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 [2]. 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 the

At 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/h

This 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 information

1. 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.

Claims

Probe 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.

 

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