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INVENTION
Russian Federation Patent RU2245679
A method for diagnosing duodenal reflux
In gastric ulcer
Name of the inventor: Surnina OV (RU); Segal ZM (RU); Halimov EV
The name of the patentee: Surnina Olga
Address for correspondence: 426034, Republic of Udmurtia, Izhevsk, street Communarov, 281, Igman, Department of General Surgery, E.V.Halimovu
Starting date of the patent: 2003.01.31
The invention relates to medicine, in particular to gastroenterology. During ultrasound stomach through the abdominal wall after taking 150 ml of water content determined volume of liquid in the cavity of the stomach after 60 minutes and the subsequent investigation conducted every 5 minutes. Repeated or repeated appearance of liquid in the stomach in a volume of 10 percent or more of total fluid judge presence duodenogastric reflux. The inventive method allows atraumatic, non-invasively and objectively, without requiring a large economic cost, without contraindications to diagnose duodenal reflux.
DESCRIPTION OF THE INVENTION
The invention relates to medicine, in particular to gastroenterology.
There is a method of diagnosis of duodenal reflux with radiopaque study. The method consists in the fact that in the duodenum through a tube introduced into a suspension of barium on the screen X-ray machine recorded a throw of contrast medium in the stomach (see Mikhailov AN X-ray diagnosis of major diseases of the stomach - Minsk.. Of Belarus, 1986, P.72).
The disadvantage of this method is that it is available during the radiation exposure to the body, and therefore, this method of research has contraindications.
It is known and the method of diagnosis of duodenal reflux ultrasonic method (see. S.I.Pimanov. Ultrasound diagnosis of duodenal reflux. Therapeutic Archives 1991 №2, S.42-44). A known method for diagnosing, taken as a prototype, is carried out by introducing into the stomach 200-1000 ml saline or 0.3-0.5% citric acid solution. After 2-4 minutes after oral administration was performed gastric fluid echography. In case the alkali content cast duodenum the acid environment of the stomach, i.e. duadenogastralnom under reflux for echogram periodically, respectively, to throw in the stomach duodenal contents, recorded retrograde motion of gas bubbles (echogenic areas), they determined the occupied area and retrograde motion of the fluid from the gatekeeper to the body of the stomach.
The disadvantages of this method are idiosyncrasy of citric acid, contraindications to the use of citric acid and a significant volume of fluid required for the study of patients with gastric ulcer. It is not always possible to differentiate the motion of small gas bubbles arising during movement of duodenogastric reflux echogenic small sections in the liquid around the stomach due to the volume of physiological stirring its contents as a result of gastric motility. This can lead to false-positive and false-negative results.
The object of the invention is the diagnosis of reflux of duodenal ulcers in the stomach in order to further select the optimal method of surgical treatment.
The technical result is achieved by the fact that according to the method of diagnosis of duodenal reflux for stomach ulcers, comprising administering to the liquid in the stomach, and to determine the state of the liquid in the stomach, the liquid is boiled water in a volume of 150 ml, an ultrasound check of fluid volume after the complete emptying of the stomach into the stomach and repeated or repeated appearance of the liquid in the stomach in a volume of more than 10 percent of the total judge duodenal reflux.
The use of the claimed invention allows atraumatic, non-invasively and objectively, without requiring a large economic cost, without contraindications to diagnose duodenal reflux.
The method is implemented as follows. After oral administration of boiled water in a volume of 150 ml gastric echography was performed, and disposes ehozond mesogastric epigastric area or horizontally, sometimes with cranial or caudal inclinations so that on the echogram defined longitudinal section of the pyloric part of the stomach. According to the individual anatomy of the stomach may not strictly gorizantalnoe and ehozonda somewhat slanted position (0-15 degrees relative to the horizontal line). Measuring the amount of liquid content was performed according to the formula for calculating the area including the length and width parameters which were fixed in a longitudinal section of the stomach. Determination of the area of the liquid contents after ingestion of 150 ml of boiled water is taken as the total liquid volume in the stomach, which corresponded to 100%. Then, the fluid volume was measured in the stomach in the same manner after 60 minutes after administration of the liquid, which was zero. 65 minute appearance in the fixed fluid cavity of the stomach, the volume of which amounted to more than 10 percent of the original. After 70 minutes the fluid was observed in the stomach. After 75 minutes again noted the appearance of more than 10 percent of the volume of liquid. In a subsequent ultrasound for 80 minutes in liquid appearance of the stomach cavity is not fixed. Thus, during the second or repeated appearance of the liquid in the cavity of the stomach by ultrasound, after its complete evacuation within 60 minutes we were judged the presence of duodenal reflux in patients with gastric ulcer.
example 1
Patient A. Diagnosis: Stomach ulcer. Chronic ulcer of the body. Duodenal reflux.
When radiopacity and hepatobiliary scintigraphy study patient was diagnosed duodenal reflux. An ultrasound at 60 minutes after administration of 150 ml of boiled water in the liquid contents of the stomach were found. After 65 minutes with ultrasound detected 13% of total liquid liquid content. After 70 minutes the volume of the liquid contents is zero, 75-minute re-fixed with 11% liquid content. After 80 minutes the liquid contents are not found in the stomach cavity. Thus, by the proposed method diagnosed duodenogastric reflux.
example 2
The patient R. Diagnosis: Stomach ulcer. Chronic ulcer of the body.
When radiopaque research and gepatostsintigrafii patient was diagnosed duodenal reflux. An ultrasound at 60 minutes after administration of 150 ml of boiled water in the liquid contents of the stomach were found. After 65 minutes with ultrasound detected 15% of total liquid liquid content. After 70 minutes the volume of liquid content is equal to zero. After 75 minutes the amount of liquid content is zero. After 80 minutes the liquid contents are not found in the stomach cavity. So obrozom, using the proposed method diagnosed duodenal reflux.
example 3
Patient K. Diagnosis: Stomach ulcer. Chronic ulcer of the body.
When radiopaque study and the patient gepatostsintigrafii duodenal reflux are not detected. When ultrasound at 60 minute volume of liquid in the cavity of the stomach contents is zero. After 65 minutes the amount of liquid content - 0 ml at 70 minute volume of liquid content - 0 mL, 75 minutes - 0 mL, 80 minutes - 0 ml. Thus, the proposed way to diagnose the absence of duodenal reflux.
CLAIM
A method for diagnosing duodenogastric reflux, gastric ulcer, comprising administering a liquid to the stomach and to determine the state of the liquid in the stomach, characterized in that the liquid is boiled water in a volume of 150 ml, conduct ultrasonic registration fluid volume after complete gastric emptying in the stomach and repeated or repeated appearance of the liquid in the stomach in a volume of more than 10 percent of the total volume, measured by calculating the area of the liquid contents, comprising the length and width parameters fixed in the longitudinal section of the stomach, duodenal reflux judge.
print version
Publication date 29.03.2007gg
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