SU1416111A1 - Method of treatment of cardiospasm - Google Patents

Abstract

In order to increase the severity and duration of the pneumocardiotic effect while reducing the number of procedures, a mixture of novocaine, atropine and alcohol is introduced into the infant esophagus at the level of the upper boundary of the constriction zone in circumference.

Description

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The invention relates to medical practice, in particular to gastroenterology.

The purpose of the invention is to increase the expression of TI and the duration of the effect of pneumocardiodylation with a decrease in the number of procedures.

Example 1. Patient T., 53 years old Bohlen 2 years. Examined in the medical unit at the workplace for dysphagia. Diagnosed with cardiospasm. Treatments are outpatient with antispasmodics, local aiieTetikami and sedatives without tangible effect. He turned to the endoscopic department of the hospital for consultation and treatment. Diagnosed with stage III cardiospasm. A course of endoscopic pneumodilation from 12 sessions was performed. The effect was satisfactory, but not lasting. After 1.5 months after pneumodilation, dysphagia reappeared, vomiting of food eaten, burning in the chest, night cough. He took only liquid food. Re-treatment of the contraction after 1.5 years. During esophagogastroduodenoscopy, the esophagus is expanded to 4.5 cm, contains a significant amount of fluid, mucus. The area of constriction with significant resistance is passable for the type D2 apparatus.

Before the cardiodination, the lumen of the cardia was medicamentally expanded: a medicinal mixture containing 10 ml of a 0.5% solution of novocaine, 2 ml of a 0.1% solution of atropine and 1 ml of absolute alcohol was thoroughly mixed and put into a sterile syringe. During the endoscopic examination, the upper boundary of the narrowing zone of the esophagus was determined. Through the endoscope channel, a needle was inserted on a flexible rod. The end of the needle was injected into the muscular layer of the esophagus at the level of the elongation of the border of the narrowing zone. The drug mixture was inserted from 3-4 points located along the circumference of the esophagus, before the formation of an infiltrate visible in the endoscope. After the introduction of the solution, the apparatus freely passes into the stomach, the expansion of zones of narrowing up to 0.5 cm is determined, it is almost freely passable for apparatus of type D2. Against the background of an alcohol-novocaine block, a cardiodilation session was performed. After 6 sessions of pneumocardiosis, the diameter of the esophagus decreases to 3 cm. There is no fasting content in it, 05 - the area of cardiospasm is free.

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ma for the D 2 apparatus. Dysphagia, night cough, disappeared in the patient. vision behind the sternum. He considers himself practically healthy. Takes any food. The result of treatment is rated as excellent.

Example 2, Patient A, 26 years old, stage IV cardiospasm, 7 years ago, for the first time, pain developed behind the sternum of a spastic nature, a violation of the passage of food through the esophagus. Then he joined the night cough. He turned to the doctor after 2 years. In a rontgenological study, cardiospasm was suspected. The patient is referred for consultation to clarify the diagnosis in the endoscopic department of the hospital. With ezo phagogastroduodenoscopy, the diagnosis of stage I cardiospasm was confirmed, and chronic gastritis was also detected. Three courses of cardiac dilatation were performed with an interval of 3 months. A total of 2 treatment sessions were performed. The effect was good, but short-lived. After 2 months, after the third course of pneumodilation, dysphagia, chest pain, reappeared. Lechils conservatively on an outpatient basis. He took no-shpu, Novocain. During esophagogastroduodenoscopy, the esophagus is enlarged to 8 cm in diameter, contains a large amount of fluid and food debris, its mucosa is thinned, hyperemic, and in the lower third of the esophagus it is eroded with fibrin plaque. The region of the cardia is markedly narrowed, difficult for the apparatus of type D2, to be difficult to pass, a large amount of fluid in the stomach. The gatekeeper is passing. The mucosa of the duodenal bulb thinned. Diagnosed with cardiospasm of Ustadia, erosive esophagitis, atrophic duodenitis. A pneumodilation session was performed, accompanied by severe pain. Pains have been bothering for days. A day later, in order to relieve the painful reaction at the time of dilatation and to increase the expansion effect, the alcohol-novocainic blockade was performed in the manner described above. Against its background, three more pneumodilatation sessions were conducted. Their conduction was not accompanied by a painful reaction and had an excellent effect. The patient's dysphagia disappeared, and no chest pains worried. He considers himself practically healthy. At follow-up in the esophagus fluid and

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No food detected. Esophagus diminished - c. up to 4 cm in diameter. The constriction area is freely passable.

In patients with advanced stages of the disease on the background of the introduction of the drug mixture into the wall of the esophagus, endoscopic pneumo-deel was performed. It should be noted that pneumo-dilatation on the background of endoscopic blockade is more easily tolerated by patients, causes no pain, and gives a more pronounced effect.

Comparative data of treatment are offered in 1 m and in known methods are given in the table.

In all patients, clinical remission of the disease occurred, no complications were observed in any patient. Since before going to the endoscopic department of the hospital, all patients underwent a course of conservative treatment in a known manner on an outpatient basis, with no effect or with little

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effect, the comparison of the known and proposed methods was carried out on the same patients.

In patients with advanced disease stages, cardiology qi was performed on the background of the alcohol-novocainic blockade. At the same time, a reduction in cardiodylation sessions and an increase in therapeutic effect are achieved.

Form la invention

A method of treating cardiospasm, including pneumocardial dilution, characterized in that, in order to increase the severity and duration of the effect with a decrease in the number of pneumocardiolation procedures, before it is carried out, a drug mixture consisting of novocaine, atropine and alcohol.

M, 24 g. Cardiospasm For 3 years - 38 sean-Satisfying-5 sessions and 3 Art. Sov cardiodel tarylnogo 2 blockade (CD)

A great

Claims (1)

A method of treating cardiospasm, including pneumocardial dilatation, characterized in that, in order to increase the severity and duration of the effect with a decrease in the number of pneumocardial dilatation procedures, a drug mixture consisting of novocaine, atropine, and alcohol. - -----------— j i 1 Sick Diagnosis Treatment Result Treatment Result in a known way the proposed method M., 24 g. Cardiospasm For 3 years - 38 sean- Satisfactory- 5 sessions and 2 blockades A great W Art. cardiodilation owls (CD) ritual T., 52 g. Also One CD course - ”- 6 sessions and _ eleven _ _ P _ 12 sessions 2 blockade TO., 36 l One CD course - ~ η _ 8 sessions and Good 35 - ”- 10 sessions 2 blockade! to., l One CD course - _ η. four session and ,, and 8 sessions one blo cada TO., 26 l - ^u - For 1 year - ⁿ - 7 sessions and - ⁿ 25 CD sessions one blockade to., 27 l Cardiospasm Ambulatory No effect 7 sessions and A great • IV Art. treatment 'that 3 blockade FROM., 24 g. Also Also · . Also 7 sessions and Good . n _ 2 blockade BUT., 26 l For 5 months Satisfy four session and A great 20 sessions Secondary1 blockade S. ₉ 63 g. Cardiospasm One CD course - Good 3 session and Good 74 IV Art. 7 sessions one blockade AND., g. also 19 CD sessions - ⁿ - 6 sessions and A great one blockade