The method of treatment of chronic tonsillitis

 

The invention relates to medicine, namely to photodynamic therapy, and can be used in otolaryngology. The method of treatment of chronic tonsillitis includes a push-up language spatula, conducting sensitization lavage of lacunas of the tonsils to clean with a solution of a photosensitizer that absorbs optical radiation in the spectral range from 625 to 700 nm and 840 to 1270 nm, rinsing throat saline solution, and then carrying out sequential exposure of each of the tonsils optical radiation matrix light-emitting apparatus for phototherapy in the spectral range of absorption of the photosensitizer with the exposure time of 2-3 min, daily for 10-15 days. As a photosensitizer may be used in 0.01-0.1% aqueous solution of methylene blue or chlorophyllipt. Rinsing throat spend 100 ml of 0.9% saline solution. The radiation produces at a distance of 0.5-1 cm from the surface of the tonsils. The method allows to increase the efficiency of photodynamic therapy by optimizing the processes of sensitization and exposure pathological area, antibacterial effects, reduce recidivism, and reduce the cost of treatment. 9 physical rehabilitation therapy, and can be used in otolaryngology.

Widely known method of treatment of chronic tonsillitis with antibiotics. However, due to development of resistance of pathogenic bacteria to antibiotics, often have a variety of complications: allergic reactions, ototoxicity, hepato-, nephro-, cardiotoxicity, and others.

There is a method of treatment of chronic tonsillitis [and.with. The USSR №1469626, with priority from 19.02.1986,], consisting in contact daily exposure of each of lacunas of tonsils radiation of helium-neon laser at a power density of 600-700 mW/cm2duration of 5-20 C for 4-6 days.

The disadvantages of this method are the low efficiency of treatment due to the absence of antibacterial effect, the possibility of burns of the mucous membranes with long-term contact with radiation, as well as its high cost.

There is a method of treatment of chronic tonsillitis [Cherednichenko Y. I., zonation D. I., A. Deribas A. a Practical guide to laser therapy in clinical practice (guidelines). Novosibirsk: Institute of General pathology and human ecology WITH a FRAME, 1994, S. 54], which includes a push-up language with a spatula and then diffuse irradiation of the tonsils and back within 5-7 sessions.

The disadvantages of this method are the low efficiency of treatment due to the lack of antibacterial effect, and the prices used in the treatment equipment.

There is a method of treatment of chronic tonsillitis in children [Cherednichenko Y. N., Zonation D. I., A. Deribas A. a Practical guide to laser therapy in clinical practice (guidelines). Novosibirsk: Institute of General pathology and human ecology SB RAMS, 1994, S. 39] was chosen as the prototype, including a push-up language with a metal spatula, the subsequent impact on the Palatine tonsils and the posterior pharyngeal wall scattered radiation of the infrared laser with a diameter of a light spot 30-50 mm at an average power density of 1-2 mW/cm2with an exposure of 10 minutes this Treatment is recommended for 10-15 days.

The disadvantage of this method is the lack of antibacterial effect, reducing the effectiveness of the treatment. In addition, the cost of treatment is quite expensive due to the use of IR laser.

The objective of the invention is to increase the efficiency of photodynamic therapy by optimizing the processes of sensitization and exposure pathological area, antibacterial effects, reduce Rea chronic tonsillitis, includes the same as the prototype, wringing language spatula and the subsequent impact of scattered radiation on the Palatine tonsil, daily for 10-15 days, according to the invention, carried out sensitization lavage of lacunas of the tonsils to clean with a solution of a photosensitizer that absorbs optical radiation in the spectral range from 625 to 700 nm and 840 to 1270 nm, rinse the throat with saline, followed by alternate irradiation of each of the tonsils optical radiation from a broadband source of radiation in the spectral range of absorption of the photosensitizer with 2-3 min. exposure time

As a broadband radiation source using led matrix apparatus for phototherapy.

Lavage of lacunas of the tonsils is carried out with a syringe equipped with a standard cannula Hartmann.

You can use as a photosensitizer 0.01-0.1% aqueous solution of methylene blue and other photosensitizers which absorb radiation in the specified range, for example, hlorofillipta.

Rinsing throat spend 100 ml of 0.9% saline solution.

