RU2259168C1 - Method for treating the cases of postoperative gastrointestinal tract paresis by means of direct vagus electrostimulation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves implanting electrodes brought out to the anterior abdominal wall through draining tube, to motor vagus branches and antral stomach region during operation. Electrostimulation is carried out with these electrodes in postoperative period. Treatment is carried out with rectangular currents of 5 mA, 5 ms duration and frequency of 50 Hz. Impulse package duration is 10 s, pauses between the packages are 20 s long and general cycle duration is equal to 20-30 min.

EFFECT: accelerated treatment course.

Description

The invention relates to medicine, namely to surgery, and can be used for any operations on the abdominal organs, accompanied by postoperative paresis of the gastrointestinal tract.

There is a method of treating postoperative paresis of the gastrointestinal tract using electrical stimulation with pulse packets with the number of pulses in a packet of 5-20 in 1 min, the frequency of the packs of 10-40 Hz, a current of 5-15 mA for 20-40 min 3-4 times day to the reflexogenic zones of the abdominal cavity through a solution of novocaine introduced into the peritoneal space [1]. This method is the closest in essence to the proposed invention and adopted as a prototype.

The disadvantages of this method and other applied methods of electrical stimulation of the gastrointestinal tract are:

- the need for repeated administration of novocaine into the peritoneal space, which can cause unwanted vegetovascular and allergic reactions in the patient;

- "blind" installation of the electrode in the retroperitoneal space, lack of visual control over the exact anatomical location of the source of electrical impulses;

- the external location of the negative electrode on the skin of the lumbar region determines a large distance between the electrodes, a large area of the electric field, and, as a result, to achieve a therapeutic effect, it is necessary to use a large current, which can cause unwanted side effects in the patient's body.

The problem to which the invention is directed, is the elimination of paresis of the gastrointestinal tract, the prevention of postoperative complications and the reduction of treatment time.

This object is achieved by the fact that the proposed method of direct electrical stimulation of the vagus in the treatment of postoperative paresis of the gastrointestinal tract, including exposure to reflexogenic zones of the abdominal cavity by rectangular currents with a force of 5 for a duration of 5 ms, a frequency of 50 Hz, a pulse packet duration of 10 s, with a pause between packets pulses of 20 s and a total cycle time of 20-30 minutes, while during the operation, electrodes output to the necks are implanted into the motor branches of the vagus and on the front wall of the antrum of the stomach ednyuyu abdominal wall through a drainage tube through which electrical stimulation is performed in the postoperative period.

At the end of the operation, according to the lesser curvature of the stomach, the anterior trunk of the vagus nerve is found, its motor branches, to which a sterilized electrode of bioinert material is fixed with two nodal sutures with a nylon thread. The second electrode, departing 5-6 cm from the first, is fixed to the front wall of the antrum of the stomach with two gray-serous sutures. End plates of electrodes with dimensions of 20x5 mm. Both electrodes are discharged to the anterior abdominal wall through a drainage tube. The electrode fixed to the motor branches of the vagus is connected to the positive terminal of the electric stimulator, and the electrode located in the antrum of the stomach is connected to the negative terminal. Rectangular impulse currents with a power of 5 mA, a duration of 5 ms, a frequency of 50 Hz, a pulse packet duration of 10 s, a pause between pulse packets of 20 s, a session duration of 20 minutes are applied by an electric stimulator. The first session of electrical stimulation is carried out a day after surgery. In the future, electrical stimulation is carried out 2 times a day, increasing the duration of exposure to 30 minutes. After resolving the paresis of the gastrointestinal tract, the electrodes are removed from the abdominal cavity along with the drainage tube.

The effectiveness of this method of electrical stimulation was evaluated according to electrogastroenterography (EEG) and clinical observations. This method was used in a clinic in 44 patients. When using direct electrical stimulation of the vagus vagina, peristalsis was heard already during the first electrostimulation session on the 1st day after the operation, independent persistent peristalsis appeared on the 2nd-3rd day, gas discharge was recorded on the 2nd-3rd day, independent stool - on the 3rd- and day. According to the EEGG, an increase in motor and electrical activity of the gastrointestinal tract during electrical stimulation was noted.

The proposed method for direct electrical stimulation of the vagus is an effective method of combating postoperative paresis in acute intestinal obstruction, peritonitis, pancreatic necrosis, etc.

Sources of information

1. Copyright certificate No. 1243737, etc. 15.07.86, the prototype.

Claims (1)

A method of direct electrical stimulation of the vagus in the treatment of postoperative paresis of the gastrointestinal tract, including exposure to reflexogenic zones of the abdominal cavity by rectangular currents with a force of 5 mA, a duration of 5 ms, a frequency of 50 Hz, a pulse train duration of 10 s, with pauses between pulse packets of 20 s and the total the duration of the cycle is 20-30 minutes, characterized in that during the operation, electrodes are inserted into the motor branches of the vagus and on the front wall of the antrum of the stomach, brought to the front abdominal wall through the drainage t ubku by which electrical stimulation is performed in the postoperative period.