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INVENTION
Russian Federation Patent RU2286813

METHOD removing stones from the ureter

METHOD removing stones from the ureter

Name of the inventor: Davydov Vladimir (RU); Semenov Anatoliy (RU); Dirin Vladimir (RU); Pasko Olga A. (RU); Davydov Dmitry (RU)
The name of the patentee: Closed Joint Stock Company "Medical and Environmental Center" Dunes "
Address for correspondence: 634061, Tomsk, ul. Herzen, 52, MEKTS "Dune", VN Dirin
Starting date of the patent: 2005.06.20

The invention relates to medicine, namely to urology, and can be used for the removal of stones from the ureter. To implement this effect on the ureter region through their projections flicker noise magnetic field, the spectral components which are in the frequency range of 2.5 × 10 -4 -2.5 × 10 1 Hz and a maximum amplitude of the magnetic flux density - between 0.1 -0.5 mT. The procedure lasts 30-60 minutes. Number of treatments per day from 1 to 3. When a kidney stones whose diameter exceeds the inner diameter of the ureter, before exposure to the magnetic field carried lithotripsy kidney stones. For 1-2 hours prior to exposure to a magnetic field is introduced antispasmodic drug. Within 30-60 minutes before exposure to the magnetic field and exposure is carried out during heating in the patient's body surface area of ​​the projection of the ureters. The method reduces the duration of treatment.

DESCRIPTION OF THE INVENTION

The invention relates to a urology and can be used to remove small stones (up to 8 mm in diameter) of the ureter and for improving kidney function and ureters, including postoperative period.

Stone (calculus) in the ureter as occlusive factor, dangerous threatening complications (acute purulent pyelonephritis, infected hydronephrosis, bacteriotoxic shock) that requires emergency surgery. Manifestation of acute pathological condition with kidney stones is often a renal colic, which is based on the obstruction of the lumen of the ureter at any level of its contributing to violation of the outflow of urine from the kidney, acute disorders of blood circulation in it, followed by increased spasm of the ureter, renal pelvis and calyces. Intense pain in this case, extend from a few hours to several days. In the absence of positive dynamics within 10-12 days there are complications, the patient's life-threatening due to the reflex anuria. Against this background, progress of deterioration of the gastrointestinal tract, liver, pancreas, acute heart failure develops.

One of the most effective tactics prevent these complications is the timely recovery of passage of urine. To do this, the doctor efforts are directed to clear, in the short term, setting the diagnosis, which in the first place, carried out X-ray and ultrasound (sometimes tomography) examination of the kidneys and ureters, preceding the beginning of the treatment.

Known is a surgical method of removing stones from the ureter during abdominal surgery [1. Tiktinsky OL Urolithiasis. - L .: Medicine, 1980. - S.92-148]. The disadvantages are the destruction of its structures of tissues, including the ureter structure, complexity and high cost of operation, a long rehabilitation period.

There is a method of removal (extraction) of ureteral stones using a puller (uretrolitoekstraktsiya) with radiologic or endoscopic control system [2. Kogan MI, Sknaryov VA, Pavlov SV Uretrolitoekstraktsiya - its place in the modern program of treatment of ureteral stones. // Abstracts .: Plenum of the All-Russian Scientific Society of Urologists, Rostov-on-Don, Sept. 24-25, 1992. - S.80-81]. The disadvantages are its tissue damage, possible postoperative complications, longer rehabilitation period.

In cases where you can not pass up the stone extractor with a view to capture, use Remote shock-wave lithotripsy or endoscopic uretrolitotripsiyu contact (using the pulsed electro-acoustic waves or bumps) [1]. Disadvantages lithotripsy is a long rehabilitation period and high cost of treatment.

Known method of removing stones from the ureter by the action of the kidneys and ureters sinusoidally-modulated currents (SMC-therapy) [3. Clinical Physiotherapy: A Reference Manual for Practitioners. Ed. I.N.Sosina /I.N.Sosin, L.D.Tondy, E.V.Sergieni etc. Kiev: Health Protection, 1996. - S.224-225].. For this purpose, one electrode dimensions 6 x 4 cm 2 in a projection area of the kidneys and ureters, and the other electrode dimensions 8 cm 2 · 6 - epigastric. Electrodes using insulated wires connected to the output of the generator sinusoidal modulated voltage. Sinusoidal oscillation frequency set in the range of 20-30 Hz. Modulation of sinusoidal oscillations carried meander with a period of 10 seconds. The modulation depth is 100%. DC Power set a value at which there abdominal muscle contraction or pressing feeling in the course of the ureter. Typically, current is 10-30 mA. Duration of the procedure chosen in the range of 6-8 minutes. The procedures used daily or every other day. The course of treatment - 15 procedures. SMT-therapy is used in 15-20 minutes after inductothermy or microwave therapy and ingestion of 400-600 ml of liquid.

