Multifunctional esophago-gastro-intestinal probe maksimova

 

The invention relates to medicine, more specifically to surgery, and can be used in patients with surgical diseases for prevention and treatment of complications, including postoperative. The device is designed as a three-channel tube that is at least 0.5 m from the input end branched into two probe fitted caps. Single-channel infusion probe made a continuation of one of the channels of the tube opening side opening of a diameter less than the internal diameter of the probe located in front of the tip. Dual evacuation probe made a continuation of the suction channel and an evacuation channel, which is formed by a longitudinal diametrical partition between them, not reaching to the tip by a distance equal to at least half the diameter of the tube, or made with a hole equal to at least half the diameter of the tube. The suction channel is made with a number of side holes. In the expanded functionality of the probe, allowing to reduce the number of complications, duration of treatment and the mortality rate. 1 C.p. f-crystals, 2 Il.

The invention relates to medicine, more specifically to surgery, and may posleoperazionny.

The purpose of the proposed probe the possibility of a permanent decompression, washing with simultaneous aspiration of the content of any site esophago-gastro-intestinal tract (PICT), aspirazione-washing treatment of a purulent cavity formed in the presence of a defect in the wall PICT, in combination with the possibility of the simultaneous holding of enteral nutrition via the underlying or other parts of the esophago-gastro-intestinal tract, formed as a result of surgery or pathological process.

Known probe Muller-Abbott, which consists of two coaxial tubes: PVC with a diameter of 2.5 mm and a rubber with a diameter of 0.5 mm At the end of the PVC tube fortified Oliva from normal duodenal probe, over which tied the balloon of thin rubber length 5,0 see a Rubber tube ends, not reaching 1.5 cm to spray (Linevsky Y. C., Pavlov, I. C. Artificial hypotension in the x-ray of bowel disease. - Kiev, 1976, s 26-28).

The disadvantage of this probe is the impossibility of uniform distribution of liquid dosage forms along the length of the intestine, as well as a greater likelihood of injury when its introduction in orzowei two channels, one of which is executed with a number of side openings, and a hollow tip, while the partition wall is separated from the tip by a distance equal to at least half the diameter of the tube.with. 880432, A 61 M 25/00, 1981).

The disadvantage of this probe is the impossibility of simultaneous decompression with lavage of the stomach and small intestine, as well as problems, other functions of the probe, as, for example, aspirazione-washing treatment, enteral nutrition, etc.

Also known probe containing in its design, the gastric tube with side holes at the working end, performed on 1/4 - 1/5 of the length of the gastric probe, and intestinal probe. While gastric tube made in the form of telescopic tubes: outer to output the intestinal probe and internal open working end (SU 1306586, from 30.04.1987).

Although this probe is designed to study the secretory functions of the digestive system and allows the sampling of gastric and intestinal contents at the same time, however, the known probe is not intended for the implementation of enteral enteral nutrition in the treatment of gastro-intestinal tract.

Closest to the proposed probe is a gastrointestinal probe containing the 3-channel tube, the right at least half the diameter of the tube and forming two channels (see 2074743, 10.03.1997, a 61 M 25/00).

The disadvantage of this probe are insufficient washing of the walls of the stomach and intestines, since the supplied wash solution immediately sucked into the side holes of the suction channel because of the proximity of their location, interacting mainly only with the walls of the probe. In addition, for the same reason, through a tube of known construction it is impossible to provide decompression of any Department of the gastrointestinal tract with concurrent enteral enteral nutrition. Moreover, it is impossible to ensure not only simultaneous, but even in sequence required to the above measures - decompression, irrigation aspiration, aspirazione-washing treatment of purulent cavity and enteral nutrition through the same probe.

Thus, the disadvantages of the known probe, as well as other known probes are the inability to simultaneously provide specified medical events in different parts of the esophago-gastro-intestinal tract and especially outside of it. Under “various” plots we understand not only above or below the departments continuous esophago-gastro-intestinal tube, as well as various razobscheniyu loop ulcers in the stomach resection in the modification of Billroth 11.

To remedy these shortcomings is an important task for both emergency and planned surgery are often circumstances (factors) that dramatically increases the risk of insolvency of intestinal sutures or already led to insolvency. In particular, these include increased pressure in the cult of 12 duodenal ulcer after gastric resection (long afferent loop of intestine is too high fixing it to the lesser curvature of the stomach, narrowing of the anastomosis, postoperative pancreatitis and others) from 200 to 500 to 600 mm of water.article or drastically reduce the reliability of the joints stump 12 duodenal ulcer, pathological processes in piloroduodenalnoy zone (inflammatory infiltrate, scarring, inflammation, low localization of ulcers with its penetration into adjacent organs and other). In such cases, it is highly advisable to conduct continuous decompression with the evacuation of the contents of the afferent loop anastomosis, especially from the area of the stump 12 duodenal ulcer to prevent the insolvency of its seams and at the same time to carry out a discharge loop anastomosis through the same probe enteral nutrition and reinfusion intestinal chyme, evacuated to cause the loop. A similar situation can occur in other transactions on zheo organ of the digestive tract of a purulent cavity, located, of course, outside of this drainage (parachanna). For example, perforation of the esophagus at endoscopy, a false stroke, and purulent cavity in the mediastinum (purulent mediastinic) when using the probe to continuously aspirate with washing purulent cavity in the mediastinum with the simultaneous introduction of nutrient solution through the same probe in the stomach. Moreover, it is desirable to be able to install this probe also endoscopically without the need for traumatic surgical intervention.

