MD620Z - Method for selective decontamination of gastrointestinal tract in the intestinal failure syndrome - Google Patents

Method for selective decontamination of gastrointestinal tract in the intestinal failure syndrome Download PDF

Info

Publication number
MD620Z
MD620Z MDS20120137A MDS20120137A MD620Z MD 620 Z MD620 Z MD 620Z MD S20120137 A MDS20120137 A MD S20120137A MD S20120137 A MDS20120137 A MD S20120137A MD 620 Z MD620 Z MD 620Z
Authority
MD
Moldova
Prior art keywords
intestinal
gastrointestinal tract
failure syndrome
intestinal failure
selective decontamination
Prior art date
Application number
MDS20120137A
Other languages
Romanian (ro)
Russian (ru)
Inventor
Георге АНГЕЛИЧ
Сергей САМОХВАЛОВ
Виорел МОРАРУ
Original Assignee
Георге АНГЕЛИЧ
Сергей САМОХВАЛОВ
Виорел МОРАРУ
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Георге АНГЕЛИЧ, Сергей САМОХВАЛОВ, Виорел МОРАРУ filed Critical Георге АНГЕЛИЧ
Priority to MDS20120137A priority Critical patent/MD620Z/en
Publication of MD620Y publication Critical patent/MD620Y/en
Publication of MD620Z publication Critical patent/MD620Z/en

Links

Landscapes

  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)

Abstract

The invention relates to medicine, in particular to surgery, and can be used for the treatment of intestinal failure syndrome in the postoperative period in patients with acute surgical diseases.According to the invention, the method for selective decontamination of gastrointestinal tract in the intestinal failure syndrome consists in that it is carried out the nasogastric or nasointestinal intubation, then is administered through the tube ozonized physiologic saline in an amount of 200 ml with the ozone concentration of 5…7 mg/L and erythromycin solution 500 mg, 2 times a day, concomitantly during 30 min is irradiated the epigastric region with electromagnetic waves in the millimetric range with an intensity of 10 mW/cm and a wavelength of 7.1 nm, the course is 7 days.

Description

Invenţia se referă la medicină, în special la chirurgie şi poate fi aplicată pentru tratamentul sindromului de insuficienţă intestinală în perioada postoperatorie la pacienţii cu patologii chirurgicale acute. The invention relates to medicine, in particular to surgery, and can be applied for the treatment of intestinal insufficiency syndrome in the postoperative period in patients with acute surgical pathologies.

Sindromul insuficienţei intestinale reprezintă totalitatea dereglărilor motorii, evacuatorii, secretorii, digestiei, funcţiei de absorbţie cu dereglarea funcţiei de barieră a peretelui intestinal manifestându-se prin translocarea florei microbiene din lumenul intestinal în cavitatea peritoneală sterilă. Totodată, e cunoscut faptul că în cadrul parezei şi stazei intestinale are loc contaminarea segmentelor proximale ale intestinului subţire din contul microflorei convenţional patogene, ca urmare a translocaţiei retrograde a reprezentanţilor microbiotei colonice. Astfel, sindromul insuficienţei intestinale reprezintă o problemă majoră pentru chirurgi, care apare în perioada postoperatorie la intervenţiile chirurgicale în caz de peritonită. Intestinal insufficiency syndrome represents the totality of motor, evacuatory, secretory, digestive, absorption function disorders with disruption of the barrier function of the intestinal wall, manifested by the translocation of microbial flora from the intestinal lumen into the sterile peritoneal cavity. At the same time, it is known that in intestinal paresis and stasis, contamination of the proximal segments of the small intestine occurs due to conventionally pathogenic microflora, as a result of the retrograde translocation of representatives of the colonic microbiota. Thus, intestinal insufficiency syndrome represents a major problem for surgeons, which occurs in the postoperative period during surgical interventions in case of peritonitis.

Este cunoscută metoda de decontaminare a tractului digestiv cu utilizarea preparatelor antibacteriale cu spectru selectiv de acţiune, care constă în introducerea în lumenul gastrointestinal prin sondă a complexului de remedii antibacteriene (ghentamicină, polimixină, nistatină) timp de 7…10 zile. Investigaţiile microbiologice demonstrează că regimul de decontaminare selectivă diminuează semnificativ gradul de colonizare şi infectare a tractului gastrointestinal, căilor respiratorii superioare şi a uroinfecţiei [1]. The method of decontamination of the digestive tract using antibacterial preparations with a selective spectrum of action is known, which consists in introducing into the gastrointestinal lumen through a probe a complex of antibacterial remedies (gentamicin, polymyxin, nystatin) for 7…10 days. Microbiological investigations demonstrate that the selective decontamination regimen significantly reduces the degree of colonization and infection of the gastrointestinal tract, upper respiratory tract and urinary tract infection [1].

