SU1657158A1 - A method of treating acute epididymoorchitis - Google Patents

Abstract

The invention relates to medicine, namely to urology, and can be used to treat nonspecific epididymoorchitis. The goal is to reduce trauma and reduce the duration of treatment. First, the adhesions and adhesions of the self-vaginal membrane are separated by hydraulic preparation by pumping a solution of novocaine into its cavity, then drainage and decompression of the membranes and the egg are performed by microirrigation, after which the cavity is sanitized once a day and the mixture is injected into it antibacterial and absorbing action in a volume of liquid up to 5 ml with the creation of an unstressed water.

Description

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The invention relates to medicine, namely to urology, and can be used for the treatment of nonspecific epidemiodi orchitis.

The aim of the invention is to reduce the morbidity and shorten the duration of treatment.

The method includes separation of adhesions and adhesions by hydraulic preparation by injecting a solution of novocaine into the cavity of the membranes, drainage and decompression of the membranes and eggs by performing punctured scrostomy with a microirrigator and sanitizing the cavity of the own vaginal membrane by injecting a mixture of antibacterial and absorbing action of the scrostomy into the cavity of the intravaginal liquids up to 5 ml with the creation of unstressed water.

In the position of the patient lying on his back, from the side of the affected half of the scrotum, a layer-by-layer infiltration of the membranes of the testicular is produced by the fluctuation or most softening of the skin surface (mainly in the anterior-scrotal area). As the needle is immersed with the syringe plunger pulling, upon receipt of exudate (amber-colored fluid or pus), 10–20 ml of novocaine solution is injected into the vaginal cavity of the patient until a sick feeling of painful discharging appears. At the same time, the adhesions and adhesions of the sheath are disconnected from the ichter and prevent the possibility of damage to the ichi by the subsequent introduction of the puncture needle.

After removing the syringe, drip or jet discharge of the liquid from the injection needle is noted, which indicates

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Finding it in the cavity, after which the needle is removed.

Then, a scrostomy is performed, for which a puncture needle, for example A-160, is used to pierce the membranes to obtain a liquid. A needle of a microirrigator, such as a catheter designed for subclavian venipuncture, is guided through the needle. The design of this catheter, its atraumatic nature, a relatively uncomplicated way of introducing into the abdominal mass, the availability of devices for a syringe and fixation on the skin surface, the presence of a cap make it acceptable and reasonable for use in puncture scrostomy. Catheters with a diameter of 0.6 and 1.0 mm are used.

After the conductor of the catheter is guided through the puncture needle, the latter is removed and a catheter is inserted through the conductor, through which the exudate is fully aspirated, the cavity is rinsed, for example, with boric acid or furatsilin solution, after which the catheter is fixed onto the scrotum skin. The resulting exudate is sent for seeding.

Then a mixture of broad-spectrum antibiotics with no gonadotoxic action, such as penicillin preparations or dioxidine, and absorbing agents, such as proteinase or dimexide, are administered through a microirrigator. At the same time, no more than 5 ml of solution is injected into the cavity of the intrinsic vaginal membrane, since a significant injection of fluid can lead to compression of the testicle. The end of the microirrigator is closed with a cap. The microirrigator is left for 4 to 5 days, during which time an acute inflammatory process is eliminated, while at the same time a longer catheter in the cavity of its own vaginal membrane can cause local irritation of adjacent tissues. Sanitation of the cavity with the introduction of a mixture of drugs is carried out once a day, which is enough to achieve a therapeutic effect. In this case, each time an analysis of the exudate obtained during the rehabilitation is carried out, according to the results of the analysis, the course of the inflammatory and cicatricial adhesions is judged, in accordance with which changes are made in the quantitative ratio and the qualitative composition of the drug mixture.

Along with this, symptomatic therapy is carried out according to the generally accepted method.

After 4-5 days, the microirrigator is removed, the fistula opening is usually closed on the first day after the drainage is eliminated.

Example. Patient D., 58 years old. was admitted to the hospital with a diagnosis of acute right-sided epididymo-orchitis. Ill 2 days ago: there was pain in the right testicle, then swelling

and scrotal hyperemia. Body temperature 39.2 ° C. 2 months before admission, underwent gastrectomy surgery. In the postoperative period, bladder catheterization was performed. Objectively: right

0 ichko increased, moderate swelling and hyperemia. On palpation, there is a cutting pain and seal in the region of the head of the appendage. In the general analysis of urine: leukocytes 18 - 20 in p / sp. In the general analysis

5 blood: ESR 18 mm / h.

On the second day started treatment by the proposed method. Using a syringe, 17 ml of novocaine solution was injected into the cavity of the own vaginal membrane.

0 then scrostomy is performed using a subclavian catheter as a microirrigator, fixing it to the scrotum. Through the catheter, 10 ml amber-colored exudate is sucked (taking into account

5 entered solution of novocaine), which is sent for sowing. The cavity was washed with a solution of novocaine, after which a mixture of 5 ml of penicillin solution (1 g) and 1 ml of chemotrypsin was introduced into it, and the catheter was closed with a plug. The lavage (sanitation) of the cavity with a solution of novocaine and the introduction of the medicinal mixture into it through a microirrigator was carried out once a day against the background of antibacterial and general strengthening therapy according to the standard technique. The temperature dropped to 36.2 ° C on the first day after the puncture scrostomy and remained normal for the following days until discharge.

0 Soreness in the right half of the scrotum significantly decreased on the second day. On the fourth day, the catheter was removed, the fistular opening was closed the next day. Blood and urine data

5 normalized. Conglomerate in the scrotum was not observed. The patient was discharged on the sixth day. Recommended outpatient follow-up care, taking a course of ionophoresis with potassium iodide.

Claims (1)

0 claims A method of treating acute epididymoorchitis, including the separation of adhesions and adhesions with the larynx of its own vaginal membrane, the subsequent drainage and sanitation of the cavity of its own vaginal membrane with the introduction into it of a mixture of drugs of antibacterial and absorbable effect, which is so tics and shorten the treatment time ki and splices are separated by a hydraulic rigger, and rehabilitation is carried out by the introduction preparation by pumping in on-the-scrotostomy drugs 1 time per day in The shell of the solution of novocaine, the volume of the liquid is up to 5 ml. At the same time, creation of the training is carried out by means of an unstressed water of the membranes and the evaluation of microscopic puncture scrostomy.