Method for treatment of pleuropulmonic complications in patient suffering from pancreatonecrosis
SUBSTANCE: claimed method includes paracentesis of pleural cavity and exudate removing by at least tree hours before surgical aggression singly and then additionally over at least one day after surgical aggression. Interval between paracentesis must be not less than one day. After exudate removing during each paracentesis 2000 Units of contrical and 30 mg of mexidole are administered intrapleurally.
EFFECT: method for treatment of increased effectiveness due to improving of ventilation-perfusion ratio and reducing of amylasemia in pleural cavity exudate.
1 ex, 1 tbl
The invention relates to medicine, namely to methods for treating pleuropulmonary complications in patients with pancreonecrosis that in 100% of cases are accompanied pleuropulmonary complications.
There is a method of treatment pleuropulmonary complications, namely pancreatic pleuritis (Vigilon, Allstudent. "Emergency pancreatology". - SPb.: Peter. - 1994. - S) consisting in doing after surgery, puncture of pleural cavity and the removal of the pleural effusion.
The disadvantages of this method is the lack of effectiveness of the procedure being performed, so as pleural cavity punctured after surgery and only when functionally significant pleural effusion, i.e. when the already significant decrease in vital capacity of the lungs, oxygenation of the blood and the cases of violation of ventilation-perfusion relationships.
In addition, in 70% of cases are observed persistent recurrence of pleural effusion, which require multiple repeated puncture of the pleural cavity. A high percentage of recurrent pleurisy causes costly monitoring of the pleural cavities, including frequent chest x-rays and ultrasound. Often pleural effusions are infected (hematogenous or lymphogenous route), resulting in empyema of the pleural cavity, which must be drained from n the number of points. Drains require careful care and 9-15% lead to abscess of the chest. Empyema is often complicated by residual cavities, otcharovanie that require operative treatment of thoracotomies access, often ending decorticate lung.
The present invention is easy to use, requires no additional equipment and devices, securely and effectively solves the problem of treatment pleuropulmonary complications in patients with pancreonecrosis.
The technical result consists in increasing the effectiveness of treatment. Using the proposed method, including multiple puncture sequential introduction into the pleural cavity multicomponent drug solution, consisting of a protease inhibitor - kontrikala (20000 units) and a synthetic inhibitor of free radical processes (membranoprotector) - Mexidol (300 mg), reduces in the pleural cavity, the level of pancreatic enzymes (primarily - amylase), kallikrein and products of lipid peroxidation (POL). This eliminates endotoxic bronchospastic effect and spasm of the pulmonary veins, causes a reduction of pressure in the pulmonary artery and reduces the amount of internal-lung bypass, thereby improves ventilation-perfusion from the osenia in the lungs, which lead to fast and reliable relief of pancreatic pleural effusion.
The possibility of multiple puncture intrapleural injection multicomponent drug solution, including contrical and Mexidol, as before the surgery and in the postoperative period, allows to increase the effectiveness of the treatment.
Multiple puncture introduction multicomponent drug solution into the pleural cavity, including contrical and Mexidol, provides improved ventilation-perfusion relationships in the lungs and, very importantly, has a long therapeutic effect for at least 24 hours. Reducing amylasemia, kallikrein and POL in the exudate pleural cavity protects the pleura and alveolararterial lung membranes from destruction, warns embolization and thrombosis pulmonary arterioles reduces pulmonary hypertension, reduces arteriovenous shunt, arterial hypoxemia.
The proposed method for the prevention and treatment of safe, simple, and available for use by the surgeon of any qualification.
This technical result is achieved in that in the method of treatment pleuropulmonary complications in patients with pancreonecrosis, consisting in running for 3 hours before surgery advanced single puncture of the pleural cavity and removal is pleural effusion, and not less than one day after the operation performed additional puncture of the pleural cavity with an interval of not less than one day, and with each puncture and after removal of the pleural effusion in the pleural cavity sequentially injected 20000 units kontrikala and 300 mg of Mexidol.
The method of treatment pleuropulmonary complications in patients with pancreonecrosis is as follows.
For the preparation of solutions for injection into the pleural cavity under sterile conditions bred 20000 units kontrikala in 20 ml of water for injections and take a 20 ml syringe, in another syringe 300 mg (6 ml 5%) of Mexidol diluted in 10 ml of physiological solution and also take a 20 ml syringe.
