Method for treating patients with gastric and duodenal ulcerous disease

FIELD: medicine, gastroenterology.

SUBSTANCE: laser therapy should be prescribed at differentiated mode. In case of primarily detected pathology or disease duration for under 10 years or rarely relapsing form and availability of pronounced pain syndrome cutaneous impact should be performed at wave length of 0.89 mcm, impulse power of 5-7 W, impulse frequency of 80-150 Hz, by contact-stable technique for standard fields of impact, impact time being 64-128 sec/field, about 10-12 procedures/course. In case of disease duration being above 10 years in elderly groups, at pronounced astheno-autonomic syndrome and at no or unpronounced pain syndrome one should conduct intravenous laser impact at wave length of 0.63 mcm, radiation power at the edge of a disposable intravenous light guide being 1-1.5 mW, duration of procedure being 20 min, 7 procedures/course. Combined method deals with daily successive intravenous and cutaneous impact according to the above-mentioned technique - in case of disease duration above 10 years, frequently relapsing form, availability of multiple or combined ulcers and availability of two or more parallel diseases. The method enables to decrease terms of hospitalization, decrease frequency of exacerbations and prolong remission period.

EFFECT: higher efficiency of therapy.

1 dwg, 2 ex, 2 tbl

 

The invention relates to medicine, namely to “gastroenterology”, and for the treatment of patients with peptic ulcer disease (PUD) of stomach and duodenum (duodenum).

Given the large number of drugs that are used in the treatment of PUD as well as the steadily rising cost of medicines, more and more interest acquires long-term use of non-pharmacological therapy, one method of which is low level laser therapy (LLLT).

It is shown that the laser effects on the body through a system of integrating adaptation processes. The interaction of LLLT with bio-object is now seen as a multilevel process with its specific mechanisms operating at these levels.

There is a method of treatment of patients YAB using cutaneous laser therapy (Bolin V.A. Application of the “Mustang-bio” in the treatment of peptic ulcer. A book published. Moscow. 1996. P.19-21), when patients realize the impact on the zone of pain in the epigastric region, segmental areas in paravertebral region ThVII- ThXIIwith the help of the “Mustang-bio”.

The disadvantage of this method of treatment is the lack of a differentiated approach to the appointment of LT, the performance of the procedures without taking into account the current version of YAB, severity of pain.

There is a method of treatment of patients YAB using intravenous laser irradiation of blood (Naumova EL, Beloborodov II Low-energy laser irradiation of the blood in the treatment of patients YAB duodenum. // The wedge. medicine. - 1996. No. 3. - P.63-64) GNL LH-75-1 with a wavelength of 632.8 nm, operating in the continuous mode, the power at the distal end of the light guide 6-8 mW, duration of exposure 30 minutes, the treatment course of 6 days.

The disadvantage of this method is that when assigning vlok not take into account the age characteristics of patients, type of flow YAB, comorbidities, severity of pain, asteno vegetative syndromes.

There is a method of treatment of patients YAB using the combined method LT - vlok and cutaneous exposure (Illarionov VE Techniques and methods of treatments of laser therapy. The Handbook. M., 1994. 49 - 54).

The disadvantage of this method of treatment is to assign patients without regard to duration of disease, frequency of exacerbations, the localization of ulcers associated gastroduodenal and extraabdominal pathology, the severity of the main clinical syndromes.

The closest to the essential features of the claimed invention is a method of treatment of patients with ulcerative diseases of the stomach and DNA taken for the prototype, including primegenerator methods LT (Myslovitz L.V. Peptic ulcer and duodenal ulcers: comparison of the effectiveness of three methods of laser therapy. // Laser medicine. - 2001. No. 5. - Issue 1. - Ñ.38-39). The prototype of the invention has the following essential features: different methods are used LT: cutaneous effects of intravenous laser irradiation of blood, the combined method - ILIB + cutaneous exposure, resulting in shorter period of cicatrization of the ulcer, to improve the quality of treatment.

The disadvantage of the prototype is the lack of differentiation in the various methods of laser therapy, that is the purpose of cutaneous method, vlok, the combined method LTL excluding the current version of YAB, duration of illness, frequency of exacerbations, the severity of the main clinical syndromes, the presence of concomitant gastroduodenal and extraabdominal pathology, the age of the patients.

