RU12789U1 - DEVICE FOR TREATMENT OF EROSIVE-ULCERAL DISEASES OF THE STOMACH AND DUODENAL - Google Patents

Abstract

A device for treating erosive and ulcerative lesions of the stomach and duodenum, containing an endoscope with a light source, an eyepiece, a control unit, a flexible light guide, a lens and a working channel for supplying drugs and introducing instruments, characterized in that it is additionally equipped with electrostimulating electrodes, a power supply , a personal computer with a software package for electrical stimulation parameters, a galvanic isolation unit, a buffer register, a digital-to-analog converter, and a current source controlled by voltage, and the electrostimulating electrodes are arranged to place the endoscope in the working channel and move longitudinally along it, while the buffer register, digital-to-analog converter and voltage controlled current source are connected in series and connected to the power supply, the buffer register through the block galvanic isolation is connected to the serial port of a personal computer, and the voltage-controlled current source is connected by insulated conductors to electrostimulating electrodes.

Description

DEVICE FOR TREATMENT OF EROSIVE-ULCERAL DISEASES OF THE STOMACH AND DUODENAL

The utility model relates to medicine, namely to means that implement combined treatment methods using electrotherapy, and can be used in the treatment of erosive ulcerative lesions of the stomach and duodenum (duodenum).

A self-contained probe-electrostimulator of the gastrointestinal tract (GIT) is known, containing two electrodes separated by a dielectric, forming a sealed cavity, inside of which there is an electronic unit with a pulse generator microcircuit, a power supply and conductors connecting the power supply and the electronic unit with electrodes (copyright certificate USSR No. 1223922 class A61 N 1/36 with a priority of 02.13.84). The self-contained electrical stimulator has a fitting for connection with a probe with openings for delivering drugs to the stimulation region. Using a probe under the control of fluoroscopy, the electric stimulator is introduced into the stimulation zone, for example, in the duodenum, and it automatically starts working in a conductive medium, giving out rectangular rectangular electrical pulses of the specified parameters, for example: pulse duration - 5 ms, pulse frequency - 50 Hz, burst duration pulses - 32 ms, the pulse train repetition period - 2500 ms, the repetition time of a series of packets - 40 s, the delay time between series of packets - 40 s, the pulse amplitude - 10 mA. The use of a stimulator of the gastrointestinal tract has a stimulating effect on the motor and evacuation functions of the gastrointestinal tract and provides the possibility of delivering drugs to the stimulation zone, which helps to increase the effectiveness of therapeutic methods for treating ulcers and erosion of the gastrointestinal tract.

The main disadvantages of the known device are:

the difficulty of delivering the stimulator directly to the area of ulcerative erosion due to the limited possibilities of visual review when using fluoroscopy;

A61 N 1/18

the danger of perforation by the stimulator of the intestinal wall in the ulcer area;

low effectiveness of the drugs introduced through the probe due to the development of proteolysis of the mucous membrane in the affected area.

In connection with the above-mentioned significant shortcomings, electrical stimulation in practice is mainly used to activate the motor and evacuation functions of the gastrointestinal tract.

In recent years, endoscopes have been widely used in medical practice. Due to advances in fiber optics and improving the design of endoscopes, the use of laparo-, thoraco-, culdo-, cystoscopy, etc., with diagnostic and therapeutic purposes has expanded. The use of endoscopes eliminates a number of the above disadvantages characteristic of electrical stimulants, mainly due to the visual viewing capabilities.

An endoscope is known for research for the diagnosis and treatment of a number of gastrointestinal diseases, in particular ulcers and erosive lesions of the stomach and duodenum, containing an eyepiece, a control unit, a flexible part with a distal controlled end, a light source and a light guide (Guide for kpinic endoscopy. -M .: Medicine, 1985.- S. 13-17). A fiber, a lens and a working channel are placed in the flexible part of the endoscope. To carry out various diagnostic and therapeutic interventions through the working channel, the endoscope is equipped with a set of special tools: biopsy forceps, grabs, catheter tubes, needles, loops, diathermic electrodes, incisors, etc. The main advantage of the endoscope is that it can be used to sequentially examine the departments of the stomach and duodenum, establish the exact location of the lesion and carry out the necessary operations, including and the supply of drugs directly on the affected area with constant visual monitoring.

The disadvantages of the known endoscope include the limited ability to treat erosive and ulcerative lesions of the gastrointestinal tract due to the lack of new treatment methods and the lack of appropriate equipment adapted to work with endoscopes.

A device is proposed for the treatment of erosive and ulcerative lesions of the stomach and duodenum, containing an endoscope with a light source, an eyepiece and a control unit, in the flexible part of which an optical fiber, lens and working channel are built-in.

The essence of the utility model lies in the fact that the device is additionally equipped with electrostimulating electrodes, a power supply unit, a personal computer with a package of electrostimulation parameters programs, a galvanic isolation unit, a buffer register, a digital-to-analog converter and a voltage controlled current source, moreover, the electrostimulating electrodes are arranged to accommodate in the working channel of the endoscope and its longitudinal movement along it, while the buffer register, digital-to-analog converter a current source, a voltage controlled sequentially connected together and to the power supply, wherein the buffer register is connected through galvanic decoupling unit to a serial port of a PC, and a current source, a voltage controlled insulated conductors coupled to electrostimulating electrodes.

The device provides the ability to select programs with impulse exposure parameters for each particular patient with a specific nosological form of the disease and conduct treatment cycles under visual control with an endoscope.