Technique intrapleural puncture differs from classic and execute it in the seventh intercostal space on signedmessage line. After preparation of the solution for 3 hours before operations are performed anesthesia conventional needle through the introduction of a 0.5% solution of novocaine at the top of the eighth rib, after the failure in the pleural cavity, the needle changing the needle with a diameter of 1.5 mm with a blunt end so as not to injure the tissue of the lung, which is held in the pleural cavity. Initially evacuated effusion from pleural cavity, then through the same needle successively introduced 20000 units kontrikala 20 ml of water for injection and 300 mg of Mexidol in 10 ml of physiologically is one solution. After the operation, not less than a day and at intervals of not less than one day perform puncture of the pleural cavity, removal of the pleural effusion and with each puncture enter 20000 units kontrikala and 300 mg of Mexidol.
After the introduction of the drug solution is distributed in the pleural cavity and surrounds the root of the lung.
The way has proved highly effective, cheap, easy to perform and eliminates the disadvantages in the above prototype.
After the introduction of drugs into the pleural cavity of the proposed method all the patients showed a reduction in the frequency of respiratory movements (NPV), increased vital capacity (VC), tidal volume (UP), reserve volume inspiratory (ROVD), expiratory reserve volume (ROWID) and average flow rate during expiration (SOS), also significantly increased blood oxygenation (SpO2).
Observations showed that in 90% of patients for reliable edema pleurisy was sufficient to perform the puncture of the pleural cavity with the introduction of drugs by the proposed method prior to surgery and once after the operation.
Table 1 presents the performance of the ventilation-perfusion lung function, characterizing the effectiveness of the treatment pleuropulmonary complications in patients with pancreonecrosis.
Clinical example: patient K., 57 years old, he enrolled in MUS KB No. 25 26.02.2002. in the 1630with complaints of acute pain in the upper abdomen "zoster" nature, bloating, nausea, repeated vomiting, shortness of breath. Sick considers itself within 3 days after receiving abundant fatty foods with alcohol suddenly developed severe pain in the epigastrium and left upper quadrant, radiating to the left of the rib-vertebral angle. Last night was joined by high body temperature up to 39°With, became evident weakness, dryness in the mouth, bloating. Took analgesics and antispasmodics - no effect. Taken by ambulance to the hospital.
Objectively: a serious condition. HELL 80/40 mm Hg, pulse 126 1 min NPV - 28 per minute. Chest left behind in breathing. In the lungs the right breathing hard, left, listens only on the top. Percutere shortening of sound left to the V ribs. Skin pale belly with spots of Mondorf. Nasolabial triangle of cyanolichen. The sclera of the eye is slightly icterina. Tongue dry, lined with brown patina. Belly swollen, tense and sharp pain in the upper sections, and on the right flank. Peristalsis is not defined, positive symptom Shchetkina-Blomberg, CERTE, Mayo-Robson. During the day the chair was gone, almost gases do not leave, diuresis drastically reduced.
Biochemical analyses were determined hepatopathy Art. I thee is the input. The hemostasis was observed activation of blood coagulation by the type of stage I of DIC due to plasma factors.
Investigation of ventilation-perfusion lung function (apparatus "ETON-SPIRON"): VC was 3,35 l TO 2.9 litres, Police - 1.25 l, ROWID - 1,15 l, SOS - 2,45 l SpO2was 82% (hemoximetry "NONIN 950". Conclusion: a significant reduction in pulmonary ventilation capacity due to impaired patency of small bronchi. Restrictive plus malabsorptive obstructive type.
On chest x-rays was determined by liquid in the rib-diaphragmatic sinus to the left to the V ribs.
Ultrasound imaging of the chest: fluid in the pleural cavity left up to 550 ml.
Abdominal ultrasound: Pancreonecrosis. Swelling of the retroperitoneal tissue. The liquid in the packing bag and the abdominal cavity. Changes hepatorenal structures of the I century Biliary hypertension.
Clinical diagnosis of Infected pancreatic necrosis. Ametabolic. Peritonitis. Obstructive jaundice. Pancreatogenic shock. Pancreatic pleural effusion on the left.
The forecast severity by Ranson was 4 points of senior (age over 55 years, blood glucose is 14.8 mmol/l, leucocytes - 20×109, Alt - 1.15 mmol/l) + 6 clinical syndromes (pain + gastroenterolgy syndrome + hemodynamic syndrome + hepatorenal syndrome + respiratory syndrome + peritoneal shall syndrome).
