SU1442221A1 - Method of treatment of purulent cholangitis - Google Patents

Abstract

This invention relates to medicine, namely to surgery. In order to shorten the treatment time, laparotomy, cholecystectomy, bile duct sanitation, external drainage of the hepaticocholedochus, introduction of a waveguide through the external drainage of the millimeter range, closure of the abdominal cavity are carried out. The effect of radiation of the millimeter range in wavelength intervals of 6.3-9.6 mm is used at a power flux density of 40 µW / cm for 20-60 minutes, the number of seances is 3-7, which depends on the degree of the inflammatory process and bacterial / J bacterial colonization of bile.

Description

11442221

The invention relates to medicine, namely to surgery,

Tseš invention shorten the treatment.

The method is carried out as follows.

After the revision of the abdominal organs, the bile duct is removed, the bile bladder is removed, the hepaticocholedochus is rinsed with antiseptic solutions or antibiotics, and the hepaticocholedochus is drained through the stump of the ductal duct with a drainage tube containing a waveguide. Dia 1§ meter-waveguide is 1.5–2 times smaller than the internal diameter of the drainage tube. The waveguide is fixed in several places to the inner wall of the drainage tube. The external drainage of the hepatic cholera-20 dox is established, fixed and removed from the abdominal cavity according to a well-known method. The abdominal cavity is sutured tightly. Then, in the postoperative period, from the first day, 25 hepaticocholedochus and excreted bile are affected by radiation from the schimeter range. The generator of microwave radiation operates in the wavelength range of 6.3-9.6 mm. The power flux density in continuous generation mode at the output of the ravia radiator is 40 μW / cm. . Duration 20–60 min. Number of seans

lk with m

ows 3 - 7j, which depends on the degree of inflammation and bacterial contamination of bile.

Example 1, Boln V., 64 years old, was admitted to the surgical department with complaints of bopts in the right hypochondrium, nausea, vomiting with yellow yellowing of the skin. Sick about 5 days. Chills occur intermittently, with an increase in temperature of up to 37.8-39.2 C. The patient underwent surgery - cholecystitis, the bile ducts were washed with an aqueous solution of chlorhexidine, through the stump of the cystic duct into the hepaticocholedochus, the Halstead drainage was inserted, containing a waveguide . Drainage with a waveguide - its free end is brought outside in the area of the right hypochondrium. The wound is sutured.

Clinical diagnosis: Acute phageal calculous cholecystitis. Chronic recurrent purulent cholangitis. Mechanical jaundice

From the first day of the postoperative period on the hepatico-choledochus and the dermatitis § 0 5 0

five

five

five

The bile in it was affected by low-intensity millimeter radiation with a wavelength of 6.3 mm. for 60 min every day for 3 days. Power flux density of 40 µW / cm,

After three sessions of exposure to low-intensity millimeter radiation, the patient had lowered temperature, decreased skin itching and jaundice. On the 5th day, blood belirubin was normalized. Freestyle was discharged on the 7th day after the operation in a satisfactory condition. A total of 3 sessions of low-intensity millimeter radiation were conducted on the hepaticoholedochus. Volna was examined after 3 and 6 months. No complications noted

PRI me R 2, Vol T, 71, entered the Kiev city center for surgery of the liver, bile ducts and pancreas.

After the examination, the patient was diagnosed with a clinical diagnosis: Acute calculous phlegmonous cholecystitis, mechanical jaundice. Purulent cholangitis. Chronic indurative pancreatitis.

A free operation was performed - cholecystectomy, choledocholithomy, and Vishnevsky drainage was inserted into the hepaticocholedochus duct, which contained the waveguide, through the stump of the cystic duct. Bile ducts are washed with an aqueous solution of chlorhexidine. Drainage together with the waveguide is brought out (its free end) outside in the area of the right hypochondrium. The wound is sutured in layers.

From the first day after the operation, the hepaticochledochus and the bile contained in it were exposed to low-intensity millimeter radiation with a wavelength of 9.6 mm daily for 20 minutes over 7 days. Power flux density of 40 µW / cm,

After 3 sessions, the patient's body temperature dropped to 37.2 ° C and returned to normal after the 5th session. By the end of the course of exposure to low-intensity millimeter radiation, jaundice disappeared (blood bilirubin decreased from 193.4 to 21.2 mmol / l) was discharged on the 10th day after the operation in a satisfactory condition.

Freestyle examined after 3 months. Complications are not noted.

The advantage of the method is as follows:

inflammation of the hepatocholedochus walls is reduced, which improves bile;

the mechanisms of local immunity are stimulated, as evidenced by the increased indices of immunological reactivity of lymphocytes (T-lymphocytes) and progenitor cells (B-li phocytes), the phagocytic activity of leukocytes increases, which ultimately accelerates recovery and shortens the time of stay of patients in the hospital.

The method was applied in the clinic in 14 patients with purulent cholangitis. All patients recovered. Examined in early and late dates from the moment of operation. Complications were not observed.

When analyzing the terms of inpatient treatment in comparison with the known method, it was established that when applying the proposed method for the treatment of purulent cholangitis, the stay of patients in

the hospital is 17 ± 1.8 beds, while using a known method, the bed-day is 25.5 t2.3. Thus, the terms of stay of patients in a hospital using the proposed method of treatment of purulent cholangitis were reduced by 8.5 bed-days.

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A method for the treatment of purulent cholangitis, including laparotomy, cholecystectomy, reorganization of the bile ducts, external drainage of the hepaticocholedochus and stricture of the abdominal cavity, characterized in that, in order to reduce the duration of treatment, to the hepatic choledochus through its external drainage. d t waveguide, then exposed to electromagnetic radiation with a wavelength of 6.3-9.6 mm at a power flux density of 40 μW / cm for 20-60 minutes.

Claims (1)

Claim A method for treating purulent cholangitis, 15 including laporotomy, cholecystectomy, bile duct sanitation, external drainage of hepatic choledochus and suturing of the abdominal cavity, characterized in that, in order to reduce the duration of treatment 20, a waveguide is introduced into hepatic choledochus through its external drainage, after which it is exposed to electromagnetic radiation with a wavelength of 6.3 to 9.6 mm at a power flux density of 40 μW / cm ² for 20-60 minutes '' Compiled by A. Kulikov