The disadvantages of this method are the low efficiency of the treatment and the limitations of application (due to a number of disease contraindications). In implementing the method a powerful packs AC occur mainly in the tissues having the greatest electric conductivity, and not on the path passing through the kidneys and ureters. They disrupt the normal operation of the systems that carry endogenous information signals that sometimes violates the urinary tract work and leads to a peristaltic reflex effect. Spasmodic contraction stones surrounding tissues leading to their injury. This method of removal of stones is contraindicated in heart failure, you have a pacemaker, malignant formations, and a number of other diseases.

The closest to the claimed method is a method for removing stones from the ureter, including the impact on the region of the ureter through their projections sinusoidal modulated magnetic field [4. RF patent №2070074, IPC 6 A 61 N 2/04, publ. 10.12.1996 city]. Sinusoidal oscillation frequency is selected in the range of 2-3 kHz.

Modulation of sinusoidal oscillations carried meander with frequency 5-6 Hz. The modulation depth is 100%. The magnitude of the magnetic induction in the selected areas within the ureter 5.1 mT. Within five days of daily conduct two sessions of treatment every 8 minutes with a break between sessions of 60 minutes. Then, after 10 days repeated five day cycle effects on the kidneys and ureters.

The disadvantages of the prototype method is the low efficiency of the treatment due to non-optimal spectral composition of the magnetic field acting on the human body and by its high magnetic induction (1-5 mT), the duration of treatment (20 days), a number of contraindications.

The spectral composition affects the body in a magnetic field of the prototype method comprises a carrier frequency, which is in the range of 2-3 kHz and lateral components of the odd harmonics of square wave. In the detection of amplitude-modulated oscillations biological membranes (which are non-linear elements in the low and very low frequencies) through which currents flow odd harmonics of square wave. The high level of the first harmonic of a meander (5-6 Hz) adversely affects the nervous and cardiovascular system of humans (especially dangerous for human electromagnetic and acoustic waves with a frequency of 7 Hz). Contraindications to the use of the prototype method is cardiovascular disease, the presence of a pacemaker, low adaptive capacity of the patient, metoochuvstvitelnost.

The objectives, which are aimed at achieving the proposed solution is to increase the effectiveness of treatment (including in the case where the removal of stones from the ureter preceded lithotripsy of kidney stones), reduction in the duration of treatment, elimination of side effects and contraindications to the use of the method.

This is achieved by a method for removing stones from the ureter includes the same as the prototype method, exposure to an alternating magnetic field through the area of ​​the projection of the ureters.

According to the invention, in an alternating magnetic field used flicker noise magnetic field, the spectral components which are in the frequency range of 2.5 × 10 -4 -2.5 × 10 1 Hz. In this case the maximum amplitude of the magnetic induction in the regions ureters chosen in the range from 0.1 to 0.5 mT, the duration of exposure of flicker noise magnetic field during one treatment - from 30 to 60 minutes, number of treatments per day - 1 through 3, and the duration of treatment - 1 to 3 days.

Upon detection of kidney stones with a diameter exceeding the inner diameter of the ureter during their normal operation, before the impact on the area of ​​the ureters flicker noise magnetic field is carried out lithotripsy of kidney stones.

In particular cases, for 1-2 hours prior to exposure flicker noise magnetic field, the patient is administered an antispasmodic drug and / or for 30-60 minutes before exposure magnitnm flicker noise field in this exposure process is performed in the heated areas of the patient ureter projections ( for example, using a heating pad).

The proposed method for the removal of stones from the kidney and ureter is based on the normalization processes in cells and tissues of the body under the influence of weak ELF (ELF) flicker-noise (PN) magnetic fields (MF) on the background of a permanent MF Earth. The spectral density of FS vibrations is inversely proportional to frequency. PN MP together with the constant component of the Earth's MP performs the role of information on ionic, molecular and cellular levels and synchronizes (normalizes) processes in cells. An important role in these processes perform biological membranes, which are the link between the objects animate and inanimate nature. First, they are highly non-linear VLF receiver elements of electromagnetic and acoustic waves, which are sensitive to these fluctuations is of the order of 10 -16 W / cm 2 [5. Pasko OA, Semenov AV On the role of electrical double layers in the interaction of objects animate and inanimate nature. Proc. rep. Fourth Pushchino Symposium: "The correlation of biological and physico-chemical processes in space and heliophysical factors", Pushchino, 1996. - S.143-144], and, secondly - oscillators VLF electromagnetic and acoustic oscillations Photoshop. Exposure to magnetic FSH and / or acoustic vibrations on the membrane leads to an increase in its permeability and normalization of metabolic processes in cells. ELF fluctuations in the kidneys and ureters in the claimed method are adequate FSH electromagnetic oscillations in the membranes of healthy human cells.

