SU1528501A1 - Method of prophylaxis of thrombosis of vessels - Google Patents

Abstract

This invention relates to vascular surgery. The goal is to increase the effectiveness of the prevention of vascular thrombosis by providing thromboresistance of the intima of the vessel or the synthetic material of the vascular prosthesis. When performing a surgical procedure, phonophoresis of a part of the vessel is carried out; a 1% solution of silver nitrate is used as a medicine. The method is technically simple, provides a long-term effect, eliminates the need for anticoagulant therapy, and allows the operation to be carried out in conditions of wound abscess.

Description

This invention relates to medicine, in particular to vascular surgery.

The purpose of the invention is to increase the efficiency of prophylaxis by ensuring the thromboresistance of the intima of the vessel or the synthetic material of the prosthetic vessel.

The method is carried out as follows.

When processing biological tissue, the entire cocy; ia nocvie segment of intimal removal is filled with a P / O-HYM solution of nitric acid silver (I -2 ml). A spherical waveguide is introduced into the vessel lumen, and throughout the de-liter vessel, ultrasonic cavitation of the solution is effected for 10-15 sec with a frequency of 26.5 kHz with an amplitude of 30-40 µm. After the inner noisepxHocTH vessel is impregnated, the residual solution is removed by leaching. The hole in the vessel wall, through the curie, was processed, sutured atraumatical, .1oi, C () L, Icc. I enter the bloodstream. . Lacto-coagulum: both during and after the operation are not applied.

When replacing a section of a vessel with a synthetic prosthesis, the last ni é creature re.ibiui is moistened with alcohol and then cured (without anticoagution, 1 nt) cr1), and then the prosthesis is moistened with suppurative alcohol. This is done for the purpose of fixing the pax tissue of the prosthesis element 1). of blood which is subsequently given to blood through the burrows of the rotosis. Then it is injected into the I light of the I / O-11 solution of Azope-acid silver and ultrasonic cavitation is carried out, as in the first case. After inserting the prosthesis into an apticulum, 1 nty is also not used.

11) preparation of thromboresistant n, iac-types from a11 valone (polymeric fabric d.1 zap.1at, pak, 1 dyapa pa defec in cocv.ia, n.in pz | () tiv, 1eni npo i c. ia

sa

Hche

00

ate

Porisguk) i.:iacTnny from Ivalon is moistened with l n-th solution of nitric acid on the sulfur, and then using a flat waveguide, it takes about 15 seconds to cavitate on the wafer of the plate. Ultrachonic cavitation is necessary for the extraction of and microcavities (). The shaking of nitrogen-11 microcrystals (silver) silver into the fabric of aivalon. After this, the laster is pinned to a sintered hp tube (of various diameters and a tip for 30 minutes. Anticoagulant therapy is also not carried out.

E (}) () the efficacy of sioosa was studied in sgen-L () B1) 1, experimental and clinical studies. imovani x.

Conducted research studies have shown that damaged intima areas (ather () ck, 1-rose) have a looseness of potential. I i 0.5 + 0.1 mV) according to OTHOineHMKi to physiological growth, vascular prostheses are of zero-Boii potential. Blood vessels of the chest with intima removed and vascular prostheses, ob-); 1botan1H: 1e according to the proposed method, nrioregiug otri11, at.nip1 pottsptspal (1.5 ± I. I mV) and in terms of nab, 1udenium or 2 hl |) d) () soo retain eio, which is confirmed by the operm of p) plepapi blood when applied to their surface fresh blood taken from bo: 1n1,1x of the total vein for examination of the product. In K (P) Gro, first observations without treatment / kc in sam1) 11 early periods are noted. us) h) i) 4iioe binding blood vessels to the wall of the I pyntiori) vessel and 1) oteza.

Something 11) (pnmep () 8) iment () B vividly PGH (l (i6; iKH).

Pz femoral u) ts;) u animals (4 experiments - producing ud. By N. intima, ntima were removed from other arteries in other animals. After ud, the intima1 on E were often found by their blood vessels, and) 1–11 ° C is up to 1.5 mV, but relative to the Adventurer. After processing by the indicated method v4) 6oM 1) 1, 1xpote n), they acquired a clear 01) type ie: ii) potent (up to 2.0 mV). On the occasion of the term of observation (up to 50 days), the vessel was dissected, visualized, 1 or 2) its divergence, measured, tp: .1ec- | 1 () 11th section of the area of the previously removed intima; he) wound up in a preliminary. (.5 to L, O mV, but constant. H, 1Y1YM in relation to a. ik ntp-uslinsky kine gis about; 1) (i-I In all about 1 work tanks) in their wall, they are found. crystal (silver and marked almost noB.ieiinc iptpmy from primitive- 3 weeks) to || () l) cifxjp-50I.

 I. Bo, 1st P., L9 years old, Liag1 (s: ofi / iii I epnpy JUNI11 atheroscle1 (oz vessels low

0

five

0

five

0

five

five

0

of them of the extremities II, ock chyuzi of the right femoral artery, Trovedena thrombendarter-ectomy from the nature of the femoral artery. After the endartrectomy, the inner wall was treated with ultrasound with application of an l / o-HO solution of silver nitrate for 15 days.

