RU2400263C1 - Method of conservative and phisiotherapeutic treatment of acute pancreatitis - Google Patents

Abstract

FIELD: medicine. ^ SUBSTANCE: invention relates to medicine, gastroenterology. Method includes introduction of glucose, physiological solution, pain-killing medications, vasopressors, antibiotics, Novocain, cytostatics, omeprazole, sandostatin. Novocaine blockades of round ligament of liver, paranephral Novocain blockade by A.A.Vishnevskiy are performed. Large amount of drinking water is introduced. Cooling of abdomen is realised. Additionally, one time for not less than 8 days, electrophoresis with 2% solution of potassium iodide on epigastrium is carried out. After that for not less than an hour cooling of epigastric and umbilical areas of abdomen is performed. During all term of treatment every day patient drinks not less than 500 ml of cooled non-carbonated table soda-alkaline water. Intra-organ galvanic electrophoresis with 2% solution of potassium iodide and 2% solution of Novocain is carried out. Positively charges plate is placed on lumbar region, negatively charged plate is placed on epigastric region. In addition, for not less than 10 days epigastric and lumbar regions one time per day for up to 15 minutes exposed to alternating magnetic field with intensity up to 30 mT. ^ EFFECT: method improves treatment results, prevents development of destructive forms of disease. ^ 2 ex

Description

The method of conservative and physiotherapeutic treatment of acute pancreatitis relates to medicine, namely to pancreatology, and can be used in the treatment of acute pancreatitis both independently and as an additional treatment, it is used in gastroenterology, surgery, resuscitation, balneology.

A known method of conservative treatment of acute pancreatitis, including the introduction of infusion drugs - glucose, saline, painkillers, the use of vasopressors, antibiotics, novocaine, cytostatics, omeprazole, santostatin, novocaine blockade of the round ligament of the liver, perinephral novocaine blockade according to A.A. Vishnevsky, for the period of treatment, drinking large amounts of drinking water, cooling the abdomen (1, 2, 3, 5).

The disadvantage of this method is the lack of correction of tissue and humoral immunity, not the use of physiotherapeutic methods of treatment - magnetotherapy, electrophoresis, dosed application of cold on the stomach in patients with acute pancreatitis.

A known method of treating acute pancreatitis, including cooling the abdomen, hunger, drinking plenty of water, antibiotic therapy (1, 2, 5).

The disadvantage of this method is the indefinite time of exposure to cold on the stomach, drinking includes ordinary water, and not standardized table water with a strictly defined composition.

There is a method of conservative treatment of acute pancreatitis, including the use of acid-lowering drugs - omeprazole, drugs that reduce the production of pancreatic enzymes - 5-fluorouracil, sandostatin, octreotide acetate, protease-contrikal inhibitors, gordox (1, 2, 3, 4).

The disadvantage of this method is the lack of correction of tissue and humoral immunity in patients with acute pancreatitis, not the use of physiotherapeutic methods of treatment.

A known method for the treatment of acute pancreatitis, including the use of novocaine blockade of perirenal fiber and the round ligament of the liver (1, 2, 3).

The disadvantage of this method is the lack of correction of tissue and humoral immunity in patients with acute pancreatitis, not the use of physiotherapeutic methods of treatment.

The aim of the method of the invention is to improve the results of conservative treatment of acute pancreatitis, prevent tissue hypoxia, correct immunity, prevent the occurrence of disorders in the hepatobiliary system, and reduce the number of cases of the transition of acute pancreatitis to destructive forms of the disease.

This goal is achieved by the fact that once for at least 8 days electrophoresis is carried out with a 2% solution of potassium iodide on the epigastric region, and then for at least an hour the epigastric and umbilical regions of the abdomen are cooled, and during the entire treatment period, the patient is treated every day drinks at least 500 ml of chilled non-carbonated table soda-alkaline water, the patient undergoes intraorgan galvanic electrophoresis with 2% potassium iodide solution and 2% novocaine solution so that the plate with a positive m charge located in the lumbar region, and a negative charge - in epigastrium, for at least 10 days in the epigastric region and lumbar affect the alternating magnetic field with intensity up to 30 mT up to 15 minutes once a day.

Comparison of the proposed method with other known methods of conservative treatment of acute pancreatitis showed its compliance with the criteria of the invention.

The method is used as follows.