The radiation produces at a distance of 0.5-1 cm from the surface of the tonsils. For this is the moment due to a large number of side effects from the use in the treatment of antibiotics and low sensitivity of microbes to them some studies, proving the high antibacterial activity of photodynamic effects [1. Millson, S. E., M. Wilson, A. J. Macrobert, J. Bedwell, Bown S. G. The killing of Helicobacter pylori by low-power laser light in the presence of a photosensitiser //J. Med. Environ. - 1996. - Vol. 44 (4). - P. 245 - 252. 2. Wilson M., Yianni C. Killing of methicillin-resistant Staphylococcus aureus by low-power laser light // J. Med. Environ. - 1995. - Vol. 42 (1). - P. 62 - 66] where as photosensitizers used - toluidine blue, protoporphyrin IX, hematoporphyrin, and phthalocyanine aluminum, as well as irradiation sources used helium-neon, indium - gallium, kimery lasers and others [3. Millson, S. E., M. Wilson, A. J. MacRobert, Bown S. G. Ex-vivo treatment of gastric Helicobacter infection by photodynamic therapy //J]. Photochem. Photobiol. - 1996.- Vol. 32 (1-2). -P. 59-65. 4. De Simone N. A., Christiansen, S., Dore D. Bactericidal effect of 0.95-mW helium-neon and 5-mW indium-gallium-aluminum-phosphate laser irradiation at exposure times of 30, 60, and 120 seconds on photosensitized Staphylococcus aureus and Pseudomonas aeruginosa in vitro// Phys. Ther. - 1999. - Vol. 79 (9). - P. 839-846].

Under the influence of radiation photosensitizer produces active (singlet oxygen) oxygen forms. As a result of singlet oxygen produced during his participation products (hydroxyl radicals and peroxides) is the death of microorganisms and pathologically changed tissues.

Drugs used as photosensitizers, compared with healthy enterprise with a specific wavelength, specially selected for each type of sensitizer is a photochemical reaction which ultimately leads to the destruction of pathogenic microorganisms. The penetration of radiation to adjacent normal tissue, which is not subjected to the sensitizer, does not lead to any negative consequences for the organism.

Since the most common cause of chronic tonsillitis are staphylococci, was mapped effect of irradiation in the range of 625 to 700 nm (red light) and 840-1270 nm (infrared radiation) on the solution of a photosensitizer (methylene blue) in different concentrations on the growth and reproduction of Staphylococcus aureus in vitro, in solid nutrient medium, which simulates the contamination of skin and mucous membranes of the skin of the body. Bactericidal effect of red light on the growth of pathogenic Staphylococcus Staphylococcus aureus in vitro demonstrated in the photos, where Fig.1 shows the control growth agar culture of staphylococci, and Fig.2 - the growth of staphylococci in culture after exposure to 0.01% solution of methylene blue and exposure to radiation in the red and infrared light.

Studies have shown that methylene blue its the s test the growth of Staphylococcus aureus strain 209 in agar culture, in table 1, demonstrate that the combination of methylene blue with light red and infrared spectrum increases 2 times the effectiveness of the pharmacological effects of the drug.

In Fig.3, 4 shows the absorption spectra of methylene blue, and Fig.5 - hlorofillipta, which clearly shows that the absorption maxima of methylene blue in the red region of the spectrum is in the range from 640 to 670 nm, and the infrared - two peak ranges from 820 to 830 nm and 900 to 940 nm. The maximum absorption hlorofillipta is located in the red region of the spectrum in the range from 640 to 660 nm.

In Fig.6 shows the emission spectrum of the broadband source (led apparatus “dune - T), which shows that the maxima of its radiation in the red spectral region are in the range from 650 to 670 nm, and in the infrared region of the spectrum in the range of 940 to 960 nm.

Comparison of the emission spectrum of the broadband source and the absorption spectra of the pigments used shows that the maxima of the absorption spectra of methylene blue and hlorofillipta in the red part of the spectrum coincide with the maximum of the emission matrix light-emitting apparatus. However, the absorption spectrum of methylene blue significantly intense is ispolzovanie on the proposed method. Thus, the choice proposed by the present method the spectral range of the absorption caused by the absorption spectrum of pigments photosensitizers.

Lavage of lacunas of the tonsils to clean with a solution of a photosensitizer produces preliminary antibacterial effect.