Thus, such situations arise when the threat of development or already developed insolvency seams of the digestive tract, damage to the various departments of this tract and other circumstances. Particularly difficult are sick, have a number of remedial measures (evacuation, flushing, decompression, aspirazione-washing treatment with concurrent enteral nutrition) should be carried out not only by the natural passage of content PICT, and equal to its departments or outside.

The present invention is the creation of multi-esophago-gastro-intestinal probe adequately the treatment of purulent cavity, formed in the presence of a defect of a hollow organ of the digestive tract with concurrent enteral nutrition and reinfuse intestinal chyme, allowing these mutually exclusive processes (evacuation and infusion) not only during the natural passage of the digestive tract, and, most importantly, in its different departments, dispersed in the surgery or pathological process.

The aim of the present invention is to expand the functional capabilities of the probe, allowing to reduce the number of complications, duration of treatment and mortality rate.

The problem is solved in that in the esophago-gastro-intestinal probe containing tube, inside of which is a longitudinal diametral partition forming two channels - one of which sucks, another evacuation, made the third longitudinal channel along the wall of the tube for feeding the nutrient solution. That is, the probe has a 3-channel tube that is at least 0.5 m from the input end branched into 2 independent probe single probe, which is a continuation of one of the channels of the channel tube, and dual evacuation probe, which is prodoljenii.

The total diameter of the three channels corresponds to the diameter of the anatomical area of introduction into the gastrointestinal tract through the nasal passage, a gastrostomy tube, jejunostomy, and the channels included in the channel of the tube, may have a different shape in cross section, for example in the form of powellites.

In Fig.1 shows a General view of the probe section, Fig.2 - section a-a, B-B, In-C.

Probe esophago-gastro-intestinal (infusion-emergency) consists of a flexible three-channel tube 1, branching at a distance of not less than 0.5 m from input 2 independent probe fitted with lugs, one of which is dual channel, which is a continuation of sector 2 of the tube 1, with a longitudinal diametrical partition 3 not reaching the input end of the probe or handpiece at a distance equal to at least half the diameter of the tube, or made with the same size hole 4, forming the suction channel 5 with a number of lateral holes 6 and evacuation channel 7. Another probe - single-channel infusion - is a continuation of the longitudinal channel 9 of the tube 1, the open side of the hole to a diameter less than the internal diameter of the probe is placed in front of a tip.

The probe operates as follows. After wauwie two branched from the main channel tube of the probe, the length of which is formed by individual, depending on the disease, even before the introduction. Dual evacuation probe installed in the cult of duodenum 12 for continuous decompression or purulent cavity through a defect in the wall of the intestine to conduct aspirazione-washing treatment. Single-channel probe spend for food, medical treatment and compensation of possible losses intestinal chyme in the discharge loop of the intestine (resection of the stomach in the modification of Billroth 11) or distal to the defect of the intestinal tube (wall). To the channel without side holes, plug the exhaust. With a stream of atmospheric air through the side holes (6) in the channel (5) is sucked from purulent exudate cavity or the contents of the stump 12 duodenal ulcer, moves through this channel and through the opening (4) in the diametrical partition (3) rush into the channel (7) and evacuated in the Bank-book. At the same time on the channel (9) serves nutrient and/or medical solution, optionally together with intestinal chyme to correct the protein, electrolyte and other types of exchange.

Thus, the present design of the probe allows the evacuation of the contents of the various atypical located in th because of a defect in the wall of a hollow organ of a purulent cavity with simultaneous infusion of nutrients, medical solutions below its departments in the course of natural passage.

The proposed probe can be installed in the gastrointestinal tract through the gastro - or jejunostomy.

An example implementation.

Patient Z. 65 years over into the pancreas penetrating ulcers of the bulb 12 duodenal ulcer was performed resection of the stomach by the Comptroller-Finsterer. With severe technical difficulties were the mobilization of the pyloric stomach and bulbar part of duodenum 12, and the closure of stump 12 duodenal ulcer. Last sutured single intestinal suture and peritonsillar the capsule of the pancreas. On the 2nd day on the background of hyperthermia and moderately significant pain syndrome in the right half of the abdomen, mainly right mesogastric, was suspected, and later radiographically confirmed partial failure of the joints 12 duodenal ulcer and communicating with her inner hiss intraabdominal under hepatic abscess. Patient was operated again. The abscess cavity is opened, sanitized, and drained the tube TIMC 24. In the stomach, introduced the proposed infusion-evacuation probe and after removing the clamps evacuation is acanella (single probe) - in a discharge loop gastrojejunostomy. After surgery TIMC - 24 and the channel without side holes, dual side-channel probe (tube) connected to the suction through the banks-collections (each separately). Through single-channel probe (tube) in a discharge loop of intestine was conducted infusion of nutrient solutions (entity) and diluted intestinal chyme derived from afferent loop anastomosis. On the 6th day after the second operation on the background of a significant improvement of the patient's condition marked obliteration of the internal fistula stump 12 duodenal ulcer, and on the 11th day the obliteration of the cavity of the abscess. She recovered.

Claims

1. Multifunctional esophago-gastro-intestinal probe containing a suction channel with a number of side openings, characterized in that it is made in the form of a three-channel tube that is at least 0.5 m from the input end branched into two probe fitted with lugs, a one - channel infusion probe, is a continuation of one of the channels of the tube opening side opening of a diameter less than the internal diameter of the probe located in front of the tip, and dual evacuation probe, is p the city between them, not reaching to the tip by a distance equal to at least half the diameter of the tube, or made with a hole equal to at least half of the tube diameter.

2. The probe p. 1, characterized in that the channels can have different shapes in cross section.

 

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