Dezavantajele metodei constă în posibilităţi limitate de aplicare din cauza reacţiilor alergice faţă de complexul de antibiotice, intoleranţă individuală la preparatele antibacteriene, efect toxic sau imunosupresiv al unor antibiotice în dozaj submaximal, antibioticorezistenţa naturală a florei microbiene. The disadvantages of the method consist of limited possibilities of application due to allergic reactions to the antibiotic complex, individual intolerance to antibacterial preparations, toxic or immunosuppressive effect of some antibiotics in submaximal dosage, natural antibiotic resistance of microbial flora.

Este cunoscută metoda de decontaminare selectivă a tractului gastrointestinal în sindromul insuficienţei intestinale în pancreonecroză, care constă în efectuarea laparatomiei, abdominizarea pancreasului, marsupializarea, drenarea bursei omentale, intubarea intestinală cu ajutorul unei sonde nasogastrale, administrarea prin sonda instalată a unei soluţii de ser fiziologic ozonat în volum de 200 ml cu concentraţia ozonului de 4…7 mg/l, de 2 ori pe zi, timp de 7 zile, concomitent se administrează per rectum ser fiziologic ozonat în volum de 300 ml cu concentraţia ozonului de 30 mg/l, de 7 ori cu un interval de 3…4 zile [2]. The method of selective decontamination of the gastrointestinal tract in intestinal failure syndrome in pancreatic necrosis is known, which consists of performing laparotomy, abdominization of the pancreas, marsupialization, drainage of the omental bursa, intestinal intubation using a nasogastric tube, administration through the installed tube of a solution of ozonated physiological serum in a volume of 200 ml with an ozone concentration of 4…7 mg/l, 2 times a day, for 7 days, simultaneously administering per rectum ozonated physiological serum in a volume of 300 ml with an ozone concentration of 30 mg/l, 7 times with an interval of 3…4 days [2].

Dezavantajele metodei constau în efectul bacteriostatic insuficient, nu acţionează asupra motoricii intestinale care necesită un timp îndelungat de restabilire a tranzitului gastrointestinal. The disadvantages of the method are the insufficient bacteriostatic effect, it does not act on intestinal motility which requires a long time to restore gastrointestinal transit.

Problema pe care o soluţionează invenţia constă în elaborarea unei metode eficiente de decontaminare, care ar acţiona concomitent asupra tuturor verigilor care provoacă sindromul de insuficienţă intestinală, ar restabili tranzitul intestinal într-un timp mai redus, ar micşora frecvenţa complicaţiilor postoperatorii, şi anume translocarea bacteriană din lumenul intestinal în cavitatea abdominală care ar agrava starea pacientului. The problem that the invention solves consists in developing an effective decontamination method, which would act simultaneously on all the links that cause intestinal insufficiency syndrome, would restore intestinal transit in a shorter time, would reduce the frequency of postoperative complications, namely bacterial translocation from the intestinal lumen into the abdominal cavity which would worsen the patient's condition.

Conform invenţiei metoda de decontaminare selectivă a tractului gastrointestinal în sindromul insuficienţei intestinale constă în aceea că se efectuează intubarea nasogastrică sau nasointestinală, apoi se administrează prin sondă sol. fiziologică ozonată în cantitate de 200 ml cu concentraţia ozonului de 5…7 mg/L şi sol. eritromicină 500 mg, de 2 ori pe zi, concomitent timp de 30 min se iradiază regiunea epigastrică cu unde electromagnetice în diapazon milimetric cu intensitatea de 10 mW/cm şi lungimea de undă de 7,1 nm, cura constituie 7 zile. According to the invention, the method of selective decontamination of the gastrointestinal tract in intestinal insufficiency syndrome consists in performing nasogastric or nasointestinal intubation, then administering through a probe ozonated physiological saline in an amount of 200 ml with an ozone concentration of 5…7 mg/L and erythromycin saline 500 mg, 2 times a day, simultaneously for 30 min the epigastric region is irradiated with electromagnetic waves in the millimeter range with an intensity of 10 mW/cm and a wavelength of 7.1 nm, the course is 7 days.