When rinsing throat saline wash away excess photosensitizer, which otherwise can serve as a screen for penetration of radiation into the amygdala. This facilitates subsequent exposure to radiation in the parenchyma of the organ tonsil.

Irradiation of each of the tonsils, pre-treated with a solution of a photosensitizer, optical radiation in the spectral range 625-700 nm and 840-1270 nm can influence low-energy radiation on all layers of fabric at a depth of 6 cm, selectively exciting photochemical reaction without heating the tissue, enhancing therapeutic antibacterial effect.

The choice of exposure time of exposure for each amygdala duration of 2-3 minutes due to the fact that at a higher exposure time, difficulties arise in the execution of the procedure because of the inconvenience suffered by the patient.

The feasibility of using telenovela blue with a concentration of less than 0.01% of the observed low therapeutic effect of treatment, and when its concentration more than 0.1% is the absorption of methylene blue in the blood and damage the membrane of erythrocytes when exposed tonsils.

The distance from the radiation source to the surface of the tonsils 0.5-1 cm is determined by the opportunity to make full impact of radiation on the entire surface of the tonsil, eliminating gagging patient.

The duration of treatment (within 10-15 days) is determined by the form of chronic tonsillitis and pathological condition of the body.

In Fig.1 presents a photograph showing the control growth agar culture of staphylococci.

In Fig.2 presents a photograph showing the growth of staphylococci in culture after exposure to 0.01% methylene blue and subsequent exposure to light of the red and infrared spectrum.

In Fig.3 and 4 presents the absorption spectra of methylene blue.

In Fig.5 shows the absorption spectrum hlorofillipta.

In Fig.6 shows the spectral characteristics of the led physiotherapeutic device.

Table 1 shows the results of testing the growth of Staphylococcus aureus strain 209 in agar culture.

Table 2 shows the effectiveness of different treatments for hronicheskoj what motor to the bottom of the mouth. Lavage is carried out lacunae of the tonsils with a solution of a photosensitizer, which have absorption spectra in the range from 625 to 700 nm and 840 to 1270 nm, for example, 0.1% aqueous solution of methylene blue. Lavage of lacunas performed using 20 gram syringe production Record, with a standard cannula Hartmann. The cannula Hartmann injected into the gaps of the Palatine tonsils and the contents of the gaps wash solution to clean. The spent material is removed patients in the tray. After washing rinse the throat 100 ml of 0.9% saline solution. Just washed the second gaps of the tonsils. After gargling carry out the irradiation of each of the tonsils within 2-3 min broadband matrix light-emitting apparatus for phototherapy, for example, “dune-T”. The radiation produces at a distance of 0.5-1 cm from the surface of the tonsils. This can be used a special nozzle in the form of a tube.

The course of treatment daily for 10-15 days.

Using the proposed method for the treatment of chronic tonsillitis was conducted at the children's hospital No. 4, Tomsk at the Department of otolaryngology.

As examples, below are extracts from the histories of children treated by the proposed method.

P is an increase of 4 5 years.

When referring to a ENT doctor temperature 36,6C. Pharyngoscope: Palatine tonsil grade 2-3, loose, damaged, gaps liquid pus. The regional lymph nodes of multiple, dense, painless. Complete blood count: erythrocytes (er.) - 4,21012/l; hemoglobin (HB) - 129 g/l; leukocytes (lake.) - 4600109/l; eosinophils (EOS.) - 1%; segments nuclei (segm. the poison.) - 31%; lymphocytes (lymp.) - 64%; monocytes (mon.) - 4%; ESR - 12 mm/hour, C-reactive protein negative. Heart rate is 97 beats per minutes Bacteriological analysis of lacunas of tonsils Staphylococcus aureus sensitive to oxacillin, lincomycin, erythromycin. Immunological analysis of blood T-lymphocytes - 47%; T-active lymphocytes - 24%; b-lymphocytes - 31%; T-helpers - 32%; T-suppressors - 15%; immunoglobulins: Ig - 2,23 g/l; Ig M - 0.74 g/l; Ig G - of 10.01 g/l; CEC - 29 srvc. unit Flush with the tonsils: T-limp. - 45%; T-act. limp. - 34%; In-limp. - 28%; T-helper. - 30%; T-supress. - 15%. Diagnosis: chronic tonsillitis in the acute stage.