The patient with acute pancreatitis is given the entire necessary amount of clinical, laboratory and instrumental diagnostics, injected with infusion preparations - glucose, physiological saline, painkillers, vasopressors, antibiotics, novocaine, cytostatics, santostatin, omeprazole is prescribed, novocaine blockade of the liver’s ligament, paranephral novocaine block according to A.A. Vishnevsky, hunger is prescribed for at least 5 days, a large amount of drinking water is given, the stomach is cooled with ice bubbles or cold water Oh. In this case, electrophoresis is carried out once for at least 8 days with a 2% solution of potassium iodide on the epigastric region, so that the plate with a positive charge is located at the level of the right hypochondrium, and with a negative charge - at the level of the left hypochondrium in the epigastric region, at least once during the treatment period, the polarity of the plates is changed. Then, for at least an hour, the epigastric and umbilical regions of the abdomen are cooled with ice bubbles or cold water. During the entire treatment period, the patient is given a daily drink of at least 500 ml of chilled still water of soda-alkaline water, preferably from 14 ° C to 20 ° C. As table water, water “Laguna”, “Noble”, “Volzhanka” or other waters of a similar composition are used. Instead of the described electrophoresis or not earlier than 12 hours after it, the patient undergoes intraorgan galvanic electrophoresis with 2% potassium iodide solution and 2% novocaine solution so that the plate with a positive charge is located on the lumbar region, and with a negative charge on the epigastric region. Instead of electrophoresis or not earlier than 16 hours after it, the patient’s abdominal region — the epigastric and lumbar regions — is exposed to an alternating magnetic field with an intensity of up to 30 mT for up to 15 minutes once a day for at least 10 days.

Clinical example 1. Patient K., 45 years old, and / b 2152, 06/10/08 was hospitalized on an emergency basis in the Department of Surgery No. 7 of MMU "Clinical Hospital named after N.I. Pirogov number 1 "g. Samara diagnosed with acute pancreatitis. The treatment according to the proposed method. 06/26/08 was discharged for outpatient treatment.

Clinical example 2. Patient M., 52 years old, and / b 1825, 06/08/08 after a road injury was hospitalized in the Department of Surgery No. 7 of MMU "Clinical Hospital named after N.I. Pirogova No. 1 Samara diagnosed with acute pancreatitis. The treatment according to the proposed method. 06/23/08 was discharged for outpatient treatment.

Using the method allows to improve the treatment results of acute pancreatitis and to prevent the development of destructive forms of the disease requiring surgical treatment. A method of conservative treatment of acute pancreatitis was used in 46 patients who achieved clinical recovery without surgery.

Information sources

1. Milonov O.B., Toskin KD, Zhebrovsky V.V. Postoperative complications and dangers in abdominal surgery. - M .: Medicine, 1990. - S.247-255.

2. Petrovsky B.V. Selected lectures on clinical surgery. -M.: Medicine, 1968. - S.360-362.

3. Bisenkov L.I., Zubarev P.N., Trofimov V.M. et al. Emergency Breast and Abdomen Surgery: A Guide for Physicians. - St. Petersburg: Hippocrates, 2002. - S.367-372.

4. Saveliev B.C. Guidelines for emergency abdominal surgery. - M., Publishing house "Triad-X", 2005, - 394-396.

5. Birkou R., Fletcher E. Guide to medicine. Diagnosis and therapy. In 2 vols. T.1 .: Translated from English .. - M .: Mir, 1997. - S.543-545.

Claims (1)

A method of conservative treatment of acute pancreatitis, including the introduction of glucose, physiological saline, painkillers, vasopressors, antibiotics, novocaine, cytostatics, omeprazole, sandostatin, novocaine blockade of the round ligament of the liver, paranephral novocaine blockade according to A.A. Vishnevsky, the introduction of a large amount of drinking water carrying out cooling of the abdomen, characterized in that in addition, once, for at least 8 days, electrophoresis is carried out with a 2% solution of potassium iodide on an epigast ral region, and then, for at least an hour, the epigastric and umbilical regions of the abdomen are cooled, and during the entire period of treatment, the patient drinks at least 500 ml of chilled still water of soda-alkaline water every day, and intraorgan galvanic electrophoresis is also performed with 2 % solution of potassium iodide and 2% solution of novocaine, with a positively charged plate on the lumbar region, and a negatively charged plate on the epigastric region, while for at least 10 days epigastric and lumbar region exposed to an alternating magnetic field intensity up to 30 mT, up to 15 minutes once a day.