Rezultatul invenţiei este tratamentul efectiv şi profilaxia complicaţiilor condiţionate de colonizarea proximală a tractului gastrointestinal, rezolvarea ocluziei intestinale dinamice cu restabilirea peristaltismului şi tranzitului intestinal într-o perioadă scurtă de timp, ceea ce duce la profilaxia complicaţiilor postoperatorii severe şi restabilirea pacienţilor în perioada postoperatorie cu micşorarea duratei de spitalizare şi a sinecostului tratamentului. The result of the invention is the effective treatment and prophylaxis of complications caused by proximal colonization of the gastrointestinal tract, resolution of dynamic intestinal occlusion with restoration of peristalsis and intestinal transit in a short period of time, which leads to the prophylaxis of severe postoperative complications and the recovery of patients in the postoperative period with a decrease in the duration of hospitalization and the cost of treatment.

Avantajele metodei revendicate sunt: The advantages of the claimed method are:

micşorarea colonizării proximale a tractului gastrointestinal cu reducerea frecvenţei complicaţiilor postoperatorii, reducing proximal colonization of the gastrointestinal tract with a reduction in the frequency of postoperative complications,

restabilirea timpurie a tranzitului intestinal, care preîntâmpină translocarea bacteriană din lumenul intestinal în cavitatea abdominală, early restoration of intestinal transit, which prevents bacterial translocation from the intestinal lumen into the abdominal cavity,

micşorarea duratei de spitalizare şi a sinecostului tratamentului. reducing the duration of hospitalization and the cost of treatment.

Totodată în scopul amplificării acţiunii bactericide şi potenţarea funcţiei motorii se utilizează ozonoterapia în combinare cu eritromicină (antibiotic cu acţiune prokinetică - agonist al receptorilor motilinici, care accelerează evacuarea conţinutului gastric datorită creşterii amplitudinii contracţiei pilorului şi îmbunătăţirii coordonării antral-duodenale). Administrarea soluţiei de ozon cu eritromicină şi iradierea cu unde electromagnetice se efectuează până la restabilirea funcţiei motorii a tractului gastrointestinal. At the same time, in order to amplify the bactericidal action and enhance the motor function, ozone therapy is used in combination with erythromycin (antibiotic with prokinetic action - agonist of motilin receptors, which accelerates the evacuation of gastric contents due to the increase in the amplitude of the pyloric contraction and the improvement of antral-duodenal coordination). The administration of the ozone solution with erythromycin and irradiation with electromagnetic waves is carried out until the motor function of the gastrointestinal tract is restored.

Metoda se efectuează în modul următor. The method is performed in the following way.

Manifestarea sindromului de insuficienţă intestinală este cauzată de o patologie chirurgicală acută sau apare în perioada postoperatorie după o intervenţie chirurgicală abdominală. Dacă este cauzată de o patologie chirurgicală acută se efectuează examenul clinic şi paraclinic pentru depistarea cauzei ce a provocat sindromul menţionat. În perioada postoperatorie precoce se utilizează metoda dată. Se efectuează intubarea nasogastrică sau nasointestinală cu administrarea prin sonda instalată a soluţiei de ser fiziologic ozonat în volum de 200 ml cu concentraţia ozonului de 5…7 mg/l şi cu soluţie de eritromicină 500 mg, care se administrează de 2 ori pe zi, concomitent timp de 30 min se iradiază regiunea epigastrică cu unde electromagnetice în diapazon milimetric cu intensitatea mai mică de 10 mW/cm şi lungimea de undă de 7,1 mm, cura de tratament se efectuează timp de 7 zile. The manifestation of intestinal insufficiency syndrome is caused by an acute surgical pathology or occurs in the postoperative period after abdominal surgery. If it is caused by an acute surgical pathology, a clinical and paraclinical examination is performed to detect the cause that caused the aforementioned syndrome. In the early postoperative period, the given method is used. Nasogastric or nasointestinal intubation is performed with the administration through the installed probe of ozonated saline solution in a volume of 200 ml with an ozone concentration of 5…7 mg/l and erythromycin solution 500 mg, which is administered 2 times a day, simultaneously for 30 min the epigastric region is irradiated with electromagnetic waves in the millimeter range with an intensity of less than 10 mW/cm and a wavelength of 7.1 mm, the treatment course is carried out for 7 days.

Metoda dată a fost aplicată la 14 pacienţi. This method was applied to 14 patients.