The claimed invention is directed to solution of the problem consisting in the creation of a method of differentiated treatment of patients with ulcerative diseases of the stomach and duodenum.

The solution to this problem provides the reduction of possible scarring ulcers, reducing beds/day, increase prodolzhitelnost remission.

To achieve this, the technical result of the claimed invention, a method for the treatment of patients with ulcerative diseases of the stomach and duodenum includes the following significant features: LT appoint differentially - cutaneous exposure is performed by the wavelength of 0.89 μm, a pulse power 5-7 W, pulse frequency 80-150 Hz, pin-stable methods on the standard field exposure, the exposure time for one field with 64-128, a course of 10-12 treatments when first diagnosed pathology or duration of disease less than 10 years, rarely recurrent form and the presence of significant pain syndrome, intravenous laser irradiation produces a wavelength of 0.63 µm, the radiation power at the end of the disposable intravenous fiber 1-1,5 mW, duration of the procedure up to 20 minutes, the course of treatment 7 procedures with duration of disease more than 10 years, older age groups, when expressed asteno vegetative syndrome and the absence or unexpressed pain syndrome, a combined method in which prescribed a daily sequential intravenous or cutaneous exposure by the above method, when the duration of disease more than 10 years, chastoretsidiviruyuschey form, the presence of multiple or combined ulcers, patients with more than two comorbidities.

In relation to the prototype of the claimed invention has the following distinctive features: LT appoint differentially - cutaneous exposure is carried out at first identified pathology or duration ill is of less than 10 years, rarely recurrent form and the presence of significant pain syndrome, endovenous laser treatment is prescribed for the duration of the disease more than 10 years, older age groups, with the Express asteno vegetative syndrome and the absence or unexpressed pain syndrome, combined method, consistent in one day cutaneous and intravenous exposure - by duration of disease more than 10 years, chastoretsidiviruyuschey form, the presence of multiple or combined ulcers, patients with more than two comorbidities.

Between the features and the technical result is the following causal relationship: due to the differential treatment of patients with ulcerative diseases of the stomach and duodenum is the specific purpose techniques for the treatment of patients depending on the duration of disease, frequency of exacerbation, severity of major clinical syndromes, the presence of concomitant gastroduodenal and extraabdominal pathology, age of patients, which increases the effectiveness of treatment, shorter hospital stay, reduce the frequency of exacerbations, increase the duration of the remission period.

According to the authors svedeniam set of essential features that characterize the essence of the claimed invention, is not known, which allows the t to conclude that according to the invention, the criterion of “novelty”.

According to the authors, the essence of the claimed invention to a person skilled not obvious from the prior art of medicine, because it is not detected by the above consideration of the duration of disease, frequency of exacerbations, the severity of the main clinical syndromes, the presence of concomitant gastroduodenal and extraabdominal pathology, age of patients with various types of LT patients ulcerative diseases of the stomach and duodenum, which differ from the prototype of the claimed invention, which allows to make a conclusion on compliance with a criterion of “inventive step”.

The set of essential features that characterize the invention, in principle, can be used repeatedly in medicine with the technical result consists in increasing the effectiveness of laser therapy in patients with ulcerative diseases of the stomach and duodenum, which allows to make a conclusion about conformity of the invention, the criterion of “industrial applicability”.

This method is as follows.

Patients performed a comprehensive anti-ulcer drug therapy with the inclusion of a course of laser therapy.

The rate of cutaneous laser therapy is carried out using a laser therapy apparatus “Mustang-bio sensors pulse and respiration (the company "Equipment"), the wavelength of 0.89 μm, the thickness 5-7 W, magnetic mirror is Asadi SM-50 intensity 50 MT (methods - contact, stable; standard field exposure - epigastric area below the xiphoid process of the sternum, the projection area of the pyloric stomach to the anterior abdominal wall, the projection area of the ulcer on the anterior abdominal wall, painful area in the field of Th10-Th12paravertebral one side or symmetrically; the wavelength of 0.89 μm, the pulse power of 5 W, pulse frequency 80-150 Hz, the exposure time for one field 64-128 with daily sessions of treatment 10-12 procedures).