The device allows to reduce the treatment time for erosive and ulcerative lesions of the stomach and duodenum in comparison with the use of known endoscopes and electrical stimulants. It allows one to obtain various characteristics of currents in terms of pulse frequency, their shape and amplitude, duration of exposure, etc. The device is reliable and safe for any circuit damage.

The essence of the utility model is illustrated in the drawing, where Fig. 1 shows a schematic diagram of an endoscope, Fig. 2 is a section I - I of Fig. 1, Fig. 3 is a block diagram of an electric stimulator.

For example, an OLYMPUS GLF - Q30 type endoscope containing a light source 1, a control unit 2, an eyepiece 3 and a flexible part 4 in which a lens 5, flexible optical fibers 6 and a working channel 7 can be used can be used in the device design. The device also contains a personal a computer 8 with an electrical stimulation parameter program package connected to the remaining units of the device through a galvanic isolation unit 9. A buffer register 10, a digital-to-analog converter 11, and a voltage-controlled current source 12 are connected in series and connected to the power supply 13. The power supply has a control system for the magnitude of the generated voltage, which, when the voltage is deviated beyond the specified limits, destroys the fuse-links of the power supply. The current generated by the power supply is limited to a patient-safe value of 25 mA. The output of the current source 12 by flexible insulated conductors is connected to electrostimulating electrodes 14, which are made in the form of a sealed capsule, on which are placed electrodes isolated from each other by a plastic sleeve. All the blocks that make up the electric stimulator contain well-known technical solutions and are used in various devices in a number of branches of technology, in particular, similar circuit diagrams of the block, galvanic isolation and electrodes are used in the gastroenterostimulator HES-35-01 Endoton-01 B.

The following is a description of the operation of the device.

To establish an accurate diagnosis, the patient undergoes fibrogastroduodenoscopy, during which the location of the ulcer in the duodenum, the size of the ulcer defect and its features, the pH of the gastric juice are determined, pieces of the mucosa are taken from different parts of the stomach, etc. The package of programs for electrical stimulation parameters is compiled on the basis of existing world clinical practice and theoretical studies conducted in this direction in various research institutes and clinics. As experience accumulates, these programs are adjusted. The software package is entered into the computer 8. The results of fibrogastroduodenoscopy are also entered into the computer, where the program of electrical stimulation parameters is automatically selected

Given the characteristics of the disease and the condition of a particular patient. The program is scanned on the computer screen to study it and make changes and additions if necessary. A flushing tube is introduced into the working channel 7 of the endoscope and the bottom of the duodenal ulcer is mechanically cleaned, after which a sanitizing solution consisting of 15 ml of a 5% solution of metrogil and 5 ml of 20% jelly solcoseryl is applied to the ulcer defect. A washing tube is removed from the working channel 7 of the endoscope and a multi-contact electrode, for example, PEDDM-9, is introduced. An electric current with blocks safe for the patient is supplied from power supply unit 13 to blocks 10.11 and 12, the value of which is constantly monitored by the generated voltage control system, which is built into block 13. The electrical stimulation program is issued in the form of a digital code through the computer’s serial port (LPT) and the unit galvanic isolation based on transistor optocouplers on device blocks that convert the code contained in the control program into the amount of current acting on the affected area through electrical stimulation s electrodes 14. The buffer register 10 stores the current value of the digital code corresponding to the magnitude of the current generated, digital-to-analog converter converts the input from the computer 8 into a digital code corresponding to the voltage value and the final formation of the set of current parameters occurs in the power source 12, a controlled voltage. Thus, this device allows you to programmatically generate and provide parameters of the acting current.

Under visual control of the endoscope, electrostimulating electrodes 14 are applied to the edges of the ulcer and a treatment cycle is carried out.

The device allows you to select the form of stimulating currents, eliminating the monotonous effect on the smooth muscles of the duodenum, in which there is adaptation and fatigue in the mechanisms of contraction of smooth muscles. The choice of parameters for changing the amplitude of the current pulses contributes to the efficiency of microelectrophoresis of drug substances in periulceral tissue.

their position. After the time specified by the program for the cycle of electrical stimulation, the computer automatically turns off the supply of pulses and the endoscope with electrodes is removed.

The proposed device implements a new method of treating erosive ulcers of the stomach and duodenum under visual control using an endoscope. The device is safe for patients and allows you to choose electrical stimulation programs specifically for each patient. The use of the device allows to reduce the treatment time by 2-3 times.

General Director of the Kemerovo Cardiocenter. ,, i., G.Yu. Tsygankova

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Claims (1)

A device for treating erosive and ulcerative lesions of the stomach and duodenum, containing an endoscope with a light source, an eyepiece, a control unit, a flexible light guide, a lens and a working channel for supplying drugs and introducing instruments, characterized in that it is additionally equipped with electrostimulating electrodes, a power supply , a personal computer with a software package for electrical stimulation parameters, a galvanic isolation unit, a buffer register, a digital-to-analog converter, and a current source controlled by voltage, and the electrostimulating electrodes are arranged to place the endoscope in the working channel and move longitudinally along it, while the buffer register, digital-to-analog converter and voltage controlled current source are connected in series and connected to the power supply, the buffer register through the block galvanic isolation is connected to the serial port of a personal computer, and the voltage-controlled current source is connected by insulated conductors to electrostimulating electrodes.