Method of postoperative stimulation of intestine in children

FIELD: medicine.

SUBSTANCE: method comprises intraoperative setting of electrodes in abdominal cavity. One of the electrodes is secured in the root of the mesentery of the small intestine, and the other one is secured to the ileum. The ends of the electrodes are brought outside throughout the layers of the anterior abdominal wall and connected with the electrocardiostimulator. The intestine is stimulated during 10-15 min with an interval of 10-30 min until peristaltic occurs. The electrostimulation is synchronized with the systole.

EFFECT: reduced traumatizing.

2 ex

 

The invention relates to medicine, namely to surgery.

Know the application of the method of electrical stimulation of the gastrointestinal tract by using probes of electrodes, which is based on the introduction into the lumen of the gastrointestinal tract of a special probe with an active electrode and is applied to the anterior abdominal wall indifferent electrode with subsequent connection to the apparatus, generating rectangular pulses (Akhalaia MG, Sakura K.A. electrical Stimulation of the gastrointestinal tract with dynamic obstruction. In the book: the Development of physiological space for scientific research in biology and medicine. M., 1968, 228 S.; Bredikis YOU Essays clinical electronics. - M.: Medicine. - 1974. - P.123-132).

The disadvantage of this method is that the propagation of peristaltic waves can be invoked when there is good contact between the electrode and the wall of the intestine in certain parts of the gastrointestinal tract, making it is not always possible.

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 (Manual physiotherapy and physio is profilaktike 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. Saint-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 present invention 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 the pacemaker. (Places CENTURIES, Pashkov S.A. and other early prolonged Autonomous electrical stimulation of the gastrointestinal tract. Patent RU No. 2216362, IPC And 61 N 1/36).

The disadvantage of this method is that the parameters of the electric pulses of the pacemaker is not configured depending on the heart rate of the child and his individual vegetative reactions. In asynchronous enable pacemaker is nesita is giving the frequency of the pulses of the pacemaker and the heart rate of the baby and may cause a redistribution of blood in the segment of intestine, what can cause the syndrome victimize and worsen the course of the pathological process.

The task is to develop a method of electrical stimulation of the gastrointestinal tract, which will allow a gentle endosurgical installing electrodes in the abdominal cavity and to electrical stimulation of the intestine in the postoperative period based on the heart rate of the patient.

The technical result when using the invention - improving the efficiency of the method, the reduction of traumatism.

This technical result is achieved due to the fact that endosurgical way at the end of endosurgical interventions installs one electrode subserous in the root of the mesentery of the small intestine, and the other electrode set subserous in ileocecal angle, the wires from the output electrodes, attached to the pacemaker and to produce electrical stimulation of the intestine within 10-15 minutes with intervals of 10-30 minutes until peristalsis, the pacemaker synchronizes with the heartbeats of the child.

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 in the W ill result the first electrode and the root of the mesentery of the small intestine it 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 root of the mesentery and ileum, respectively connected first to the "+" terminal, and the second to the "-" terminal of the pacemaker, synchronize with the heartbeats by means of an oscilloscope and produce electrical stimulation of the intestine for 10-15 minutes with intervals of 10-30 minutes. After restoring intestinal motility, the electrodes are removed from the abdominal cavity, gently pulling at the outer ends. This method was conducted by electrical stimulation of the intestine in 10 children. In all cases, was achieved this technical result.

The proposed method is illustrated by the following examples.

EXAMPLE 1. Patient H, and b/W No. 2203, 14 years old, was admitted on an emergency basis. Diagnosis: Acute gangrenous-perforated appendicitis. Periappendicular abscess. Omentitis. Diffuse purulent peritonitis. Operation performed: Laparoscopic appendectomy, resection of the strands of the packing. Sanitation and drainage of the abdominal cavity. Endosurgical the installation in endosurgery eliminate obstruction, abdominal cavity. There is paresis of the intestine. After endosurgical interventions within the and puncture of the anterior abdominal wall in the epigastric region, the needle in the abdominal cavity is entered electrode and using clepatra his subserous were fixed in the root of the mesentery of the small intestine. Similarly the other electrode is carried out through the anterior abdominal wall in the right iliac region and its recorded subserous to the ileum at the ileocecal corner. 1.5 hours after surgical intervention initiated electrical stimulation of the intestine. The ends of the electrodes bred out, was connected to the pacemaker configured under the heart rate of the child for 10 minutes every 30 minutes. The first peristaltic waves appeared 30 minutes after the start of stimulation. Peristalsis recovered after 5 hours. The chair received after 12 hours. After restoring intestinal motility electrodes extracted from the abdominal cavity after 16 hours, gently tightening their outer ends. The postoperative course without complications. The child was discharged on the 10th day.

EXAMPLE 2.

Patient L., and/b No. 7117, 10 years old, was admitted urgently to hospital of peritonitis. Operated in an emergency endosurgical way after preoperative preparation. During inspection of the abdomen revealed a large number of purulent effusion, marked paresis of the intestine. Analogously to example 1, after the end of the endosurgical interventions, using CL is Patara 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 pacemaker 10 minutes every 20 minutes. The first peristaltic waves appeared after 20 minutes. Peristalsis recovered after 4 hours. The chair received after 9 hours. Upon recovery of intestinal motility electrodes extracted from the abdominal cavity after 12 hours, gently tightening their outer ends. The postoperative course smooth. The child was discharged on the 10th day.

The method of electrical stimulation of the intestine, including intraoperative installing electrodes in the abdominal cavity, removing them all through all layers of the anterior abdominal wall, connected to the pacemaker, wherein the endosurgical by one of the electrodes is fixed at the root of the mesentery of the small intestine, the other to Powszechny intestine and conduct electrical stimulation of the intestine for 10-15 min with an interval of 10-30 min until peristalsis, the pacemaker synchronizes with the heartbeats of the child.



 

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FIELD: medicine.

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Electrode device // 2252793

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