Method for post-surgical treatment of patients after intestinal obstruction surgery

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery, and can be used for post-surgical treatment of the patients after an intestinal obstruction surgery. That is ensured by the diversional therapy. It is added with the intravenous drop-by-drop introduction of ozonised physiologic saline of ozone concentration 5mg/l in amount 200 ml for the first seven postoperative days once a day.

EFFECT: reduced time of enteroparesis relief with higher physiological value of the treatment and extended range of products for enteroparesis relief in such patients.

2 tbl

 

The invention relates to medicine, in particular to surgery, and can be used for the care of patients operated for about intestinal obstruction.

There is a method of treatment in the postoperative period of patients operated for about intestinal obstruction, including the introduction of saline, glucose, antibiotics, oxygen therapy if respiratory difficulties, the appointment of cardiac drugs, fighting paresis: probes for intestinal intubation through the nose; the probe into the stomach, enemas; stimulation of the motor responses of the intestine procaine blocks of the lumbar spine; the appointment of a neostigmine methylsulfate, hypertonic solution of chlorides and other (Ummerer. Pathogenesis and treatment of acute intestinal obstruction. M.: Medicine, 1971, s).

There is a method of treatment in the postoperative period of patients operated for about intestinal obstruction, including infusion-transfusion therapy; antibiotic therapy; methods extrakorporale detoxification; introcision introduction drip saline, glutamine, pectin; stimulation of motility introduction of prokinetics (reglan) (Ermolov ASI other Syndrome of intestinal failure in emergency abdominal surgery // the Basic principles of treatment of the syndrome of intestinal failure. M.: OOO "Medexpress", 2005, s).

The most the e closest to the present invention is a method of treating postoperative patients operated about intestinal obstruction, including drainage or aspiration of stomach; decompression of the bowel through a tube; stimulation of the intestine proserin 6...8 times per day; infusion therapy (dropper); drug therapy in accordance with the condition of the patient (Oscagne. Surgery emergency diseases // Postoperative management. Publishing house of Kazan University, 1981, s).

The disadvantage of this method consists in the following. In the postoperative period when the operations for acute intestinal obstruction the main efforts at nursing the patient is directed to recovery of bowel function, which is in a state of paralysis, and restoration of disturbed homeostasis. Normally, under the influence of the above rehabilitation therapy and in the absence of complications in the postoperative period, paresis of the gastrointestinal tract remains for a long time. During this time the patient receives different ways of introducing a large number of chemicals, which disrupts the function or liver condition. In addition, methods of stimulation of motor responses of the intestine (all probes) unpleasant and difficult tolerability. All this reduces the physiology of known methods.

The present invention solves the problem of creating a method of treatment in the postoperative lane is the ode to the sick, operated about intestinal obstruction, which provides the ability to achieve a technical result, which consists in reducing time resolution paresis of the intestine and restoration of disturbed homeostasis in increasing physiology, as well as in the expansion of the means to resolve paresis of the intestine in patients operated for about intestinal obstruction.

The essence of the claimed invention is that the method of treatment in the postoperative period of patients operated for about intestinal obstruction, including rehabilitation therapy, what is new is that, in addition, the patient receives during the first seven days after surgery once a day by intravenous drip injection of ozonized physiological solution with an ozone concentration of 5 mg/l in 200 ml.

The technical result is achieved in the following way. Rehabilitation therapy provides recovery of all vital functions of the patient, the recovery of internal homeostasis, increase immunity, and therefore provides and the achievement of the claimed technical result.

The use of medical ozone has long been known. Ozone therapy has a wide range of effects on the human body. She has a PR is telegiornale action supports high speed of blood flow in microcirculation the channel, increases the adaptive reactions of the respiratory and cardiovascular systems, activates metabolic processes, regulates the status of lipid peroxidation and antioxidant system, has immunomodulatory, as well as analgesic, anti-inflammatory, antibacterial, antiviral and fungicidal action (IAuto, Epomeno. Pathogenetic aspects of ozone therapy. M.: 2005, p.16.,.24; Ovislink, Concentrica. Guidance on ozone therapy. Nizhny Novgorod: Vector Tees, 2005, p.18...33).