At the end of treatment, after 10 sessions of photodynamic therapy on the proposed method using as a photosensitizer 0.1% solution of methylene blue, the patient Goldline 1-St degree, tight, pink, gaps pathological contents no. Regional lymph nodes are small, soft, painless, single. Complete blood count: er. - 4,11012/l; HB - 121 g/l; lake. - 5700109/l; EOS. - 1%; stab neurophilia leukocytes (PAL. the poison.) - 3%; segm. the poison. - 33%; limp. - 59%; Mont. - 4%; ESR - 3 mm/hour, C - reactive protein negative. The heart rate of 78 beats per minutes Bacteriological examination of tonsils: sparse growth of Neisseria perflava. Immunological blood test: T-limp. - 44%; T-act. limp. - 32%; In-limp. - 30%; T-helper. - 33%; T-supress. - 12%; Ig And - 1.8 g/l; Ig M - 0.95 g/l; Ig G to 10.0 g/l; CEC - 29 srvc. unit Flush with the tonsils: T-limp. - 46%; T-act. limp. - 33%; In-limp. - 34%; T-helper. - 29%; T-supress. - 12%. Diagnosis: chronic tonsillitis in remission.

After 6 months of treatment. The patient no complaints. She feels good. Angin was not. The body temperature of 36.4C. Pharyngoscope: Palatine tonsils 2-nd degree, tight, pink, in the lacunae of tonsils pathological content there.

Regional lymph nodes isolated, elastic, painless. Heart rate is 72 beats per minutes CBC: er. - 3,91012/l; HB-the MA - 2 mm/h Bacteriological examination of tonsils: no growth of microorganisms. Immunological blood test: T-limp. - 45%; T-act. limp. - 25%; In-limp. - 32%; T-helper. - 35%; T-supress. - 10%; Ig And - 0.5 g/l; Ig M - 0,61 g/l; Ig G - 10,22 g/l; CEC - 20 sm. unit Flush with the tonsils: T-limp. - 40%; T-act. limp. - 24%; In-limp. - 20%; T-helper. - 28%; T-supress. - 12%.

Diagnosis: chronic tonsillitis in stable remission. Changes of indices of blood systems do not have immunity.

Example 2. Patient I., 12 years. Complaints on frequent colds, sore throats 1 time per year, fatigue during the study, a constant low-grade fever associated with colds. Considers herself a patient in the course of 3 years.

At primary inspection body temperature was 37.4C. Pharyngoscope:

the Palatine tonsils 2-nd degree, loose, damaged, gaps liquid pus, caseous mass. Regional lymph nodes isolated, dense, enlarged, painless. Bacteriological analysis of lacunas of tonsils: moderate growth Strept. oralis and Staph aureus. The heart rate of 78 beats per min-reactive protein negative. Complete blood count: er. - 4,41012/l; HB - 138 g/l; lake. - 5800109/l; PAL. what%; In-limp. - 35%; T-supras. - 15%; T-helper. - 50%; Ig A - 1.0 g/l; Ig M - 1,82 g/l; Ig G - 7,12 g/l; CEC - 56 srvc. unit Flush with the tonsils: T-limp. - 51%; T-act. limp. - 24%; In-limp. - 45%; T-helper. - 40%; T-supras. - 6%. Diagnosis: chronic tonsillitis in the acute stage.

After a 10-day course of treatment by the proposed method using as a photosensitizer hlorofillipta, the patient had no complaints, feel good, temperature is 36.2C. Pharyngoscope: Palatine tonsils 1st degree, tight, pink, pathological content in the gaps there. Regional lymph nodes are not palpable. C-reactive protein negative. The heart rate of 74 beats per minutes Bacteriological analysis lacunae of tonsils: moderate growth Strep. oralis. Immunological blood test: T-limp. - 61%; T-act. limp. - 34%; In-limp. - 25%; T-helper. - 48%; T-supras. - 18%; Ig And - 1.6 g/l; Ig M - 1.1 g/l; Ig G - 12.3 g/l; CEC - 59 srvc. unit Flush with the tonsils: T-limp. - 41%; T-act. limp. - 30%;-limp. - 41%; T-helper. - 30%; T-supras. - 8%. Complete blood count: er. - 4,41012/l; HB - 129 g/l; lake. - 5600109/l; PAL. the poison. - 3%; segm. the poison. - 42%; limp. - 41%; Mont. - 10%; ESR - 2 mm/hour, a Diagnosis of chronic tonsillitis in remission.