After an 8-hour training in intensive care the patient is removed from pancreatogenic shock. 3 hours before the operation the patient was performed pleural puncture to the left VII intercostal space at signedmessage line, evacuated 450 ml light serous fluid. Amylase it was 47 mg/SL, gidroperekisi lipids and 18.2 mmol/l (in the peripheral blood - amylase 35 mg/SL, gidroperekisi lipids of 14.5 mmol/l). Introduced into the pleural cavity by the method described above consistently 20000 units kontrikala and 300 mg of Mexidol. The breath left (hard) began to listen to all fields. The NPV decreased to 22 minutes Improved ventilation-perfusion lung function, VC was 3,85 l TO 3.4 liters, Police - 1.55 l, ROWID - 1,42 l, SOS - 2,95 l, SpO2- 88%. Noted a significant improvement in the ventilation of small bronchi.
Urgently performed laparoscopic examination of the abdominal cavity. Verified positive form of pancreatic necrosis. Conversion to upper median laparotomy. Revealed diffuse enzymatic peritonitis, ametabolic, purulent fusion of tissues of the pancreas in the area of its tail and parapancreatic klekotki with the transition to the mesentery of the colon. The pancreas was administerable. Made cryogenic on the pancreas. Parapancreatic fiber is widely trenirovka is and the drains of Penrose and 2-translucent drains through the gastrocolic ligament and additional lobotomise incision with subsequent formation of a flow-through system drainage stuffing bags. Stuffing the bag marsiliana. Imposed cholecystostomy. Conducted nasointestinal probe to the ileocecal angle. Drained the umbilical vein and the inguinal lymph node on the right for subsequent injections of drugs. Thoracic lymphatic duct drained with the purpose of in vitro electrochemical detoxification of the lymph.
Postoperative diagnosis: Infected pancreatic necrosis. Abscess retroperitoneal space. Diffuse enzymatic peritonitis. Pancreatogenic shock. Pancreatic pleural effusion on the left.
24 hours after surgery has been performed puncture of the left pleural cavity in the seventh intercostal space, evacuated 120 ml light serous fluid, and (by the above method) was introduced 20000 units kontrikala and 300 mg of Mexidol. On the 3rd day after the operation began to listen vesicular breathing with both sides in all fields. The chest on the left side when breathing has ceased to be outdone, the NPV is 22 minutes of Ventilation-perfusion lung function has undergone significant improvement, VC increased to 4,45 l TO 3.9 l, Police - 2,15 l, ROWID - 1,73 l, SOS - 3,65 l, SpO2- 94%. Marked patency of small bronchi is almost the norm. Control radiographs and ultrasound of the chest data for pneumonia or pleurisy is not received.
Since 4 days General condition began to improve. Purulent% the SS in mud and retroperitoneal tissue has been limited. Control radiographs and ultrasound of the chest pleuropulmonary complications were not observed, so the NPV was 20 min, VC increased to 4.62 l TO 4.1 l) Police Department - 2,34 l, ROWID - 1,79 l, SOS - 3,94 l, SpO2- 95%. The patient activated mode, normalized sleep, appetite. Diuresis fully recovered. The independent chair. 7 day phenomenon hepatoprotective were cropped. Hemostasis by this time come fully to normal. On the 15th day after the first operation performed planned sequestrectomy through bursectomy. Further postoperative period without features.
Drainage from the gallbladder removed on 22 days. She recovered. The patient is in satisfactory condition on the 34th day of hospital stay was discharged under the supervision of a physician at the place of residence.
The method reduced the development pleuropulmonary complications, such as pleural effusion, patients pancreonecrosis from 74% to 32%, and the mortality associated with it - from 22.5% to 16.7%.
Dynamics of ventilation-perfusion lung function after conducting intrapleural injections kontrikala and Mexidol in patients with pancreonecrosis with pleuropulmonary complications (pancreatic-pleurisy) (N-28).