Exemplu Example

Pacientul D., 57 ani a fost internat în secţia chirurgie generală cu diagnosticul la internare de peritonită generalizată. La internare acuză dureri pronunţate pe tot traiectul abdominal, balonare, absenţa tranzitului intestinal care se manifestă prin lipsa emisiilor de gaze şi lipsa scaunului, vome, greţuri. Din anamneză se determină că simptomele au apărut cu 10 ore în urmă şi au progresat în timp. S-a stabilit că provocări alimentare sau traumatism abdominal nu au fost. Stare generală gravă. La examenul radiologic se determină aer liber în cavitatea abdominală, la examenul ultrasonor se atestă prezenţa lichidului liber în cavitatea abdominală. S-a efectuat operaţie de urgenţă - laparotomie, rezecţia unui segment de ileon perforat, asanarea şi drenarea cavităţii peritoneale, intubarea intraoperatorie a intestinului subţire cu sondă nasointestinală. Perioada postoperatorie se manifestă cu semne clinice de insuficienţă intestinală, pareză. Prin sonda instalată se administrează soluţie de ser fiziologic ozonat în volum de 200 ml cu concentraţia ozonului de 5…7 mg/l şi cu soluţie de eritromicină 500 mg, care se administrează de 2 ori pe zi, concomitent timp de 30 min se iradiază regiunea epigastrică cu unde electromagnetice în diapazon milimetric cu intensitatea mai mică de 10 mW/cm şi lungimea de undă de 7,1 mm, cura de tratament durează timp de 7 zile. Patient D., 57 years old, was admitted to the general surgery department with a diagnosis of generalized peritonitis upon admission. Upon admission, he complained of severe pain throughout the abdominal tract, bloating, absence of bowel movement, which is manifested by the lack of gas emissions and the lack of stool, vomiting, nausea. From the anamnesis, it is determined that the symptoms appeared 10 hours ago and progressed over time. It was established that there were no food challenges or abdominal trauma. General condition is serious. The radiological examination determines free air in the abdominal cavity, the ultrasound examination attests the presence of free fluid in the abdominal cavity. Emergency surgery was performed - laparotomy, resection of a segment of perforated ileum, sanitation and drainage of the peritoneal cavity, intraoperative intubation of the small intestine with a nasointestinal probe. The postoperative period is manifested by clinical signs of intestinal insufficiency, paresis. Through the installed probe, ozonated saline solution in a volume of 200 ml with an ozone concentration of 5…7 mg/l and erythromycin solution 500 mg is administered, which is administered 2 times a day, simultaneously for 30 min the epigastric region is irradiated with electromagnetic waves in the millimeter range with an intensity of less than 10 mW/cm and a wavelength of 7.1 mm, the treatment course lasts for 7 days.

După aplicarea metodei date starea generală s-a îmbunătăţit, s-a restabilit funcţia intestinului obiectivizată prin apariţia mai timpurie a perstaltismului, emisiei de gaze, scaun desinestătător. After applying the given method, the general condition improved, the intestinal function was restored, objectified by the earlier appearance of peristalsis, gas emission, and loose stools.

1. Stoutenbeek C. P., van Saene H. K. F., Miranda D. R., and Zandstra D. F. A new technique of infection prevention in the intensive care unit by selective decontamination of the digestive tract. Acta naesthesiologica Belgia, 2983, vol. 34, nr. 3, p.209-221 1. Stoutenbeek C. P., van Saene H. K. F., Miranda D. R., and Zandstra D. F. A new technique of infection prevention in the intensive care unit by selective decontamination of the digestive tract. Acta naesthesiologica Belgia, 2983, vol. 34, no. 3, p.209-221

2. RU 2194513 C2 2002.12.20 2. RU 2194513 C2 2002.12.20

Claims (1)

Metodă de decontaminare selectivă a tractului gastrointestinal în sindromul insuficienţei intestinale, care constă în aceea că se efectuează intubarea nasogastrică sau nasointestinală, apoi se administrează prin sondă sol. fiziologică ozonată în cantitate de 200 ml cu concentraţia ozonului de 5…7 mg/L şi sol. eritromicină 500 mg, de 2 ori pe zi, concomitent timp de 30 min se iradiază regiunea epigastrică cu unde electromagnetice în diapazon milimetric cu intensitatea de 10 mW/cm şi lungimea de undă de 7,1 nm, cura constituie 7 zile.Method of selective decontamination of the gastrointestinal tract in intestinal insufficiency syndrome, which consists in performing nasogastric or nasointestinal intubation, then administering through a probe ozonated physiological saline in an amount of 200 ml with an ozone concentration of 5…7 mg/L and erythromycin saline 500 mg, 2 times a day, simultaneously for 30 min the epigastric region is irradiated with electromagnetic waves in the millimeter range with an intensity of 10 mW/cm and a wavelength of 7.1 nm, the course is 7 days.
MDS20120137A 2012-10-08 2012-10-08 Method for selective decontamination of gastrointestinal tract in the intestinal failure syndrome MD620Z (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
MDS20120137A MD620Z (en) 2012-10-08 2012-10-08 Method for selective decontamination of gastrointestinal tract in the intestinal failure syndrome