However, patent research has shown that how to resolve paresis of the intestine and reduce the time resolution of paresis of the intestine and restoration of disturbed homeostasis in patients operated for about intestinal obstruction, ozone therapy, namely by intravenous drip injection of ozonized physiological solution, not used or used for the first time by the author. In the expanding Arsenal of tools to allow paresis of the intestine in patients operated for about intestinal obstruction.

The mechanism of action of ozone therapy in the claimed method can be explained as follows. It is known that intestinal peristalsis is controlled by the parasympathetic nerve the th system. The absence of peristalsis, namely paresis of the intestine says about the absence of this control connection. Due to the fact that in the proposed method the use of the intravenous drip injection of ozonized physiological solution, ozone falls directly into the circulatory system of the patient, including in the microcirculatory bed, and enters the capillary network system, smooth muscles of the intestine. While ozone irritates directly receptors of the intestine. As a result, recovering managing communication parasympathetic system with the process of peristalsis, which stimulates smooth muscles of the intestine to move, resulting in faster restoration of disturbed homeostasis and, consequently, to accelerate the recovery of motor-evacuation function and shorten resolution paresis. The latter allows to reduce the rate of intake of certain medication is to restore homeostasis and repair of motor-evacuation function and cancel unpleasant for the patient procedure for the resolution of paresis. Reducing the number of acceptable patients of chemicals reduces the load on the liver. All this provides increased physiology of the claimed method, and also expands the Arsenal of tools to allow paresis of the intestine in patients, prooperiruem is the R about intestinal obstruction.

The first seven days after surgery - this is the period when a patient is in dire need of restoring homeostasis. It has been proved that the background ozone positive changes in the microvasculature of the patient, and therefore, improves metabolism and restores internal homeostasis (Kulikov A.G. the Influence of ozone therapy on the parameters of microcirculation according to laser Doppler flowmetry // Ozone in biology and medicine. Abstracts of the III all-Russian scientific-practical conference. N.Novgorod, 1998, s; Gulman M.I. Mechanism of action and prospects of application of medical ozone in clinical practice // the quarterly journal of medicine. Krasnoyarsk, No. 9, 2001, p.1-6). In addition, ozone therapy by intravenous drip provides a longer contact of ozone with the internal environment of the patient, which enhances therapeutic effect of ozone, because ozone has the property potentiation of drug action. As a result, the introduction of ozonized physiological solution during this period, in conjunction with traditional rehabilitation therapy, contributes to the rapid restoration of the body of the patient, and hence ensures the achievement of the claimed technical result.

Use C the opening of the way of ozonized physiological solution with an ozone concentration of 5 mg/l is optimal and achieves the stated technical result. The use of ozonated physiological solution with ozone concentration of more than 5 mg/l, as follows from the literature, has the risk of hemolysis (Kostina O.V. Effect of ozone on free radical processes in the blood of burn patients in the model vitro // Ozone in biology and medicine. Abstracts of the III all-Russian scientific-practical conference. N. Novgorod, 2000, p.23-24). Concentration less than 5 mg/l for carrying out the proposed method is inefficient, as it is known that the half-life of ozone is not dependent on its concentration in solution and the maximum decrease in the concentration of ozone occurs in the first 10-15 minutes after preparation of the solution. Thus, the ozone concentration in the solution is 5 mg/l is selected taking into account the above-mentioned properties of ozone and is optimal. It also ensures the achievement of the claimed technical result.

The introduction of ozonated saline solution once a day with 200 ml is optimal and sufficient for the implementation of the proposed method with the stated technical result.

From the analysis of patent literature were identified technical solutions, including the essential features of the claimed method set forth in the characterizing part of the claims, namely: the patient receives during the first seven days after surgery, one RA is a day intravenous drip of ozonated physiological solution with an ozone concentration of 5 mg/l in 200 ml.