|Indicators||Before the treatment||After the treatment|
|Respiratory rate, %/min||16±2||24±2||20±1*|
|Vital capacity, l||4,5±0,3||3,3±0,2||3,9±0,1*|
|Tidal volume, l||0,6±0,2||0,3±0,05||0,5±0,05*|
|Reserve volume inspiratory, l||1,9±0,1||1,3±0,1||1,7±0,1*|
|Reserve volume expiratory, l||1,9±0,1||1,3±0,1||1,5±0,1|
|Average flow rate during exhalation, l/sec||3,9±0,3||2,7±0,2||3,6±0,3*|
|Blood oxygenation, %||96±2||84±2||93±2*|
|* reliable differences with values obtained before treatment;|
|- norm obtained from averages 20 untrained people (aged 18-24 years).|
The method of treatment pleuropulmonary complications in patients with pancreonecrosis consisting in doing after surgery, puncture of pleural cavity and removal of the pleural effusion, ex is different, however, no less than 3 hours before the operation is conducted additionally a single puncture of the pleural cavity and removal of the pleural effusion, and no less than one day after the operation performed additional puncture of the pleural cavity with an interval of not less than one day, and with each puncture and after removal of the pleural effusion in the pleural cavity sequentially injected 20000 IU kontrikala and 300 mg of Mexidol.
FIELD: burning injuries.
SUBSTANCE: invention relates to treating thermo-inhalation damages of respiratory tract via Bronchoalveolar lavage. In particular, in the final stage of lavage, tracheobronchial tree is sprinkled with perfluoran followed by removing the rests thereof. Thereafter, 10-20 ml of perfluoran are introduced without subsequent removal thereof. This procedure is repeated 2-3 times a day until normal function of mucosa is restored. Method ensures rapid restoration of circulation and adequate gas exchange in lungs due to perfluoran-mediated oxygen transfer to body tissues leaving aside damaged lungs.
EFFECT: enabled artificial ventilation of lungs, if necessary, at lower respiration volume and respiration rate.
FIELD: veterinary science.
SUBSTANCE: the suggested preparation for preventing and treating respiratory and gastrointestinal infectious diseases of bacterial and viral etiology in farm animals contains tetracycline (oxytetracycline) (8-10%-solution) at the quantity of about 10-15 vol.%, polyethylene glycol (15-20%-solution) - about 10-15 vol.%, polyvinyl pyrrolidone (15-20%-solution) - about 10-20 vol.%, ethylene diamine tetraacetate (0.01-0.02%-Versen's solution) - about 10-15 vol.%, and, also, trypsin (0.01-0.25%-solution) - the rest. As for the method for preventing and treating the above-mentioned diseases, it deals with a single intramuscular injection of the present preparation for farm animals (predominantly, for piglets) at the dosage of about 0.5-1.0 ml/animal. The suggested preparation is of immunostimulating properties and provides efficient therapy of respiratory and gastrointestinal diseases of bacterial and viral etiology.
EFFECT: higher efficiency of prophylaxis and therapy.
2 cl, 6 tbl
FIELD: pharmaceutical industry, in particular mucolytic pharmaceutical agent.
SUBSTANCE: claimed composition contains therapeutically effective amount of bromohexin as active ingredient and sugar, starch and stearinic acid salt as target additives. Pharmaceutical composition is provided in form of tablets.
EFFECT: composition with improved physical and pharmaceutical properties, such as dissolving and active ingredient releasing.
8 cl, 2 tbl, 4 ex
FIELD: organic chemistry, biochemistry, pharmacy.
SUBSTANCE: invention relates to derivative of pyridine of the general formula (I): wherein each symbol has the following values: R1 and R2 mean hydrogen, halogen atoms, lower alkyl, lower alkoxy-group; R3 and R4 mean hydrogen atom, lower alkyl, halogen atom; R5 means hydrogen atom, lower alkyl; n = 0 or 1, or its pharmaceutically acceptable salts. Also, invention describes a pharmaceutical composition based on compounds of the formula (I) and intermediates substances used in synthesis. Compounds possess inhibitory effect on activity of phosphodiesterase of type 4.
EFFECT: valuable medicinal and biochemical properties of derivatives.
9 cl, 13 tbl, 147 ex
FIELD: organic chemistry, biochemistry, medicine, pharmacy.
