Method for carrying out gastrointestinal tract electrostimulation in children

FIELD: medicine.

SUBSTANCE: method involves setting electrodes into the abdominal cavity during operation. One of them is subserously introduced into pyloric region of the stomach. The second one is subserously attached to the ileum in the ileocecal angle. The electrodes are fixed in endosurgical way by means of clepator. The ends are drawn through all layers of the anterior abdominal wall outside and connected to low frequency therapy apparatus. Intestine electrostimulation is carried out during 10-15 min with 10-30 min long pauses until peristalsis manifestations occur. Stimulation is carried out at 0-5 mA, with current intensity growing. Myorhythm 040 is applied as the low frequency therapy apparatus.

EFFECT: reduced risk of traumatic complications.

3 cl

 

The invention relates to medicine, namely to pediatric surgery.

Known way to restore intestinal motility in children, consisting in the use of electrical stimulation of the gastrointestinal tract in the form of application of the dynamic and sinusoidal modulated currents in the region nizhnegrudnogo-lumbar-sacral spine and the anterior abdominal wall ("guidelines for physiotherapy and physioprophylactics childhood diseases" edited by Hamilton-Jacobi equations A.N., Karachevtseva T.V., Moscow, "Medicine", 1987, pp.42-55; Komarova L.A. "Methods of physiotherapy in the rehabilitation of patients after operations on the digestive system", St.-Petersburg, 1998, pp.69-72).

The disadvantage of this method is that to achieve the effect of restoring intestinal peristalsis takes a long time. Children very often are the contraindications to physical therapy due to irritation of the skin and allergic reactions.

Closest to the proposed method is a method of prolonged electrical stimulation of the gastrointestinal tract, in which the active electrode is injected subserous in the front wall of the pyloric calving stomach, and the indifferent electrode subserous in the anterior abdominal wall, and then the wires from the electrodes are brought out through all the layers of the anterior abdominal wall to the outside and connected to electric is the pacemaker (places CENTURIES, Pashkov S.A. and other "Way early prolonged Autonomous electrical stimulation of the gastrointestinal tract". Patent C1 RU # 2216362, 2003, IPC A 61 N 1/36).

The disadvantage of this method is that the frequency and intensity of the electrical pulses of the pacemaker is not regulated depending on the age of the child and vegetative reactions. To install electrodes in the abdominal cavity is performed laparotomy.

The task is to develop a method of electrical stimulation of the gastrointestinal tract, which will allow endosurgical installing electrodes in the abdominal cavity and perform regulated stimulation of the intestine in the postoperative period as necessary.

The technical result is achieved by the use of the invention is to reduce the morbidity method, conducting controlled stimulation.

This technical result is achieved due to the fact that endosurgical way, at the end of endosurgical interventions, install one electrode subserous in the pyloric part of stomach, and the other electrode set subserous in ileocecal corner of the ileum, the wires from the output electrodes and attached to the electrodes of the device low-frequency therapy "BIORITM 040", which picked meant the e current, increasing from minimum to 5 mA for 10-15 minutes with intervals of 10-30 minutes until peristalsis.

Our proposed method is as follows. After endosurgical interventions produce puncture of the anterior abdominal wall in the epigastric region, the needle in the abdominal cavity enter the first electrode and using cleator, in the pyloric stomach of his subserous fix. Similarly the second electrode is carried out through the anterior abdominal wall in the right iliac region and fix it subserous to the ileum at the ileocecal corner. Outer ends of the electrodes coming from the pyloric stomach and ileum, is connected to the electrodes of the apparatus of BIORITM 040" and produce electrical stimulation of the intestine by low-frequency currents for 10-15 minutes with intervals of 10-30 minutes until peristalsis. Start stimulation with the minimum value of the current, gradually increasing to 5 mA. The procedure of stimulation is repeated until peristalsis. After restoring intestinal motility, the electrodes are removed from the abdominal cavity, gently pulling at the outer ends.

EXAMPLE 1.

Patient Z., and/b No. 3581, 15 years old, was admitted urgently to hospital of peritonitis. Operated in an emergency endosurgical way after before perational training. During inspection of the abdomen revealed a large number of purulent effusion, marked paresis of the intestine. After endosurgical interventions, using clepatra in the pyloric part of stomach to the ileum at the ileocecal corner subserous fixed electrodes. One hour after the end of the surgical intervention initiated electrical stimulation of the intestine. The ends of the electrodes bred out, was connected to the apparatus "BIORITM 040" for 10 minutes every 20 minutes and gradually increase the minimum value of the current to 5 mA. The first peristaltic waves appeared after 30 minutes. Peristalsis recovered after 4 hours. After 6 hours began to depart gases. The chair received after 12 hours. Upon recovery of intestinal motility, the electrodes are extracted from the abdominal cavity on the second day, gently tightening their outer ends. The postoperative course smooth. The child was discharged on the 8th day.

EXAMPLE 2.

Patient b, and/b No. 7065, 8 months, was admitted to the emergency order. Diagnosis: acute adhesive intestinal obstruction. Resection of altered bowel and imposed anastomosis end-to-end. For electrical stimulation of the gastrointestinal tract was to be installed in abdominal cavity electrodes. After surgery through an incision in the anterior abdominal wall in EP the gastric region, the needle in the abdominal cavity is entered the first electrode and the pyloric part of stomach he subserous fixed. Similarly the second electrode is carried out through the anterior abdominal wall in the right iliac region and fixed subserous to the ileum at the ileocecal corner. One hour after the end of the surgical intervention initiated electrical stimulation of the intestine. The ends of the electrodes bred out, was connected to the apparatus "BIORITM 040" for 10 minutes every 30 minutes and gradually increase the minimum value of the current to 5 mA. The first peristaltic waves appeared after 1 hour. Peristalsis recovered after 5 hours. Gases have begun to move away after 8 hours. The chair received after 14 hours. After restoring intestinal motility, the electrodes are extracted from the abdominal cavity on the second day, gently tightening their outer ends. The postoperative course without complications. The child was discharged on the 9th day.

The proposed method operated 3 patients. In all cases, was achieved this technical result.

Thus, the proposed method allows you to set the electrodes into the abdominal cavity endosurgical through and managed to hold the contact stimulation of the intestine in the postoperative period. The proposed method can improve treatment outcomes and reduce the time the pre is ivania in the hospital.

1. The method of electrical stimulation of the gastrointestinal tract, including intraoperative installing electrodes in the abdominal cavity with the introduction of one of them subserous in the pyloric part of stomach and removing them all through all layers of the anterior abdominal wall to the outside, the connection to the electrical apparatus, characterized in that the electrodes are fixed endosurgical by using cleator, while the second electrode is fixed subserous to Powszechny intestine at the ileocecal angle, then connect to the device low-frequency therapy and conduct electrical stimulation of the intestine for 10-15 min with an interval of 10-30 min until peristalsis.

2. The method according to claim 1 characterized in that the stimulation is carried out on growing at an amperage of 0-5 mA.

3. The method according to claim 1 characterized in that in an apparatus of low-frequency therapy using "Bioritm 040".



 

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