A course of intravenous RT was carried out with the help of laser therapy “Mulatto” (produced by “Equipment”) with a wavelength of 0.63 µm, the radiation power at the end of the disposable intravenous fiber 1-1,5 mW (procedure duration of 20 minutes; daily sessions, the course 5-7 procedures).

The combined method LT: total intravenous and local (reflex) exposure was performed on the above described methods (5-7 sessions vlok and 10-12 sessions cutaneous laser therapy), procedures were performed daily, first vlok, then cutaneous laser in one day.

The purpose of the various methods LT was carried out differentially with regard to duration of disease, frequency of exacerbations, the severity of the main clinical syndromes, the presence of concomitant gastroduodenal and extraabdominal pathology, against whom the patients. An indication for cutaneous LT method were first identified BU or BU not longer than 10 years, ulcerative diseases of the stomach and duodenum with recurrences of not more than 2 times per year, the presence of pronounced pain in patients with YAB. An indication for vlok was: missing or unexpressed pain syndrome, patients YAB older age groups, expressed asteno vegetative syndrome. An indication for a combined method LT were: duration of disease more than 10 years, zestoreticbuy form, the presence of multiple or multiple ulcers, the presence of more than two comorbidities.

Investigated the aggregation properties of platelets. During studies in patients with gastric ulcer and duodenal ulcer in acute phase prior to treatment we identified a variety of shifts of the curves of platelet aggregation: in this giperagregatsiyu noted in 73,8% of patients, hypogravity at 21.6 per cent, norvegiae was in 4.6% of patients. That is, for most patients with peptic ulcer disease source in the acute phase was characterized hyperaggregation the curve type.

The two most important parameters of the aggregation of platelets in acute YAB were significantly changed in comparison with the healthy group. The most pronounced pathological changes of the main parameters of aggregation thrombus is of Titov have been identified in patients with disease duration more than 10 years, the frequency of exacerbations more than three times per year and the duration of the last exacerbation 1.5 months and over.

Comparative analysis of the impact of LT on platelet aggregation showed a significant change in the degree of aggregation (one Hundred) and the speed of aggregation (Ska) under the influence of cutaneous LT method (when the original hyperaggregation significant decrease Hundred - 80,86±2,149 before and 61,16±6,011 after (p<0.005 percent); when the original hypogravity increase a Hundred - 31,66±9,845 before and 62,28±6,712 after (p<0,01).

In the second subgroup under the influence vlok showed a significant change Ska and platelet count: if the original hyperaggregation - Ska to 33,42±3,201, after 12,8±3,008 (p<0,01); when the original hypogravity - platelet count before treatment 274,7±6,4-and 198,0±20,19 after (p<0,005).

The combination of vlok and cutaneous method led to a significant decrease Hundred and Ska (one Hundred 84,98±4,645 before and 70,91±2,96 after (p<0,01); when the original hypogravity 14,56±4,594 before and 34,18±9,477 after (p<0,05); Ska 39,88±2,719 before and 27,31±2,111 after (p<0,001). When the original normatively in the control and main groups, significant changes occurred.

The results of the study are shown in table 1, indicate normalizing, correlating the effect of different methods LT on aggregation capacity of platelets,

The result of the ATA, our study revealed signs of secondary immunodeficiency in patients with ulcerative diseases in acute phase, which was reflected in a pronounced depression of local humoral immunity (decreased IgG and IgA in saliva), the General imbalance of humoral immunity (increased IgG in serum), as well as the reduction of nonspecific resistance of the organism (decrease phagocytic function of neutrophils).

Comparison of the performance of all components of the immune system in patients YAB before and after treatment (table 2) revealed a clear dependence of the degree of change from treatment. Marked by a more pronounced effect of LT in group I (cutaneous method) on the immune system. While significant changes have occurred in all parts of the immune system. Thus, the level of serum Ig G decreased from 26,09±0.9 to 18,8±1,3 (p<0,05). Revealed a stimulating effect cutaneous method on local immunity and phagocytic activity of neutrophils (Ig G in saliva increased from 44,2±6,2 to 77.5±3,2 (p<0.05), and the index of completeness of phagocytosis (ISF) increased from 0.64±0,3 to 1.68±0,5 (p<0,05), normalized bactericidal function of neutrophils is the index of activation (EA) increased from 1.9±0,8 to 3,2±0,6 (p<0,05).