SUBSTANCE: invention relates to novel amino- and hydroxy-derivatives of phenyl-3-aminomethylquinolone-2 of the general formula (1):
wherein R1, R2, R3 and R4 are independently similar or different and R1 is chosen from hydrogen atom (H), Alk, OAlk; R2 is chosen from H, Alk, OAlk, -OCF3; R3 is chosen from H, Alk, OAlk, -SCH3; R4 is chosen from H. Alk, OAlk, or R2 and R3 are chosen from -(CH2)3, -OCH2O-, -OCH2CH2O-; R5 means H or Alk; R6, R7 and R9 mean H; R8 is chosen independently from the following substitutes:
wherein n = 1, 2, 3; Het represents furan; R represents hydrogen atom or alkyl. In case of hydroxy-derivatives at least one among R6, R7, R8 or R9 is -OH and other represent H. Also, invention relates to methods for synthesis of these compounds and to a pharmaceutical composition based on these compounds inhibiting activity of NO-synthase. Invention provides preparing novel compounds and pharmaceutical compositions based on thereof in aims for treatment of diseases associated with hyperactivity of phagocytizing cells, for example, rheumatic arthritis, asthma and others.
EFFECT: improved preparing method, valuable medicinal and biochemical properties of compounds and pharmaceutical composition.
32 cl, 1 tbl, 132 ex
SUBSTANCE: method involves administering Isoniazide on the background of standard drug therapy. Magnetic laser radiation therapy is additionally administered to a patient by irradiating cubital veins with low intensity laser radiation. Biologically active additive of Adaptovit is additionally administered at a dose of 1 drop at 8 and 12 o'clock daily during 15 days. Pulsating laser radiation frequency is equal to 600 Hz with 6-7 W power. Exposure time is equal to 4 min upon each upper extremity. The total magnetic laser radiation therapy treatment course is 8-12 procedures long given in daily mode.
EFFECT: enhanced effectiveness of treatment; accelerated exudates resorption.
FIELD: medicine, pulmonology, gastroenterology.
SUBSTANCE: in 10 d after the onset of therapeutic course at applying basis therapy one should introduce antidepressant - fluvoxamine maleate for patients with observed anxious-depressive disorders at the dosage of 50 mg daily in evening period for 8 wk. The present innovation enables to decrease the degree of symptoms of the above-mentioned disease at the background of decreased number of relapses of bronchial asthma, in case of resistance to conventional therapy, diseases of gastroduodenal area and normalization of psychic status in patients, among them.
EFFECT: higher efficiency of therapy.
FIELD: organic chemistry, medicine.
SUBSTANCE: invention relates to novel retinoid compounds of the structural formula (I) or their pharmaceutically acceptable salts and pharmaceutical compositions possessing agonistic activity with respect to retinoid receptors and comprising indicated compounds wherein n = 1; d = 0 or 1; B means -CR7=CR8-, -CH2O- wherein R7 and R8 each means independently hydrogen atom; X means phenyl optionally substituted with halogen atom, or 5-membered heteroaryl comprising sulfur atom (S) as a heteroatom; R1 means -C(=O)-R9 wherein R9 means alkyl, hydroxyl, amino-, heteroaryloxy-group comprising oxygen atom (O) or 6-membered heterocyclyl comprising nitrogen atom (N) as a heteroatom; R2 means: (a) -(CR10R11)m-Yp-R12; m means a whole number from 1 to 10; p means 0 or 1; R10 and R11 mean hydrogen atom; Y means -O-, -S- or -NR13-; R13 means hydrogen atom; R12 means hydrogen atom, alkyl, cycloalkyl, phenyl, 5- or 6-membered heteroaryl comprising atoms N, S, O as a heteroatom, 5- or 6-membered heteroarylalkyl comprising atoms N, S, O as a heteroatom, heteroalkyl comprising atoms N, S, O as a heteroatom, 5- or 6-membered heterocyclyl comprising atoms N, S, O as a heteroatom, or 5- or 6-membered heterocyclylalkyl comprising atoms N, S, O as a heteroatom under condition that when p means 0 then R12 doesn't mean hydrogen atom or alkyl; (b) 5- or 6-membered heteroaryl comprising atoms N, S, O as a heteroatom; (c) -Z-L wherein Z means -CR14=CR15-, -C≡C-, -C(=O) or -S-; R14 and R15 mean hydrogen atom; L means 5- or 6-membered heteroaryl comprising atoms N, S, O as a heteroatom; (d) -CR14=CR15-L1 wherein L1 means -S(O)2R17 or -SO2NR18R19 wherein R17 means alkyl; R18 and R19 mean hydrogen atom; each R3 means independently hydrogen atom, hydroxyl or oxo-group; t means 1 or 2.
EFFECT: valuable medicinal properties of compounds and compositions.
59 cl, 10 tbl, 54 ex
FIELD: organic chemistry, medicine, pulmonology.
