RU2335020C1 - Method for modelling obturation intestinal obstruction by non-surgical means - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to experimental medicine. Probe of corresponding diameter is introduced into the chosen part of intestine. Bag-like elastic film is put without fixation onto probe operating end. Through probe, self-hardening liquid is introduced into the film in amount required to close intestine lumen. Probe is removed. In special cases self-hardening liquid is introduced in amount of 1-100 ml. In special cases as self-hardening liquid water solution of medical gypsum or liquid compounds are used. The method allows simplifying method, eliminating opening abdominal cavity, enhancing convenience of work of operating experimentalist, making model closer to natural pathology, increasing reproducibility.

EFFECT: simplification of method for treatment of obturation intestinal obstruction by non-surgical means.

4 cl, 1 ex

Description

The present invention relates to experimental medicine, namely to experimental surgery and pathological physiology. It can be used to simulate obstructive intestinal obstruction in laboratory animals in order to study the stages of its development, pathogenesis, treatment options and further transfer of their results to the human body.

There are several methods for modeling obstructive intestinal obstruction (Lopukhin Yu.M. "Experimental Surgery", M., 1971, p. 68-69), ("The effect of an autonomous electrical stimulator of the gastrointestinal tract and mucous membranes (GIT and SOA NPPs) on the functional state of organs GIT "http://ecomed.webzone.ru/enotz7_1.htm) and others.

A known method of modeling obstructive intestinal obstruction (SU 1534494, GV 23/28, 01/07/90), taken as a prototype.

The method is as follows.

The gut selected for obstruction is wrapped around the small intestine, which is passed through the "window" made in the mesentery of the intestine, and its ends are brought to the anterolateral wall of the abdomen in the form of two lip-shaped fistulas. Intestinal continuity at the site where the small intestine section is turned off is restored by the application of end-to-end inter-intestinal anastomosis. The wound of the anterolateral wall of the abdomen is sutured in layers tightly.

3-4 weeks after this preparatory surgical intervention, a rubber probe is inserted through one of the lip-shaped fistulas and past the cavity of the turned-off section of the small intestine through the second of the fistulas and tightened, then tied on a gauze roller so that the intestine located in the loop is pressed to the anterolateral wall of the abdomen, which leads to the occurrence of obstructive intestinal obstruction.

The above methods for modeling obstructive intestinal obstruction, with all their positive aspects, have significant disadvantages. They reproduce the model in a surgical "bloody" way, which in itself is technically difficult to accomplish and at the same time significantly "blur" the clinical picture of intestinal obstruction in the experimental animal. Therefore, the known methods for modeling obstructive intestinal obstruction cannot ensure the approximation of the model to natural pathology and increase the reproducibility of the method.

The objective of the invention is to create a simple method for modeling obstructive intestinal obstruction, without opening the abdominal cavity of the experimental animal and suturing, as well as without preparatory surgery, with high reproducibility in various types of laboratory animals.

The technical result is a simplification of the method, increasing the convenience of the operating experimenter, approximating the model to natural pathology, increasing reproducibility.

The invention is carried out as follows.

The laboratory animal under anesthesia is fixed on the operating table. To the intestinal section, where it is planned to simulate the state of obstructive intestinal obstruction, a probe of the appropriate diameter is introduced. A small part of a thin elastic bagged latex product (for example, the head of a condom) is loosely mounted on the working end of the probe without fixation.

Through a probe, a liquid, quick-hardening substance related to liquid compounds, for example, sielast, pastes K and U-1, SKTN, latex, roller mass or an aqueous solution of gypsum, is injected into the lumen of the intestine into the intestinal lumen. A valuable advantage of gypsum mortar is that it is available, quickly hardens and at the same time increases slightly in volume. In addition, there is no need to heat the solution to body temperature, since the hardening of the gypsum solution is accompanied by heat.

The liquid is administered in an amount of 1-100 ml, sufficient to close the lumen of the intestine, which depends on the diameter of the intestine of the selected type of laboratory animal. Then the intestinal tube is carefully removed from the digestive tract. In a warm and moist environment of the intestine, a quick-hardening substance surrounded by an elastic film begins to expand, slightly increases its volume and gradually hardens, filling the intestinal lumen. The latex membrane is designed to exclude possible local toxic and irritating effects on the intestinal mucosa of the not yet hardened injected fluid. The full solidification time, according to manufacturers' guarantees, ranges from several minutes to several hours. But for the purposes of the experiment, this is not an essential condition, since the solidification process begins gradually, and the substance introduced in liquid form inevitably turns into a foreign solid that blocks the intestinal lumen.