Effects from exposure to PN MP unusual in its properties. They are small, are developing slowly. Their latent (hidden), and long-lasting periods ranging from several minutes to several hours.

The proposed method has its own inflammatory properties and without the use of antispasmodic drugs and thermal effects on the kidneys and ureters. Under the action of the kidneys and ureters, containing stones, PN MP withdrawal occurs spasm of smooth muscles of the urinary tract. The inner diameters of the ureters expanded to 8-10 mm, appears normal motility of smooth muscle kidney and ureter, and rocks (8 mm in diameter, and sometimes up to 10 mm) down to the bladder.

Lower cut-off frequency of the claimed range PN oscillation f n = 2.5 × 10 -4 Hz corresponds to a maximum time of one procedure T max = 60 min (n f = 1 / T max). Increasing the time of one procedure over 60 minutes, in our view, inappropriate, although ELF FSH fluctuations in the membranes of cells are observed at frequencies lower than 2.5 × 10 -4 Hz. Increase the upper cut-off frequency higher than 25 Hz, and is impractical because the frequency of parametric resonance for the first, second and third harmonic oscillation important biological ions (inorganic cations and anions, organic acids, co-enzymes, DNA, lipids, neurotransmitters, proteins) are below this frequency [6 . Uzda AB On the biological effect of ELF magnetic fields resonance mechanisms and their implementation in the cells // Biophysics. - 2000. - T.45. - Issue 5. - S.888-893].

The positive effect of the use of the claimed method is achieved and the impact on the area of ​​the ureters PN MP with a maximum induction amplitude of less than 0.1 mT (in the case of low-level magnetic interference, deriving from these networks and the networks of commercial frequency devices) and more than 0.5 mT . However, in the latter case, this leads to increase in the dimensions of devices used in the practice of the method and / or an increase in power consumption of the power sources.

The procedure lasts less than 30 minutes is not practical due to the elimination of fluctuations in the spectrum PN several important biological membranes frequencies. Duration of the procedure over one hour irritate the patient.

Research on removal of ureteral stones in 13 patients, conducted in the MSU-2 in Tomsk in 2004, showed that the duration of treatment MP FS does not exceed 3 days.

The additional use of antispasmodic drugs and the heating of the surface of the patient in the ureter projection areas accelerates the process of bringing down stones.

The following are examples of ureteral stones excretion inventive method. We used the device comprising an interface connected in series, a microcontroller, reprogrammable storage device, a digital to analog converter, a current amplifier and an inductive coil [7. RF patent №2243007, 7 IPC A 61 N 2/00, 1/00, 5/06, A 61 G 7/04, publ. 27.12.2004]. The coil was formed as a circular loop having seven turns of insulated wire. The inner diameter of the coil was 100 mm. In memory reprogrammable memory PN signal was recorded, the spectral components which extend from 2.5 x 10 -4 to 25 Hz. Maximum rated amplitude of FN magnetic induction at the site of the location of the ureters was 0.3 mT. The loop superimposed on the stripped and dressed the patient's body in the projection of the ureter that contains the stone. PN MP from the loop and impacted on the kidney, which departs from the ureter. Removal of stones held in the MSU-2 in Tomsk in 2005

Example 1. Patient S., 62 years old, appealed to the urology department NFM-2 with complaints of paroxysmal pain in the lumbar region right, radiating pain in the right iliac region, periodic feeling of chills, nausea, vomiting. These phenomena were observed during the last three days for the first time. On palpation the expressed pain along the right ureter. There was a sharply positive symptom Pasternatskogo. In the urine were observed isolated leukocytes and erythrocytes Fresh - 12-15 in sight. Overview According urinary tract radiography contrast observed shadow dimensions 4 × 5 mm 2 along the lower third of the right ureter. The results of renal ultrasonography were typical violations of the outflow of urine from the cavity system of the right kidney, which was subsequently confirmed by excretory urography.

Based on history, the patient's condition during the period of examination and studies were diagnosed with a stone in the lower third of the right ureter (marked right-sided renal colic).