SUBSTANCE: invention relates to a new chemical compound, namely, 7-bromo-4-acetylthiazolo[5,4-b]indol-2-succinimide of the formula: that is able to protect body against hypoxia and possesses the curative effect in lung toxic edema. The melting point of this compound is 267-269°.
EFFECT: valuable medicinal properties of compound.
2 tbl, 1 ex
FIELD: organic chemistry, medicine, pulmonology.
SUBSTANCE: invention relates to a new chemical substance, namely, 4-acetylthiazolo[5,4-b]indol-2-succinimide of the formula: that is able to protect body against hypoxia and possesses the prophylactic effect in lung toxic edema. The melting point of this substance is 264-265°C.
EFFECT: valuable medicinal properties of compound.
2 tbl, 1 ex
FIELD: medicine, oncosurgery.
SUBSTANCE: the present innovation deals with surgical treatment of tumors in biliopancreatoduodenal area. In the course of pancreatoduodenal resection, at the stage of forming a pancreatoenteroanastomosis it is necessary to introduce a button probe into widened pancreatic duct for the distance of about 4-5 cm, not less. One should dissect pancreatic tissue at the probe, withdraw the end of button probe outwards, fix a silicone drainage tube to the probe's end, tube's diameter should correspond to that of the duct. Then one should withdraw the probe outwards by applying the silicone tube through pancreatic tissue, apply a pancreatoenteroanastomosis, apply the end of the tube that drains pancreatic duct in area of pancreatic anastomosis, withdraw a free end of silicone tube onto the skin to be fixed. In postoperational period it is necessary to fulfill constant injection of cooled solutions by drops into silicone drainage tube. This method provides reliable drainage of pancreatic duct, prevents its obturation in postoperational period and provides prophylaxis of pancreatic anastomosis failure.
EFFECT: higher efficiency of prophylaxis.
FIELD: medical equipment.
SUBSTANCE: drainage intends for removal of pathologic liquid out of abdominal cavity. Surgical drainage is made in form of flexible longitudinal case which has part for being introduced into damaged area, and guiding part. Both parts of drainage are formed onto diametrically opposed windows, which are closed from outside with latex sleeve connecting both parts of drainage. Round openings with different diameters are made onto case of drainage to be introduced; openings are made apart. Easy removal of wound exudation is provided.
EFFECT: reduced traumatism.
1 dwg, 1 ex
FIELD: medicine; emergency surgery.
SUBSTANCE: device can be used for treatment of perforation of organs of abdominal cavity. Double-lumen drainage tube is installed into omental bursa. PVC drainage tube of smaller diameter is installed into silicone drainage of bigger diameter. Smaller-diameter tube has five perforation holes at intra-drainage end; diameters if holes are equal to internal diameter of PVC tube. Ends of drainage tubes are stitched by 4 single ligatures being equidistant from each other to step 1 centimeter away from stitched end of tube. Four through curs are made in silicon tube in parallel to axis of the tube; cuts are disposed equidistant from each other along perforated part of PVC drainage tube. After being installed into omental bursa, external drainage is shifted relatively internal one.
EFFECT: prevention of formation of comissure; proper drainage of fluid from omental bursa.
FIELD: medicine, neurosurgery.
SUBSTANCE: one should perform puncture of subarachnoidal space at L4-L5 level of lumbar vertebrae at introducing lumbar end of drainage into subarachnoidal space of spinal cord and withdrawing its abdominal end into abdominal cavity due to microlaparotomy. Moreover, in anterior-superior spine of iliac wing one should form a through foramen to develop a hole from external side to place a valve pump there to be fixed to the bone. Lumbar end of drainage from internal side of iliac wing should be directed through a through foramen to be connected with a pump, and a pump-connected abdominal end of drainage should be placed into abdominal cavity. The innovation enables to decrease the quantity of post-operational complications due to providing regulated liquor reflux.
EFFECT: higher efficiency.
1 dwg, 1 ex
FIELD: medicine, neurosurgery.
SUBSTANCE: one should form a cutting foramen, make a drainage into cystic cavity, fix it and withdraw its distal end beyond cystic limits. Moreover, on installing proximal end of drainage in cystic cavity its distal end should be curved, closed to perform longitudinal incision of a wall and direct it into subarachnoidal space. Drainage should be fixed with a coupling installed at a drainage at the level of a cutting foramen, and a clamp made out of shape-memory metal. A clamp should be installed so, that one of its pedicle be between coupling wall and drainage, and the second - between the bone and external surface of dura mater. The innovation enables to decrease traumatism of surgical access due to excluding liquor flow and reliable drainage fixation.
