RU165362U1 - METHOD FOR MEASURING INTERNAL PRESSURE IN PATIENTS IN THE POSTOPERATIVE PERIOD - Google Patents

Abstract

A method for measuring intra-abdominal pressure in patients in the postoperative period using a low pressure gauge, characterized in that after the main stage of surgical care is performed, a rubber balloon is installed between the peritoneum and the aponeurosis through a skin puncture between the peritoneum and the aponeurosis, and hermetically connected to the tube of the mechanical air blower and to the manometer low pressure, then conduct injection 5 mm cube. air into a rubber bottle to create a working volume in a rubber bottle, the oscillations of which are transmitted to a low pressure gauge, and this indicator is considered a zero reference point.

Description

The utility model relates to medicine, namely to abdominal surgery, and can be used to measure and monitor intra-abdominal pressure (IAP) in patients undergoing abdominal surgery.

As a prototype, a method for measuring intra-abdominal pressure was chosen (M. Abakumov. The value of high intra-abdominal pressure syndrome in surgical practice (literature review) / M. M. Abakumov, A. N. Smolyar // Surgery. - 2003. - No. 12. - P. 66-72), including the use of a conventional Foley urinary catheter, through which 50-100 ml of sterile physiological saline is injected into the bladder cavity, after which a transparent capillary or ruler is attached to the Foley catheter and the intravesical pressure is measured, taking the pubic joints as zero, also a low pressure gauge can be attached to the Foley catheter, the indicators of which will correspond to the level of pressure in the abdominal cavity.

Signs that coincide with the essential features of the claimed method are: the use of a low pressure gauge.

The reasons that impede the achievement of the expected technical result are: during each measurement it is necessary to reassemble the system, which implies a high risk of developing an ascending urinary tract infection, as well as measuring the pressure in the bladder, cannot be used in patients with pelvic fracture, with paravesical hematomas and trauma Bladder.

The utility model is based on the task of improving the prototype method by measuring the pressure of the abdominal cavity without catheterization of the urinary tract, which will achieve the expected technical result - to improve monitoring of IOP in the postoperative period.

The technical result of the utility model is: increasing the accuracy and information content of measurements, the ability to monitor IAP for a long period, preventing infection of the urinary tract, and the possibility of widespread use in patients with various pathologies.

The problem is solved in that in the method for measuring intra-abdominal pressure in patients in the postoperative period using a low pressure gauge, according to a utility model, after performing the main stage of surgical assistance, a rubber balloon is installed between the peritoneum and the aponeurosis through a skin puncture, tightly connected to a pipe of a mechanical air blower and with a low pressure gauge, then 5 mm cubic meters are injected. air into a rubber bottle to create a working volume in a rubber bottle, the oscillations of which are transmitted to a low pressure gauge, and this indicator is considered a zero reference point.

A causal relationship between the totality of the essential features of the proposed method and the expected technical result is as follows: the use of a system for measuring IAP, consisting of a rubber cylinder hermetically connected to the pipe of a mechanical air blower and with a low pressure gauge, conducting air injection into the cylinder to create a working volume in it, the fluctuations of which will be transmitted to a low pressure gauge, allows you to determine the IAP for a long time in order to avoid NOSTA urinary tract infection, and allows the desired quality monitoring in the postoperative period.

The drawing shows a diagram of postoperative measurement and monitoring of intra-abdominal pressure, where 1 is the skin, 2 is the peritoneum, 3 is an aponeurosis, 4 is a rubber balloon, 5 is a tube, 6 is a mechanical air blower, 7 is a low pressure gauge, 8 is a valve, 9 - laparotomy wound.

After the main stage of surgical assistance is performed on the abdominal organs through a puncture of the skin 1, a rubber balloon 4 is installed on the lateral surface of the abdomen between the peritoneum 2 and aponeurosis 3, it is hermetically connected to the system consisting of a tube 5, a mechanical air blower 6 with a valve 8, and a low pressure gauge 7. Then carry out the injection of 5 mm cube. air into the rubber balloon 4 using a mechanical air blower 6 with the valve 7 closed to create a working volume in the rubber balloon 4, the fluctuations of which will be transmitted to the low pressure gauge 7, this indicator is a zero reference point, since with an open abdominal cavity, the rate of intra-abdominal pressure is to zero. After that, the laparotomy wound is sutured 9. The difference between the existing and initial readings of the low pressure gauge 7 is the value of the intra-abdominal pressure. The system can be used throughout the postoperative period to control abdominal pressure in

any moment. To remove the presented system for measuring intra-abdominal pressure, it is enough to bleed air through valve 8 and remove the system from the wound.

The developed method for measuring and monitoring intra-abdominal pressure in the postoperative period is technically simple to implement, has no contraindications, convenient for monitoring intra-abdominal pressure throughout the postoperative period, can be performed in any hospital.

This intra-abdominal pressure monitoring system was used in the postoperative period in 11 patients who underwent surgery for common peritonitis. The control of intra-abdominal hypertension made it possible to promptly make adjustments to the diagnostic and treatment process, and contributed to an earlier diagnosis of prolonged peritonitis and postoperative complications from the abdominal cavity.

Clinical examples of the use of the proposed method.

Patient V., 57 years old, was operated on for segmental necrosis of the small intestine due to mesenteric thrombosis. A 1 meter resection of the affected area of the small intestine 50 cm from the ileocecal junction was performed, an intra-abdominal pressure monitoring system was installed. On the second day, an increase in IOP to 16 mm Hg was noted. Art., which led to suspect complications in the abdominal cavity. In the future, an increase in IOP by 1-2 mm RT. Art. every hour, the appearance of peritoneal symptoms, deterioration in homeostasis and hemodynamics. The patient underwent relaparotomy, during which anastomotic suture failure due to prolonged necrosis was found, anastomosis was resected with a new one. The postoperative period was uneventful.

Patient Sh., 28 years old, was operated on for acute gangrenous appendicitis, widespread peritonitis. Appendectomy performed

installed system for monitoring WBD. On the 3rd day of the postoperative period, an increase in ICP to 20 mm Hg was noted. Art. with a tendency to increase. This circumstance was a predictor of early adhesive obstruction. Relaparotomy, elimination of the cause of obstruction, intubation of the small intestine. Subsequently, the postoperative period was uneventful.

The proposed method allows to determine the intra-abdominal pressure for a long time in order to avoid the possibility of infection of the urinary tract, makes it possible to carry out the necessary and high-quality monitoring during the postoperative period.

Claims (1)

A method for measuring intra-abdominal pressure in patients in the postoperative period using a low pressure gauge, characterized in that after the main stage of surgical care is performed, a rubber balloon is installed between the peritoneum and the aponeurosis through a skin puncture between the peritoneum and the aponeurosis, and hermetically connected to the tube of the mechanical air blower and to the manometer low pressure, then conduct injection 5 mm cube. air into a rubber bottle to create a working volume in a rubber bottle, the oscillations of which are transmitted to a low pressure gauge, and this indicator is considered a zero reference point.

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