After the introduction of fluid into the intestines, the laboratory animal is withdrawn from anesthesia. Then, in the natural habitat they are observed for their behavior, the increase in clinical symptoms of obstructive intestinal obstruction and are regularly examined, including using electrophysiological methods, and, if necessary, they are operated on.

The proposed method is illustrated by the following example.

Example. A male Mongrel dog named Teddy, age 3 years, weight 9.5 kg, was transferred to the dry food Chappi and Pedigree a month before the experiment. Degelmentized twice with an interval of seven days with the drug Azinox +. For three days it was kept on a hungry diet with free access to water. Under promedol-hexenal anesthesia, the dog is fixed on the operating table. With the help of a Janet syringe, with little effort, through a flexible probe with an elastic saccular membrane at the working end (part of a condom), carefully inserted into the rectum to a depth of 52 cm, 85 ml of freshly prepared gypsum solution are poured into the intestine. A solution of gypsum in water is prepared immediately before administration (for 2.5-3 glasses of water 500-600 g of gypsum). To do this, gypsum powder is slowly poured into the vessel with water with continuous stirring. (The gypsum solution must have a consistency of thick sour cream. To increase the fluidity of the gypsum solution, the amount of water can be slightly increased. In this case, the hardening time increases. The gypsum usually sets in 5-7 minutes, but the hardening time can be adjusted. So that the gypsum solution does not harden quickly, when mixing the solution add a little vinegar, citric acid or alcohol.

And so that the gypsum solution hardens faster, when mixing the solution, you can add a little table salt or knead in warm water.

After solidification of the fluid in the intestines, the dog is withdrawn from anesthesia, freed from fixation and fed. Further, the dynamics of the development of clinical signs of intestinal obstruction were regularly monitored with a diary of observations according to the following indicators: temperature, pulse, respiratory rate, digestive system study (feed and water intake, body weight weighing, abdominal wall palpation).

Hematological studies were determined: the number of leukocytes, red blood cells, hemoglobin, ESR, leukogram. Biochemical studies of blood serum were carried out according to the following indicators: calcium, potassium, sodium, phosphorus, uric acid.

Starting from the third day after intestinal obstruction, the dog's condition deteriorated sharply, it became inactive, lost its appetite, and weight loss began. The abdominal wall during palpation is very tense. With deep palpation of the abdomen, the dog is restless, arching the back, pulling the stomach into itself, screeching. Throughout the experiment, water intake remained free. Hematological parameters were characterized by the following changes: erythrocytes decreased by 15%, white blood cells increased by 19%, hemoglobin decreased by 16%. In the leukogram - a decrease in the number of eosinophils, a nuclear shift to the left, lymphocytopenia and monocytopenia.

With increasing symptoms of acute intestinal obstruction and worsening general condition, Teddy was operated on using endotracheal anesthesia and muscle relaxants. The abdominal cavity is opened by mid-median access. The non-viable colon is resected within healthy tissues and is directed for histological examination. In the postoperative period, intensive complex therapy was carried out: replacing the functions of the main organs and systems, restoring bcc and water-electrolyte metabolism, correcting metabolic disorders, preventing thromboembolic complications, antibiotic therapy with two antibiotics, detoxification therapy, stimulating intestinal motility. The abdominal cavity is sutured in layers, a drainage tube is left for control. The postoperative period was uneventful.

The proposed method allows you to create a model that is as close as possible to natural pathology, to reproduce both full and partial obstructive bowel obstruction of varying degrees, depending on the formation in each case of a hardened foreign body of the appropriate size.

The method is relatively simple and easy to perform, humane, excludes preparatory manipulations and preliminary surgical interventions, reliably reproducible in various types of laboratory animals.

Claims (4)

1. A method for modeling obstructive intestinal obstruction, characterized in that a probe is inserted into the lumen of a selected intestinal tract section, a flexible elastic bagged film is placed on its working end without fixation, inside which a self-hardening fluid is injected in an amount sufficient to close the intestinal lumen, after which the probe removed. 2. The method according to claim 1, characterized in that the self-hardening liquid is administered in an amount of 1-100 ml. 3. The method according to claim 1, characterized in that an aqueous solution of gypsum is used as a self-hardening liquid. 4. The method according to claim 1, characterized in that liquid compounds are used as self-hardening liquid.