EFFECT: higher efficiency of draining.
1 cl, 3 dwg, 1 ex
FIELD: medical equipment.
SUBSTANCE: device is applied onto blood vessel in such a way that the device together with the vessel forms new channel, which combined device can be used for curing (shunting) for hydrocephaly when there is need to create channel for passing spinal fluid from catheter passing fluid into deep neck vein without having contact between device, catheter (or any other foreign body) and blood current in vessel. Device for passing fluid from catheter to blood vessel together with mentioned blood vessel forms channel at part of length of the blood vessel. Channel goes in parallel to the vessel. Blood current, which goes through blood vessel, doesn't have contact either with device or with mentioned catheter. Applicator for application onto blood vessel of the device for passing fluid from fluid-passing catheter to blood vessel has frame part made for holding infusion needle, punching needle fastened to applicator by means of lock, tube and glue supplying tube connected with syringe filled with glue. Method of application of the device for passing fluid from passing catheter to blood vessel has aid for fixing to applicator by means of glue-supplying tube and infusion needle. Part of neck vein of patient is released by means of slight cutting. Then that part is lifted and fixed. Double folded ligature, in which ligature the ligature strands are used, is disposed around supposed point of puncture. Then wall of vein is lifted by means of surgical needle to make punching easier. Punching needle is removed and infusion needle is introduced into vein simultaneously with pulling ligature strands at the direction being opposite to direction of introduction of infusion needle to make passage of device easier. Then ligature is tied up. Additional ligature is attached to hole fro stitching to fix wall of vessel to device near mentioned hole. Biological glue is introduced from syringe filled with glue. After glue hardened, infusion needle is removed and pulled back completely for separation of device from application. Then device is connected with catheter which comes from valve of shunt.
EFFECT: reduced danger of thrombosis.
15 cl, 10 dwg
SUBSTANCE: method involves layer-by-layer infiltrating tissue above cavity with Novocain, making test cavity puncture with needle and skin incision, introducing trocar and draining the cavity with Foley catheter. The needle is left in the cavity as guide member for introducing the trocar. When taking cavity content, the needle is removed after having removed stiletto. The Foley catheter is introduced into the cavity through nonseparable metal bush sleeve. The trocar bush sleeve is removed from the cavity and taken away from the catheter. The bush sleeve is withdrawn through lateral slit being as long as the bush sleeve and 1/2 diameter in width.
EFFECT: high accuracy in introducing trocar; reduced risk of traumatic complications; enhanced effectiveness in draining cavities having rigid walls.
SUBSTANCE: method involves setting two tubes perforated along their length into mastoidal cavity. Discharge tube has grove on internal end for the first tube to be placed into it. Irrigation tube is set into the entrance to the cave and fixed near upper skin wound angle and discharge tube is fixed in the lower skin wound angle. Concurrent vacuum treatment of cavity content via the discharge tube is carried out next to it.
EFFECT: enhanced effectiveness of cavity perfusion with antibacterial and immunomodulating drug solutions.
SUBSTANCE: method involves removing sphacelous retroperitoneal cellular tissue. Draining system is introduced through each of counteropenings located on the left and right side along posterior axillary line 10 cm far from costal arch edge. Draining system has two polyvinyl chloride tubes arranged on the upper and lower end of 500 ml large rubber balloon. The drains are brought out through counteropenings in lumbar region. Balloons are pumped and retroperitoneal space is rinsed every day in postoperative period.
EFFECT: enhanced effectiveness in removing pathological exudate; prevented pyo-necrotic mass fragmenting.
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: medicine, ophthalmology, chemico-pharmaceutical industry.
SUBSTANCE: the suggested pharmaceutical composition is indicated for local application and contains an inhibitor angiotensin converting enzyme as an active substance and target additions, moreover, the content of active substance corresponds to about 1-20 mg/ml. The composition suggested could be designed as eye drops, spay, gels, solution for local injections. As target additions one should apply water that contains a buffer agent, an isotonic mixtures, a conservant and a prolongator. Additionally, this composition contains preparations chosen out of the following groups: antibiotics, macro- and microelements, vitamins, adrenoblocking agents. The innovation provides anti-ischemic action, improves reparative processes and accelerates the processes of healing.
EFFECT: higher efficiency.
3 cl, 7 ex