RU2252041C1 - Hemostatic duodenal probe - Google Patents

Abstract

FIELD: medical engineering.

SUBSTANCE: device has 150 cm long rubber double-lumen tube, hemostatic balloon placed 3.0-3.5 cm from the beginning of the rubber tube, holes in anterior and posterior portion of the hemostatic balloon and metal olive placed at the probe end. Marks are available on the probe at 45, 70 and 80 cm from its beginning.

EFFECT: no special equipment required for setting the device; available features for determining probe position; enabled X-ray control.

1 dwg

Description

The invention relates to medicine, namely to surgery, and can be used in the treatment of patients with ulcerative duodenal bleeding.

Currently, bleeding from duodenal ulcers is stopped by coagulation (laser, electro, diathermo), coating the ulcer with medical adhesives, and introducing sclerotizing substances into the ulcer.

The disadvantages of these methods are that they require expensive equipment and highly qualified specialists to work on it.

A known probe for stopping bleeding from a duodenal ulcer (RF Patent No. 2218948), which consists of a rubber double-lumen tube, a hemostatic balloon, which is located 3.0-3.5 cm from the beginning of the tube and is connected by an opening to one of the gaps of the tube, devices for introducing the probe into the duodenal bulb, which is a loop of synthetic thread tightly fixed to the rubber tube in front of the cuff; the tube has one hole in front of the cuff and 5.0-8.0 cm behind it, which are connected to the second lumen of the tube.

This probe is taken by us as a prototype.

The aim of the present invention was the creation of a hemostatic probe to stop bleeding from duodenal ulcers located in the duodenal bulb, which does not require special equipment for its installation, which will improve the results of treatment of this heavy contingent of patients.

The drawing shows a General view of a hemostatic duodenal probe.

A hemostatic duodenal probe to stop bleeding from a duodenal ulcer consists of a 150 cm long rubber double-lumen tube, a hemostatic balloon (2), which is located 3.0-3.5 cm from the beginning of the tube and is connected by an opening to one of the tube gaps , of metallic olive at the end of the probe (3), the tube has one hole (4) in front of the cuff and 5.0-8.0 cm behind it, which are connected to the second lumen of the tube, as well as 3 marks in 45 (one strip), 70 (two strips) and 80 (three strips) cm from the beginning of the probe to determine its location (5).

Structurally, a hemostatic probe to stop bleeding from a duodenal ulcer differs from its prototype in the presence of a metal olive at the end of the probe for insertion into the duodenal bulb and possible subsequent x-ray control, the presence of marks on the probe to determine its location and the absence of a device for introducing the probe into the duodenal bulb .

The probe is used as follows. During fibrogastroduodenoscopic examination, the presence of ongoing bleeding from a duodenal ulcer is established. The fibrogastroduodenoscopy is removed, the patient is placed on the right side, a probe is inserted through the mouth for 5-10 minutes to the 3rd mark, which corresponds to the location of the probe in the duodenal bulb. A balloon of 50-80 ml of air is inflated, the probe is pulled all the way to the gatekeeper, after which a control x-ray study is performed to monitor the correct placement of the probe. The label is a metal olive at the end of the probe. You can also use the introduction of radiopaque substances through the lumen of the probe or a sample with air.

The test is carried out as follows: inject air with a syringe through the lumen of the probe. Moreover, if the probe is in the stomach, then the patient feels the introduction of air and rumbling is heard, and if the probe is in the duodenum, then these signs do not. To control whether the bleeding has stopped or not, openings on the rubber tube in front and behind the balloon are used. Through the lumen of the rubber tube, the patient can also eat, and through it the gastric contents are evacuated to the small intestine, since during the balloon inflating, the lumen of the duodenal bulb is obstructed. For this purpose, openings in front and behind the hemostatic balloon serve.

The advantage of this probe to stop bleeding is that its manufacture does not require large expenditures, and any doctor can use it, unlike other methods. The use of this method will reduce the time of fibrogastroduodenoscopic examination and does not require the presence of a qualified endoscopist in the hospital, who is well versed in manipulation equipment for endoscopic examinations. It is also difficult to introduce the probe, which we took as a prototype, into the stomach, since there is a fibrogastroduodenoscope in the lumen of the esophagus. In addition, the probe can be delivered without fibrogastroduodenoscopic examination, if the source of bleeding was established earlier and clinical signs of bleeding from a duodenal ulcer appeared. This probe, like its prototype, carries out a constant hemostatic effect on the ulcer, unlike other methods of endoscopic bleeding stop. This probe can be used both for a final stop of bleeding, and for a temporary stop for the purpose of carrying out at the patient preoperative preparation or transportation of the patient from a regional hospital to a specialized hospital.

This probe is designed to stop bleeding from ulcers located in the duodenal bulb, which make up about 90% of bleeding duodenal ulcers.

The proposed probe was used in the treatment of 2 patients. We give as an example an extract from the medical history of one of them.

Example. Patient S. was admitted to the surgical department with a clinic of gastrointestinal bleeding. A fibrogastroduodenoscopic examination was performed, in which an ulcer of the anterior wall of the duodenal bulb about 8 mm in diameter, covered by a loose thrombus, from which fresh blood was leaking, was revealed. A hemostatic probe was inserted into the patient’s bulb of the duodenum, the balloon was inflated with air, the probe was pulled back to the stop against the pylorus. A fluoroscopic examination confirmed the presence of a hemostatic balloon in the duodenal bulb. Then, the pulse and arterial blood pressure, the general blood count (hemoglobin, the number of red blood cells, hematocrit), the nature of the contents in the lumen of the duodenum and stomach by aspiration of the contents through a probe were monitored. Conducted infusion and hemostatic therapy. After 12 hours, the probe was removed and a control fibrogastroduodenoscopic examination, which established that the bleeding from the ulcer was stopped.

Thus, the use of the proposed probe to stop bleeding from a duodenal ulcer will allow any doctor to stop bleeding from a duodenal ulcer and thereby improve the treatment results of this severe contingent of patients, by reducing the number of patients who need surgical treatment in an emergency.

Claims (1)

Hemostatic duodenal probe, including a 150 cm rubber double-lumen tube, a hemostatic balloon located 3.0-3.5 cm from the beginning of the rubber tube, openings in front and behind the hemostatic balloon, characterized by the presence of a metal olive at the end of the probe and marks on the probe at 45 , 70 and 80 cm from its beginning.