After 6 months the sting is">C. Pharyngoscope: Palatine tonsils 1st degree, tight, pink, gaps pure. Regional lymph nodes are not palpable. Bacteriological analysis of the microflora of the tonsils: no growth. C-reactive protein negative. Heart rate is 80 beats per minutes CBC: er. - 4,21012/l; HB - 138 g/l; lake. - 5000109/l; EOS. - 2%; segm. the poison. - 37%; limp. - 50%; Mont. - 11%; ESR - 2 mm/H. Immunological blood test: T-limp. - 57%; T-act. limp. - 21%; In-limp. - 30%; T-supras. - 26%; T-helper. - 31%; Ig A - 0.66 g/l; Ig M - 1.2 g/l; Ig G and 10.8 g/l; CEC - 25 srvc. unit Flush with the tonsils: T-limp. - 45%; T-act. limp. - 30%;-limp. - 20%; T-supras. - 13%; T-helper. - 32%.

Data examination, bacteriological analysis, studies of the immune system suggests no acute process. Diagnosis: chronic tonsillitis in remission.

Example 3. Patient P., aged 14. Complaints of angina 1-2 times per year, low-grade fever of permanent nature, tachycardia, fatigue, weakness. Sick for 6 years. When referring to a ENT doctor temperature 37,0-37,1C. Pharyngoscope: Palatine tonsils 2-nd degree, hypermonogenic, loose, gaps caseous-purulent tube. Regional limpet the isseria pirflava and abundant growth of Staph. aurens, sensitive to oxacillin, lincomycin, erythromycin, ofloxacin. Complete blood count: er. - 4,21012/l; HB - 133 g/l; lake. - 5400109/l; EOS. - 2%; PAL. the poison. - 2%; segm. the poison. - 50%; limp. - 41%; Mont. - 5%; ESR - 14 mm/h heart rate of 78 beats per min-react. protein ++. Immunological blood test: T-limp. - 50%; T-act. limp. - 40%;-limp. - 39%; T-helper - 40%; T-supress. - 10%; Ig A - 0,81 g/l; Ig M - 1,41 g/l; Ig G to 15.0 g/l; CEC - 48 sm. unit Flush with the tonsils: T-limp. - 22%; T-act. limp. - 16%; In-limp. - 26%; T-helper. - 20%; T-supress. - 2%. In immune status minor-lymphocytosis. The decrease in T-lymph., T-act. limp., T-helper cells., T-supras. in the flush of the tonsils. Diagnosis: chronic tonsillitis, acute exacerbation.

After a 10-day course of treatment with cephalosporin antibiotic, the patient performed a medical examination. The temperature of 36.2C. Pharyngoscope: Palatine tonsils 1st degree, pink, tight, gaps pure. Regional lymph nodes are not palpable. Bacteriological analysis of lacunas of tonsils: Staph. aurens - absent, scanty growth of Neisseria pirflava. Complete blood count: er. - 4,61012/l; HB - 125 g/l; lake. - 5100109/l; EOS. - 3%; PAL+. Immunological blood test: T-limp. - 54%; T-act. limp. - 35%;-limp. - 32%; T-helper. - 41%; T-supras. - 14%; Ig And 1.1 g/l; Ig M - 1.2 g/l; Ig G - 12 g/l; CEC - 52 srvc. unit Flush with the tonsils: T-limp. - 34%; T-act. limp. - 21%; In-limp. - 32%; T-helper. - 22%; T-supras. - 5%. Diagnosis: chronic tonsillitis in remission.