Due to the ineffectiveness of held for two days of symptomatic therapy, during which the patient was administered intravenously and intramuscularly baralgin, on the third day of his therapy PN MP lower third of the right ureter was nominated three times a day for 30 minutes after 6 hours. After the third session the next time you urinate moved the stone with a diameter of 5 mm. Paroxysmal pain stopped. Subsequently, normalized urine tests, ultrasound data and survey radiography of the urinary tract.

Example 2 Patient S., 29 years, appealed to the urology department NFM-2 with a typical picture of renal colic right the first time. Attacks of pain accompanied by characteristic changes in the urine, where the number of fresh erythrocytes in the field of view is 30-35. Ultrasound detected ectasia junction chashechkovoy system right kidney and upper ureter. There have soreness at the level of the right kidney and localization sharply positive symptom Pasternatskogo. Before contacting the urology department patients received infusions of diuretic herbs, baralgin (3 times daily), Urolesan (10 drops 3 times a day), thermal procedures. The urology department he FSH MP therapy was appointed (three times a day for 30 minutes, 6 hours). Less than a day later the patient appeared typical symptoms of stone to offset nadpuzyrnogo ureter, ie, developed symptoms of pollakiuria - mandatory increased urge of urination. On the third day the pain in the lumbar region have stopped, urination was normalized. According to X-ray observation of the urinary tract stone in the ureter was not. Notes after the end of treatment were absent.

Example 3. Patient K., 52 years old, was admitted to hospital MSU-2 Department of Urology for emergency indications with paroxysmal pain in the left lumbar region, radiating pain in the left groin, frequent urge of urination, recurrent pains at the end of urination, chills, nausea. The patient differed restless behavior (a certain position of the body is not found for improvement). I had a pained look, his left hand supporting the left lumbar region. On palpation there was soreness in the left upper quadrant and left groin. In the urine were observed individual leukocytes and 10-12 fresh red blood cells in the field of view, oxalate salt. There was a sharply positive symptom Pasternatskogo. These urinary tract X-ray survey confirmed the presence of the stone 4 mm in diameter along the lower third of the left ureter. As a result of renal ultrasonography were observed clear signs of expansion cavity system of the left kidney, characteristic disturbance of outflow of urine along the ureter. The same situation was confirmed by excretory urography.

In the absence of positive dynamics over the past two days, during which conducted drug therapy and used water load and the subsequent sharp patient jumps on his left leg, the patient PN MP therapy has been assigned in the course of the lower third of the left ureter (three times a day for 30 minutes after 6 h). Less than a day later noted passage of the stone diameter of 4 mm. The general condition of the patient after discharge of the stone has been quite satisfactory. Control renal ultrasound showed that severe ectasia cups and pelvis in the left kidney is not. The patient was discharged from hospital with a recommendation: outpatient at the urologist in the community.

The above examples clearly demonstrate the effectiveness of removal of ureteral stones offered by a non-invasive manner. If the removal of stones from the ureter prototype method requires up to 20 days, the proposed method - up to 3 days. For removal of ureteral stones from the claimed method is sufficient maximum amplitude of MF induction, 1,000 times smaller than the prototype method. The claimed method has no contraindications to the use of the small value of MF induction acting on the person, which is below the ELF magnetic induction interference from power frequency networks and electrical values, and because of the nature of normalizing FSH MP range.

This method can be used both independently and in complex treatment of nephrolithiasis. The advantage of this method is his cheapness.

CLAIM

1. A method of removal of stones from the ureter, including a field effect on the ureter through their projections alternating magnetic field, characterized in that the alternating magnetic field is used flicker noise magnetic field, the spectral components which are in the frequency range of 2.5 × 10 -4 -2.5 × 10 1 Hz, while the maximum amplitude of the magnetic induction in selected areas of the ureters in the range 0.1 to 0.5 mT, the duration of exposure of flicker noise magnetic field during one treatment - from 30 to 60 minutes, the amount of treatments a day - 1 through 3, and the duration of treatment - from 1 to 3 days.

2. A method according to claim 1, characterized in that upon detection of kidney stones with a diameter greater than the inner diameter of the ureter during their normal operation, prior to exposing the ureter area flicker noise magnetic field carried lithotripsy kidney stones.

3. The method of claim 1 or 2, characterized in that for 1-2 hours prior to exposure flicker noise magnetic field are administered to a patient antispasmodic drug.

4. A method according to claim 1 or 2, characterized in that 30-60 minutes exposure to the flicker noise and the magnetic field during exposure of the heating surfaces is carried out in the areas of the patient ureter projections.

print version
Publication date 06.01.2007gg