Intragastric rn-metriya

Description:

Intragastric rn-metriya – an electrometric technique of a research of acidity of the gastric environment by means of the rn-metric transnasal probe connected to the independent registering block. The intragastric rn-metriya is shown at a peptic ulcer, GERB, chronic gastritises, Zollingera-Ellison's disease, phrenic hernias, for assessment of states after stomach resections. Data of a short-term and daily intragastric rn-metriya allow to judge objectively acid-forming and motor function of a stomach, to differentiate tour and cardial pains, to pick up adequate therapy at kislotozavisimy diseases of a stomach.

Indications to an intragastric rn-metriya:

Indications for carrying out a rn-metriya are:

- gastroesophageal reflux disease (GERB);
- peptic ulcer of a stomach and duodenum;
- various forms of chronic gastritis, duodenitis, dyspepsia;
- Zollinger's syndrome — Ellisona;
- Barrett's gullet;
- assessment of effect of the medicines reducing secretion, their individual selection for the patient;
- states after a stomach resection.

Contraindications to an intragastric rn-metriya:

Contraindications to a research consist of contraindications to introduction of a gastric tube and contraindications to use of these or those stimulators or inhibitors of gastric secretion.

Contraindications to introduction of the rn-probe:
- gastric bleeding (in a bleeding time and within 10 days after its end);
- aortic aneurysm;
- burns, diverticulums, gullet strictures;
- severe forms of an idiopathic hypertensia and coronary insufficiency;
- obstruction of a nasopharynx;
- severe maxillofacial injuries;
- severe forms of coagulopathies.

Relative contraindications to introduction of the rn-probe:
- recent surgical interventions on upper parts of a GIT;
- tumors and ulcers of a gullet;
- existence of varicose veins of a gullet;
- bleeding from upper parts of a GIT (after a stop of bleeding carrying out a long rn-metriya for control of efficiency of effect of the anti-secretory drugs preventing development of repeated bleedings is possible).

Classification:

Allocate the following main types of an intragastric rn-metriya:

- a daily rn-metriya of a gullet (within 24 hours and more);
- a daily rn-metriya of a stomach (within 24 hours and more);
- a short-term intragastric rn-metriya (within 2-3 hours);
- the express a rn-metriya (within 15-20 minutes);
- an endoscopic rn-metriya [⇨] (during gastroscopy).

Short-term intragastric rn-metriya:

The short-term intragastric rn-metriya is used for a research of acid-forming and kislotoneytralizuyushchy functions of a stomach in basal conditions and after stimulation (a histamine or Pentagastrinum). The average levels рН are measured in different departments of a stomach, and on them the conclusion becomes. Assessment of neutralized function of antral department of a stomach is carried out on a difference of the minimum sizes рН in a body of a stomach and maximum – in an antruma.

The main functional test at a short-term intragastric rn-metriya is the alkaline test of Noller. It is that to the patient through a mouth enter 0,5 g of the hydrosodium carbonate (baking soda) dissolved in 30 ml of water into a stomach and by means of the device for an intragastric rn-metriya register dynamics рН in a stomach body. Administration of alkali the neutralization test of HCl hydrochloric acid + results from NaHCO3=NaCl + CO2 + H2O, level рН increases, and through, so-called, alkaline time is returned to initial level because of release of hydrochloric acid in a stomach.

At the express of a rn-metriya only the basal level of acidity is defined, i.e. the issue of existence or lack of hydrochloric acid is resolved and level рН in a stomach body is defined.

For short-term and the express of a rn-metriya it is possible to use the multichannel device about which allows to inspect several patients at the same time.

Endoscopic rn-metriya:

The endoscopic rn-metriya is carried out by means of the special endoscopic rn-probe entered via the tool channel of the endoscope. The research is conducted during gastroscopy, extending an ordinary procedure approximately for 5 minutes. During this time measure acidity in 9 standard points of a stomach and a duodenum under direct vision.

At interpretation of results it is necessary to consider that the endoscopic research in itself is the factor stimulating a kislotoobrazovaniye.