After 6 months at the control examination the patient had no complaints. Feeling good, Angin was not. Low-grade temperature - 37,2C. If pharyngoscopy: Palatine tonsils 2-nd degree, hypermonogenic, loose, gaps liquid pus. Regional lymph nodes isolated, dense, painless. Bacteriological analysis of tonsils showed scanty growth of Staph. aurens, sensitive to erythromycin, oxacillin, lincomycin, tsefalotina. Complete blood count: er. - 4,31012/l; HB - 134 g/l; lake. - 7000109/l; EOS. - 1%; PAL. the poison. - 2%; segm. the poison. - 51%; limp. - 35%; Mont. - 11%; ESR - 5 mm/hour, C-reactive protein negative. The heart rate of 68 beats per minutes Immunological blood test: T-limp. - 45%; T-act. limp. - 20%; In-limp. - 22%; T-helper. - 23%; T-supras. - 22%; Ig And 1.5 g/l; Ig M - 0.7 g/l; Ig G - 8,2 g/l; CEC - 83 srvc. unit Flush with the tonsils: T-limp. - 27%; T-act. limp. - 20%; In-limp. - 28%; T-helper. are about the beginning of exacerbation. Diagnosis: chronic tonsillitis in the acute stage.

For clinical studies on the effectiveness of the proposed method were treated 80 children aged 10-15 years with a diagnosis of chronic decompensated tonsillitis, recurrent angina (28 people); chronic decompensated tonsillitis, recurrent angina, low grade fever (52 patients). Of this group, 60 patients were treated by the claimed method, and 20 patients antibiotic.

In the process of treatment and monitoring during the year of the 80 patients in 15 patients had a recurrence of angina, which amounted to 18.8% of the entire group, 20 patients were periodically raised body temperature up to subfebrile, which accounted for 25% of all treated.

Of the 60 patients treated by the claimed method, 9 patients had angina, which amounted to 15% of treated patients, 11 patients had temperature rise to low values, which amounted to 18% of those treated.

Of the 20 patients treated with antibiotics, 6 had a recurrence of angina, which accounted for 30% of the treated patients, 9 patients were periodically raised the temperature to low values, which amounted to 45% of treated patients.

Thus, it can be noted that the treatment of patients by the claimed method in cranea.

Table 2 shows summary data about the effectiveness of different methods of treatment of chronic tonsillitis: using as a photosensitizer 0.1% solution of methylene blue or chlorophyllipt with subsequent irradiation of the tonsils by the present method; carrying out washing lacunae of tonsils with a solution of 0.1% methylene blue without further exposure and to compare the traditional treatment of antibiotic - Cefazolin.

From table 2 it follows that the method of treatment of chronic tonsillitis using as a photosensitizer solution of methylene blue is more effective than antibiotic therapy and phototherapy with hlorofillipta, with higher and more persistent antimicrobial effect against pathogenic Staphylococcus.

Thus, using the proposed method for the treatment of chronic tonsillitis increases the efficiency of photodynamic therapy by optimizing the processes of sensitization and exposure pathological lesions, antibacterial effects, reduce recurrence of the disease. This method does not cause complications inherent in other known methods for treating tonsillitis. The proposed method of treatment is safe. the Denmark. It costs compared with the methods of treatment of chronic tonsillitis using a laser, depending on the type of laser, below 40-100 times.

Claims

1. The method of treatment of chronic tonsillitis, including wringing language spatula and the subsequent impact of scattered radiation on the Palatine tonsil, daily for 10-15 days, characterized in that conduct sensitization lavage of lacunas of the tonsils to clean with a solution of a photosensitizer, rinse the throat with saline, followed by alternate irradiation of each of the tonsils optical radiation matrix light-emitting apparatus for phototherapy in the spectral range from 625 to 700 nm and 840 to 1270 nm with an exposure time of 2-3 minutes

2. The method according to p. 1, characterized in that the lavage of lacunas of the tonsils spend solution of photosensitizer absorbing optical radiation in the spectral range from 625 to 700 nm and 840 up to 1270 nm.

3. The method according to p. 1, characterized in that the lavage of lacunas of the tonsils is performed using a syringe with cannula Hartmann.

4. The method according to p. 1, characterized in that opolaskivanija at the distance of 0.5-1 cm from the surface of the tonsils.

6. The method according to p. 1, characterized in that the irradiation is made by means of the nozzle in the form of a tube to led matrix device for phototherapy.

7. The method according to p. 2, characterized in that as a photosensitizer use of 0.01-0.1% aqueous solution of methylene blue.

8. The method according to p. 1, characterized in that the photosensitizer is used chlorophyllipt.

9. The method according to p. 7, characterized in that the impact of optical radiation in the range from 625 to 940 nm.

10. The method according to p. 8, characterized in that the impact of optical radiation in the range from 640 to 660 nm.

 

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EFFECT: enhanced effectiveness of treatment.