In particular: know the use of ozone therapy in acute pancreatitis, which consists in intravenous drip injection of ozonized physiological solution with a concentration of from 2 to mg/l in 200 ml every other day for 7...10 days (Dwikardana, Usenik, Avispero and other Diagnosis and treatment of oxidative stress in acute pancreatites. Krasnoyarsk, 2002-148 S.; Migulin, Usenik, Swiller and other Correction of homeostasis in acute pancreatitis method of ozone therapy. Krasnoyarsk, 2003, Mark. - 178 C.).

The use of ozone therapy in the known method provides for the achievement of the technical result consists in relieving the symptoms of endogenous intoxication due to the stimulation ozone antioxidant protection, reducing the frequency of septic complications and mortality in the postoperative period in patients operated for acute pancreatitis.

There is a method of adaptation of the body during pathological processes involving metabolic disorders, including a single intravenous infusions of ozonated saline 200...400 ml with ozone concentration 2...6 mg/L. the Necessity of repeated injections determined from parameters of metabolism or in the presence of bacterial infections (RF patent No. 2132192, A61K 33/00, bull. No. 18, 1999). Dostigao the first technical result in this case - elimination of violations in the metabolic processes in the body of the patient in pathological processes.

From the above it follows that the identified technical solutions are not installed fame influence of distinctive signs consistent with distinctive features set forth stated in the claims, the claimed technical result, which consists in reducing time resolution paresis of the intestine and restoration of disturbed homeostasis in increasing physiology, as well as in the expansion of the means to resolve paresis of the intestine in patients operated for about intestinal obstruction.

Therefore, the claimed invention meets the criterion of "inventive step".

Thus, from the above it follows that the claimed method of treatment in the postoperative period of patients operated for about intestinal obstruction, if the implementation provides the achievement of the technical result consists in reducing time resolution paresis of the intestine and restoration of disturbed homeostasis in increasing physiology, as well as in the expansion of the means to resolve paresis of the intestine in patients operated for about intestinal obstruction.

The claimed method of treatment in the postoperative period of patients, PR is operated on for intestinal obstruction, as follows. Operated about intestinal obstruction patients received rehabilitation therapy. In addition, the patient received during the first seven days after surgery once a day by intravenous drip injection of ozonized physiological solution with an ozone concentration of 5 mg/l in 200 ml.

As a source of ozone used medical ozonator "Medozons BM". In the machine through reducer filed medical oxygen. Was ozonirovanie within 20 minutes of 0.9% sodium chloride solution until the ozone concentration of 5 mg/l, while the flow rate of solution of sodium chloride was 1 l/min

The rate of introduction of ozonized physiological solution corresponded recommended for the introduction of drugs by intravenous drip and was 30 minutes.

Rehabilitation therapy consisted of common measures:

drainage or aspiration of stomach; decompression of the bowel through a tube; stimulation of the intestine proserin 6...8 times per day according to the testimony; intravenous infusion therapy; drug therapy in accordance with the condition of the patient.

To confirm the performance of the claimed method of treatment in the postoperative period of patients operated for about intestinal obstruction, were given life is s group of patients, surgery for acute intestinal obstruction in the strangulated hernia and the adhesive obstruction. With strangulated hernia: 6 patients - control group without ozone; 5 patients with ozone therapy.

With adhesive obstruction: 8 patients - control group without ozone; 11 patients with ozone therapy.

The results are shown in tables 1 and 2 respectively.

Table 1.
Strangulated hernia/dayControl group - 6 patientsOzone - 5 cases
1Chair noChair in 1 patient
4Chair in 2 of 6 patientsChair in 3 of 5 patients
8The chair at allThe chair at all

Chair no
Table 2.
Acute adhesive obstruction/dayA control group of 8 patientsOzone - 11 patients
1Chair no
4Chair in 3 of 8 patientsChair in 8 of 11 patients
8The chair at allThe chair at all

The method of treatment in the postoperative period of patients operated for about intestinal obstruction, including rehabilitation therapy, characterized in that, in addition, the patient receives during the first seven days after surgery once a day by intravenous drip injection of ozonized physiological solution with an ozone concentration of 5 mg/l in 200 ml.



 

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