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
MDS20120137A MD620Z (en) 2012-10-08 2012-10-08 Method for selective decontamination of gastrointestinal tract in the intestinal failure syndrome

Publications (2)

Publication Number Publication Date
MD620Y MD620Y (en) 2013-04-30
MD620Z true MD620Z (en) 2013-11-30

Family

ID=48227609

Family Applications (1)

Application Number Title Priority Date Filing Date
MDS20120137A MD620Z (en) 2012-10-08 2012-10-08 Method for selective decontamination of gastrointestinal tract in the intestinal failure syndrome

Country Status (1)

Country Link
MD (1) MD620Z (en)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2709113C1 (en) * 2019-02-19 2019-12-16 Михаил Викторович Быков Method of treating intestinal failure with an oxygenated saline enteral solution

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
MD888G2 (en) * 1997-04-17 1998-10-31 Gavril Boian Method for postoperation complications prophylaxis at the planned proctological operations
RU2194513C2 (en) * 2001-01-25 2002-12-20 Красноярская государственная медицинская академия Method for decontamination of gastrointestinal tract by using ozone in pancreonecrosis-suffering patients
  • 2012

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
MD888G2 (en) * 1997-04-17 1998-10-31 Gavril Boian Method for postoperation complications prophylaxis at the planned proctological operations
RU2194513C2 (en) * 2001-01-25 2002-12-20 Красноярская государственная медицинская академия Method for decontamination of gastrointestinal tract by using ozone in pancreonecrosis-suffering patients

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
Stoutenbeek C. P., van Saene H. K. F., Miranda D. R., and Zandstra D. F. A new technique of infection prevention in the intensive care unit by selective decontamination of the digestive tract. Acta naesthesiologica Belgia, 2983, vol. 34, nr. 3, p.209-221 *

Also Published As

Publication number Publication date
MD620Y (en) 2013-04-30

Similar Documents

Publication Publication Date Title
SCHWARTZ et al. Management of Perforated Appendicitis in Children The Controversy Continues
Otto et al. Efficacy of antibiotic penetration into pancreatic necrosis
MD620Z (en) Method for selective decontamination of gastrointestinal tract in the intestinal failure syndrome
RU2189822C2 (en) Method for treating gastroduodenal ulcers complicated with scar-ulcerous stenosis of the upper departments of gastrointestinal tract
RU2594512C1 (en) Method for intraportal ozone therapy in patients with widespread peritonitis
Ismail Hyperbaric oxygen therapy as a complementary or alternative therapy for chronic oral and gastrointestinal disorders: A narrative review
RU2341269C1 (en) Method of surgical endotoxicosis treatment
RU2648346C1 (en) Method of treatment of intestine insufficiency syndrome in patients with general peritonitis
RU2196577C2 (en) Method for treating peritonitis
RU2445130C2 (en) Method for prevention of postoperative enteroparesis
RU2398535C1 (en) Method of carrying out endoscopic hemostasis in case of acute gastroduodenal hemorrhage
RU2202964C2 (en) Method for treating patients for acute cholecystitis aggravated with cholangitis in postoperative period
RU2523822C1 (en) Method for postoperative prevention of colocolonic anastomotic leakage
Becker et al. Colectomy, mucosal proctectomy, and ileal pouch-anal anastomosis. A prospective trial of optimal antibiotic management
RU2283120C1 (en) Method for treating intestinal dysbacteriosis in peritonitis cases
RU2359673C2 (en) Way of treatment of chronic helicobacter pylori-associated gastritis of gastric remnant
RU2661090C1 (en) Method of treating pleural empyema
UA11994U (en) Method for treating acute erosion and ulcer of intestine and stomach in acute pancreatitis
RU2295350C1 (en) Method for treating female chronic cystitis cases
RU2631561C1 (en) Method for treating acute widespread purulent peritonitis
RU2836377C1 (en) Method for enteral rehydration of patients with acute intestinal obstruction
RU2265455C1 (en) Method for treating chemical esophageal burns
RU2644934C1 (en) Method for endoscopic treatment of gastroduodenal ulcers
RU2418591C1 (en) Method of treating chronic ductoforitis
RU2243780C1 (en) Method for treating postoperational abscesses of abdominal cavity

Legal Events

Date Code Title Description
FG9Y Short term patent issued
KA4Y Short-term patent lapsed due to non-payment of fees (with right of restoration)
MM4Y Short-term patent definitely lapsed due to non-payment of fees