4 cl

FIELD: medicine.

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EFFECT: complete destruction of neoplasm; excluded its further growth.

4 cl

FIELD: medicine.

SUBSTANCE: method involves applying transscleral diaphanoscopic examination method for adjusting intraocular neoplasm localization and size. Rectangular scleral pocket is built 2/3 times as large as sclera thickness which base is turned from the limb. Several electrodes manufactured from a metal of platinum group are introduced into intraocular neoplasm structure via the built scleral pocket. Next to it, intraocular neoplasm electrochemical destruction is carried out in changing electrodes polarity with current intensity of 100 mA during 1-10 min, and the electrodes are removed. Superficial scleral flap is returned to its place and fixed with interrupted sutures. 0.1-2% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, transpupillary laser radiation of 661-666 nm large wavelength is applied at a dose of 30-120 J/cm2. the operation is ended with placing sutures on conjunctiva. Platinum, iridium or rhodium are used as the metals of platinum group. The number of electrodes is equal to 4-8. 0.1-1% khlorin solution, selected from group containing photolon, radachlorine or photoditazine, is additionally repeatedly intravenously introduced in 2-3 days at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, repeated laser irradiation of the intraocular neoplasm is carried out with radiation dose of 30-45 J/cm2.

EFFECT: complete destruction of neoplasm; excluded tumor recurrence; reduced risk of tumor cells dissemination.

3 cl, 3 dwg

FIELD: medicine.

SUBSTANCE: the present innovation deals with treating vascular cutaneous neoplasms, such as nevus flammeus and gemangiomas. Light-thermal impact at energy ranged 39-47 J/sq. cm should be performed in two stages, and between them, 2-3 wk after the onset of vascular resistance at the first stage one should perform beta-therapy daily for 2-3 d at single dosage being 20 g. Then, 3 wk later it is necessary to conduct the second stage of light-thermal impact by starting at energy value being 42 J/sq. cm, not less. The method enables to shorten therapy terms due to applying combined method to affect vascular cutaneous neoplasms.

EFFECT: higher therapeutic and cosmetic effect.

1 ex

FIELD: medicine.

SUBSTANCE: method involves intravitreously introducing two electrodes into intraocular neoplasm after carrying out vitrectomy and retinotomy to expose the intraocular neoplasm. The electrodes are manufactured from platinum group metal. Electrochemical destruction is carried out with current intensity of 100 mA during 1-10 min or 10 mA during 10 min in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous laser radiation is carried out in parallel light beam of wavelength equal to 661-666 nm is applied at a dose of 30-120 J/cm2.The transformed retina and tumor destruction products are intravitreally removed. Boundary-making endolasercoagulation of retinotomy area is carried out after having smoothed and compressed retina with perfluororganic compound. The operation is finished with placing sutures on sclerotomy and conjunctiva. Platinum, iridium or rhodium are used as the platinum group metals. Another embodiment of the invention involves adjusting position and size of the intraocular neoplasm in trans-scleral diaphanoscopic way. Rectangular scleral pocket is built above the intraocular neoplasm to 2/3 of sclera thickness with its base turned away from limb. Several electrodes are introduced into intraocular neoplasm structure via the built bed. The electrodes are manufactured from platinum group metal. Electrochemical destruction is carried out with the same current intensity in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. Superficial scleral flat is returned to its place and fixed with interrupted sutures. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg after having carried out vitrectomy and retinotomy. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous laser radiation is carried out in parallel light beam of wavelength equal to 661-666 nm is applied at a dose of 30-120 J/cm2. The transformed retina and tumor destruction products are intravitreally removed using vitreotome. Boundary-making endolasercoagulation of retinotomy area is carried out after having smoothed and compressed retina with perfluororganic compound. The operation is finished with placing sutures on sclerotomy and conjunctiva. Platinum, iridium or rhodium are used as the platinum group metals. The number of electrodes is equal to 4-8.

EFFECT: reduced risk of metastasizing.

4 cl, 13 dwg

FIELD: medicine.

