| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention is related to medicine, in particular to surgery, oncology, gastroenterology and clinical pharmacology and may be used for intubation of thin bowels and intrabowel introduction of medicinal agents and food products to patients in early postoperational period after stomach removal in case of esophageal-thin bowel anastomosis. Multifeeder includes reservoir, batching device, which connected reservoir to probe made of soft plastic, rubber or silicon tube with external diametre of 2-50 mm, oxygen hose, impeller, reducer, and hollow stem with sealing plug, at the end of which there is a mixer. Reservoir is made in the form of thermostat and comprises outlet valve. Oxygen hose is connected via nozzle to body of impeller, which under action of pressure from oxygen stream rotates mixer. At the same time some oxygen arrives to reducer into hollow stem connected to it with cross radial holes, and from it goes to reservoir of thermostat and is mixed with mixture. Batching device is equipped with nozzle and nipple, outlet valve, timer and controller with arrow and vernier with division value of 1 ml. Outlet end of probe is coated with heat insulation material. Working end with length of 40 cm is made of cellulose waxed on two sides with thickness of 50 - 500 mm with longitudinal stiffening ribs along the whole length arranged on internal surface, is filled with gelatin. Out of free butt end of working part there is gelatin protruding in the form of hemisphere with diametre equal to external diametre of probe. Method for enteral introduction of medicines and food after surgery on stomach includes intraoperational introduction of probe-multifeeder into thin bowel through jejunostome, control over location of multifeeder probe with the help of ray-tracing methods of diagnostics, multiple daily infusion of food mixtures homogenised in mixer for 6-7 days through probe, and these mixtures contain sufficient amount of proteins, fats, carbohydrates, vitamins in liquid or semi-liquid state, analysis of introduction intensity and cessation of introduction in case of painful feelings in abdomen, or repeated liquid stool, working end of probe is inserted into stump of duodenum and is moved to its proximal end. Control over location and availability of mixture in duodenum stump is done with the help of ultrasound. Single-time dose of medicine and natural gastric juice in volume of 15-30 ml are additionally added to mixture and heated up to not more than 45C. Homogenising of mixture is carried out continuously with the help of mixer that operates under action of oxygen stream at higher pressure, dosed and controlled supply of ready mixture into duodenum stump is started after gelatin melting. Volume of mixture needed for complete filling of duodenum stump filling, mixture evacuation from it is controlled. Interval of time required for complete evacuation is identified, and another introduction of mixture is done in portions in this volume with established time interval. ^ EFFECT: invention improves efficiency and safety of nutrition and treatment due to better quality of mixture preparation, increased accuracy of its introduction and dosing. ^ 2 cl, 1 dwg, 1 ex |
