimulate motor function of the intestine and correction of metabolic abnormalities. When the above conditions occurs, the dissociation activity of the stomach and intestines, erosive lesions of the esophagus and stomach. Therefore, it is preferable to drive the nutrient mixture in the duodenum, bypassing the stomach.Effect: enhanced functionality, the ability to commit to a certain level the probe 6 mm, length 1500 mm At a distance of 100 mm from the distal end it has a blown cylinder 1 rounded shape with a volume of 30 ml (30000 mm2).In Fig.2 shows the arrangement of the channels of the probe section at different levels: cross section a-a proximal portion of the probe; section b-b to the locking cylinder; section-With - following the locking of the container.The probe has a single wide channel and three narrow.Wide channel 5 (Fig.2) with the cross-sectional area of 4 mm2passes through the probe and opens six holes 2 (Fig.1) with a diameter of 1.5 mm for the distal end of the probe to inflate the balloon, and eight holes within 10 cm from the balloon in the proximal direction. Through this channel is the evacuation of stagnant contents of the stomach and duodenum 12.The first narrow channel 6 (Fig.2) with a diameter of 1.5 mm through the entire probe and opens a hole 4 (figure 1) at the end of the probe. It serves for the introduction of nutrient solutions into the lumen of the intestine.The second narrow channel 7 (Fig.2) with a diameter of 1 mm continues to 800 mm from the proximal end of the probe and opens ten holes 3 (Fig.1) with a diameter of 0.7 mm during the last 270 mm It is used for continuous administration of antacid components in the lumen of the esophagus.T the/p>The proposed probe is used as follows.The probe is inserted through the nasal passage into the oropharynx, picked up by the manipulator fibergastroscope and carried with it into the duodenum. Locking cuff through the second narrow channel is inflated to the desired volume with subsequent careful removing the endoscope. When this bloated cuff rests on the pyloric sphincter and thereby fixes the probe at a certain level of the duodenum.After installing the probe through the third narrow channel starts continuous drip infusion of saline (saline, ringer's solution, Hartmann, Trial and so on) into the duodenum. Is reflex, mechanical and chemical stimulation of the peristaltic movements of the intestine, as well as the leaching of toxins from the intestinal lumen.When excess stagnant content in the stomach and duodenum is removed through a wide-channel probe. Through a wide channel is internal drainage between the cavity of the stomach and duodenum by discoordination motor-evacuation function of the stomach and intestines. The disappearance of congestive separated by a wide channel of the probe is theAt the same time in the prevention and treatment of erosive lesions of the esophagus and stomach through the first narrow channel into the esophagus with the help of dosing solutions are introduced with antacid components (Almagell, Maalox, etc.,) at the rate of 1-2 ml/hThis probe was used in 12 patients. The time spent on the installation of the entire system - from the introduction of the endoscope prior to the operation amounted to (19,42,6) min. Stay of the probe in the gastrointestinal tract was (4,21,8) days. Any complications were noted.Example. Sick of Badrutdinov 38, No. 17925, was admitted to the intensive care unit 20.09.2001 with a diagnosis of Posttraumatic infected pancreatic necrosis, retroperitoneal abscess, diffuse purulent-fibrinous peritonitis. The severity of the condition on a scale of ARACNE-II 17 points. On the first day with the help of an endoscope installed-channel probe for enteral nutrition with balloon fixation, started the infusion of salt solutions (starting mode) in the amount of 1500-2000 ml / day. Through the first narrow channel had been dosed supply of antacid drugs. On the second day showed signs of intestinal peristalsis. Initiated the introduction of nutrient mixtures. Precreasing tube feeding. When control EGD signs of ulcerative the gastrointestinal tract is not revealed. The patient was in the ICU 10 bed days, the presence of the probe in the intestinal tract 6 days. In the future, the condition improved, the patient was discharged with recovery.Sources of information1. Slabinsky N. N., Yarmilko P. F. Probe for enteral nutrition. Clinical surgery. - 1985 No. 1, S. 74 and 75.2. Abbott, W. O., A. J. Rawson A tube for use in postoperative care of gastroenterostomy patients - correction. //JAMA. - 1939, vol. 112, p.2114.
ClaimsProbe for enteral nutrition containing a channel for drainage with a hole and a channel for enteral nutrition, characterized in that it introduced the locking cylinder mounted on the distal end of the probe and is made in the form inflate the cuff, the channel for inflating the cuff up to the cuff, and a channel for the introduction of drugs, and the channel for the drainage passes through the probe and contains additional holes over from the distal end of the tube to inflate the balloon for drainage between the stomach and duodenum, the channel for the introduction of drugs ends in the middle of the probe and on the last section of OS probe has at the end of the feed holes of salt and nutrients in the duodenum.
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
SUBSTANCE: method involves carrying out thoracocentesis, introducing draining tube and fixing it in chest wall. The tube is fixed by introducing corrugated part of device for draining pleural cavity into trocar stiletto cylinder sleeve, moving it into the pleural cavity and fixing corrugation near costal part of parietal pleura. The device has trocar, draining tube, tubular pusher for moving the tube into the pleural cavity and external fixing member. The trocar is manufactured as stiletto having an enveloping cylinder sleeve. The draining tube has corrugation manufactured some distance away from draining tube end, the distance being equal to purulent cavity size determined in X-ray examination. The corrugation collapses when being introduced into the cylinder sleeve. The fixing member is manufactured as plate having a hole tightly embracing the draining tube.
EFFECT: enhanced effectiveness of treatment irrespectively of patient chest wall thickness; reliability and accuracy in tube fixation.
2 cl, 4 dwg
FIELD: medical equipment.
SUBSTANCE: catheter has flexible catheter tube and device for controlled deviation of distal end part of catheter tube. Device for controlled deviation of distal end part of flexible catheter tube is made in form of wire conductor made of springing elastic material. Conductor is capable of free moving along catheter tube into neutral position or initial position. As a result, when conductor is more or less pulled in relatively its initial position, end part of flexible catheter tube does move. Conductor has twisted spiral-shaped end part which when being in neutral or initial position takes place directly in opposition to external end of catheter tube. As a result, when wire conductor is pulled in relatively its initial position inside flexible tube, the end part of tube deflects at adjusted angle under influence of compression power of twisted spiral-shaped end part, which straightens forcedly.
EFFECT: minimal invasive surgery; ability of controlling catheter tube outside patient's body.
5 cl, 2 dwg
FIELD: medicine, oncology.
SUBSTANCE: method involves autoblood sample taking off in the amount 200-250 ml into a sterile flask with hemopreserving agent "Glugitsir" followed by centrifugation at 1500 rev/min for 30 min. Then supernatant plasma is placed into another sterile flask with a hemopreserving agent and cellular precipitate is reinfused. A single dose of a cytostatic agent is mixed with 10-100 ml of autoplasma, incubated at temperature 37°C for 1 h and administrated through catheter in abdominal cavity by puncture in lower quadrant of abdomen. Procedure is repeated if necessary. Method provides decreasing toxicity of chemotherapy, simple method and uniform distribution of volume of injected preparation for all abdomen cavity. Invention can be used in carrying out chemotherapy of abdomen cavity tumors with ascites.
EFFECT: improved method for treatment.