SUBSTANCE: method involves building tunnel to posterior eyeball pole in inferoexterior and superexterior quadrants. The tunnel is used for implanting flexible polymer magnetolaser implant to the place, the subretinal neovascular membrane is localized. The implant has a permanent magnet shaped as a cut ring and is provided with drug delivery system and a short focus scattering lens of laser radiator connected to light guide. The permanent implant magnet is axially magnetized and produces permanent magnetic field of 5-7 mTesla units intensity. It is arranged with its north pole turned towards sclera at the place of the subretinal neovascular membrane projection with extrascleral arrangement of laser radiator lens membrane being provided in the subretinal neovascular membrane projection area. The other implant end is sutured to sclera 5-6 mm far from the limb via holes made in advance. The implant is covered with conjunctiva and retention sutures are placed thereon. Light guide and drug supply system lead is attached to temple with any known method applied. Drugs are supplied via the implant drug supply system in retrobulbary way in any order. Triombrast is given in the amount of 0,4-0,6 ml and dexamethasone or dexone in the amount of 0,4-0,6 ml during 3-4 days every 12 h. 0.1-1% aqueous solution of khlorin is intravenously introduced at the third-fourth day after setting the implant as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, at a bolus dose of 0.8-1.1 mg/kg. Visual control of subretinal neovascular membrane cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the subretinal neovascular membrane with the photosensitizer to maximum saturation level, intravitreous, transretinal laser radiation of 661-666 nm large wavelength is applied at general dose of 30-120 J/cm2. The flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, samarium-iron-nitrogen or neodymium-iron-boron system material. The photosensitizer is repeatedly intravenously introduced at the same dose in 2-3 days after the first laser radiation treatment. Visual intraocular neoplasm cells fluorescence control is carried out using fluorescent diagnosis techniques. Maximum level of saturation with the photosensitizer being achieved in the subretinal neovascular membrane via laser light guide and implant lens, repeated laser irradiation of the subretinal neovascular membrane is carried out with radiation dose of 30-60 J/cm2.

EFFECT: accelerated subretinal edema and hemorrhages resorption; regression and obliteration of the subretinal neovascular membrane; prolonged vision function stabilization.

6 cl

FIELD: medicine.

SUBSTANCE: method involves filling vitreous cavity with perfluororganic compound. Two electrodes manufactured from platinum group metal are intravitreally, transretinally introduced into intraocular neoplasm. Electrochemical destruction is carried out with current intensity of 10-100 mA during 1-10 min in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous, transretinal laser radiation of 661-666 nm large wavelength is applied at a dose of 30-120 J/cm2 in perfluororganic compound medium. The transformed retina and tumor destruction products are intravitreally removed with perfluororganic compound volume being compensated with its additional introduction. Boundary-making endolasercoagulation of retinotomy area is carried out. The perfluororganic compound is substituted with silicon oil. The operation is ended in placing sutures over sclerotmy areas and over conjunctiva. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity. Platinum, iridium or rhodium are used as the platinum group metals.

EFFECT: complete destruction of neoplasm; reduced dissemination risk.

6 cl, 12 dwg

FIELD: medicine, applicable for stopping of pains of various nature.

SUBSTANCE: the device has a quantum-mechanical oscillator located in a casing, magnet, vessel for medicinal agent and a hollow cylinder. The magnet is installed between the oscillator and the vessel. Positioned in the vessel is a hollow cylinder having through holes on its surface.

EFFECT: quick and absolute anestesia.

2 ex, 1 dwg

FIELD: medicine.

SUBSTANCE: method involves administering laser radiation therapy once a day using low intensity pulsating radiation of wavelength equal to 890nmand power density of 0.03 mW/cm2. Injured organ projection to frontal abdominal wall is exposed to radiation at the first laser therapy stage in two fields acting upon each field for 2 min with radiation pulse succession frequency equal to 80 Hz in applying stable contact-type method. Total treatment dose on two fields is equal to 0.008 J/cm2. The second laser therapy stage begins immediately after having finished the first one in applying radiation along the large intestine path using labile contact-type method in a way that radiation pulse succession frequency equal to 80 Hz is applied first during 1 min and then frequencies of 600, 150 and 300 Hz are applied also during 1 min, respectively. Total treatment dose is equal to 0.032 J/cm2 at the second stage. Total treatment dose is equal to 0.04 J/cm2 at both stages.

EFFECT: enhanced effectiveness in inhibiting dysbacteriosis; reduced frequency of postoperative complications.

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