Measurement data on the inner surface of the vessel; after arteriotomy + 0.5 mV, but indarterectomy + 0.4 mV; after treatment with 1 ° / o-nym solution of nitric acid silver -1.2 mV. Anticoagulants were not used. Discharged home with restored krovotoko.m.

Example 2. Patient K., 57 years old, Diagnosis; obliterating atherosclerosis of the left) of the lower extremity, ipimi p1, thrombosis of the left femoral artery. Oneratsi - open: (ndartertrombektomi from the left common, the city of the horny and the surface hip | | arthritis |). After endarterectomy, the internal surface is treated with l / o-Hbiw solution of silver nitrate by ultrasound cavitation for 15 s.

Measurement data on the inner surface of the vessel; after arteriotomy +2.2 mV; iioc.ie: ndarterek1o.mni +0.3 mV; after treatment with 1 / o-nym solution of nitric acid silver 0.8 mV. After surgery, anticoagulant drugs PS were used. The wound healed by primary tension. The patient was discharged from during ..- sganov.tenny blood flow. No complaints.

Example 3. Bol1) Noah YES ,, 46 years. Diagnosis; about;; pgeriruk) 1nd ate) osc, 1rose of the lower ovaries (with: her (on the right 111 degree, (Meva II degree), occluses of the femoral apTCpiiii. Nro-1); | upoplasty on the right, arterialization of the right After the operation, suppuration of the wound on the thigh and rosive hemorrhage has been established Provo; suturing the artery of the artery cH iriBa, enveloping the auroiit noii. P. red suturing the artery defect) its surface was treated with a 1% solution of nitrogen-cyst silver using ultrasound for 15 seconds. The wound 1 was also treated with l / on) ii silver nitrate solution for 15 seconds. xT, measurements of the internal surface of the vessel; pic, te argerio 1 omia through arterial defect - 0.2 6; after about 1) ab (; current, 3 mV. After the operation, no antibiotics and antibiotics were used. Discharged i recovered 1m with a good result, lana signed up 1.h with a high tension.

Example 4. Bolyi.) B. y., 60 years old. Diagnosis; oblnter) 1) uk piy, 1terosklrosz nizhnyh ko-psichnost P th century, occlusion of the abdominal aorta I of the subconcedural arteries. The aorto operation, the | hilarious bifurcation allo- |: | y1G1irovaniye. Before the denture, the prosthesis is treated with SIPPTOM) 1. as well as I Vo-HbiM solution of nitric acid (AND (silver by y, lt |) sound ()) in a cavitipip to a circuit of 10 s.

Measurement data of the inner surface of the dacron prosthesis: before treatment, about mV; after processing - 1.2 mV. After the operation, anticoagulants were not used, there were no signs of suppuration of wounds, the pulsations on the prosthesis branch are distinct.

The method was applied in 12 batches with occlusive lesions of the vessels of the aorto-femoral-popliteal segment and concomitant diseases in which anti-coagulant therapy (stomach and duodenal ulcer, kidney disease, etc.) is contraindicated.

During the operation, after dissection of the artery, patients measured the magnitude and nature of the electric potential, de-blittered and measured the potential, then the disobliterized area of the vessel was treated using the proposed method, the value of the negative electric potential was measured and the vessel's wound was sutured with an atraumatic needle, the vessel entered the bloodstream. Anticoagulants were not used either during surgery or in the postoperative period. Troba mboza of the vessel for 1.5–2 months was not observed in any of them. Repeated surgeries for suppuration of the wound and bleeding iredstav, t - suit. 1A very challenging task. However, taking into account the high bactericidal activity of nitric acid silver, it is possible to obtain favorable results after surgery and under wound suppuration conditions.

The proposed electrochemical method creates reliable anti-trenching protection according to the following characteristic features.

five

0

significantly increases e. econotrinate.:) - ness (affected areas of the intima): creates a negative potential of the middle shell (media) on the sections of the vessel after the removal of the intima, and on the inner surfaces of the vascular lines and polymeric tissues; It provides up to the trophic resistance of the surfaces subjected to the above treatment, due to the high electrochemical negativity of nitric acid on silver, slow absorption of its crystals, independent of metabolic activity and: 1x processes in the vessel wall.

The method is technically simple. eliminates the need for anti-coagulant therapy both before and after the operation, which allows to expand the range of surgical interventions on the vessels in patients for whom anti-coagulant therapy is contraindicated; allows to carry out operations in conditions of wound suppuration, providing high bactericity due to the difference in the wound of crystals of nitric acid and silver.

25

Claims (1)

Invention Formula A method for the prevention of vascular thrombosis, which includes conducting phonophoresis of a portion of a vessel when performing surgical surgery, differing in that, in order to increase the effectiveness of prophylaxis by providing thrombore: (intimacy of the intima of the vessel or with the prosthetic material of the prosthesis vessel, as a drug use And ;, ,, Hbiii solution of nitric acid silver.