At the same time in the control group after treatment was the only change the absorption capacity of neutrophils (percentage of phagocytosis after 30 minutes of incubation (PF30) - 60,1±10,4 before treatment, after treatment 71,2±7,9 (p<0,05, phagocytic index after 30 minutes of incubation (Fizeau) - 5,5±0.3 to treatment and 6.8±0,2 after treatment, p<0,05).

Low level laser therapy, according to our data, also provides a stimulating and corrective influence on the performance of local immunity, as evidenced by the increase in the content of Ig G and Ig a in saliva only I and III groups of patients, whereas in the group of patients with only vlok, these figures have not changed substantially. So, there was a reliable increase of Ig G and Ig a in saliva in I and III group I - Ig G 44,2±6.2 to and 77.5±3,2 after; Ig A - 95,3±9,5 to and 148, 8 persons±20,5 after; in group III Ig G increased from 57.2±5,5 to 68.6±2,5, Ig And to 97.1±4.9 to 163,0±22,6 (p<0,05).

The healing of the ulcer in the main group was significantly faster (see the drawing)than in the control group. So, the average time to healing of ulcers of the stomach and duodenum least in the third subgroup - YAB KDP - 17,8±0.8 days, YAB W - 19,3±3.4 days), which was significantly different from the control group, where the healing time in patients YAB, YAB KDP amounted to 29.3±5,7 (p<0,05) and 28.5±, and 5.5, respectively (p<0,01).

Accordingly, the duration of hospitalization was reduced in the study group, depending on the localization of ulcers and method LT: in group I when YAB W average period of hospitalization was - 22,3±4,0, when YAB KDP - 20,8±3.3 days; in group II - when YAB W 2,2± 5,1, when YAB KDP 19,8±3.5 days; in group III when YAB W 21,4±3,1, when YAB KDP 19,5±1.8 days. The difference was significant compared with the control group, where the average duration of hospitalization in patients with GU amounted to 27.3±2.8 days, when YAB KDP 25,0±4.7 days (p<0,05).

To illustrate the differential use LTL, as well as normalizing influence cutaneous LT on aggregation activity of platelets below is a brief extract from a case history No. 592.

Example 1.

Patient S., 64 years old, was admitted 01.03.03, gastroenterology Department complaining of severe pains in the epigastrium, emerging through 1-1,5 hours after a meal, a night of pain, sometimes heartburn, belching air, dryness, bitterness in the mouth, swelling in the abdomen, weakness, fatigue, and headaches. From the anamnesis it is known that in the last 2 months the patient was bothered by nagging pains in the epigastrium, periodically heartburn, belching air. The deterioration of the notes for the week prior to admission.

When receiving a satisfactory condition, the shape is correct, the normal power supply. Skin and visible mucous regular color. From the lungs and cardiovascular system revealed no pathology. The language of low humidity, white furred. Belly actively participates in the act of breathing, palpation local Bo is znanosti in the epigastrium and projection bulb duodenum without irradiation. The liver is at the edge of the costal arch. Spleen not palpated. Symptom tapping on the lumbar region is negative on both sides. A General analysis of blood, urine, biochemical analysis of blood without significant changes.

On EGD # 79 from 01.03.03, the mucosa of the stomach hyperemic, with isolated erosions on the front wall to 0.1 cm, covered with a dark brown patina. On the anterior wall of the duodenal bulb ulcer size 0,7-0,6 see the Conclusion: Ulcer of the duodenal bulb. Erosive gastritis.

The radiological examination from 07.03.03,: Esophagus freely pass. The stomach of the usual form, contours equal. The folds of the mucosa was normal. Peristalsis is satisfactory. The bulb of the duodenum irritated, on the relief of the small sizes of the plague. Conclusion: peptic Ulcer disease. Ulcer of the duodenal bulb.

Indicators aggregation activity of platelets at entry: the degree of aggregation of 98.3%; time aggregation - 09:56 min:sec; top speed aggregation - 36,8%/min; platelet - 230,0 thousand/ál.

The patient took the course cutaneous LT method according to the above method, one session per day, for a treatment course of 10 sessions.

After the second session the patient noted a significant decrease in pain after the third session LTL pain and dyspeptic syndromes were stopped completely.

After completion of the course the LT parameters of platelet aggregation have been following is: the degree of aggregation - 73,4%; time aggregation - 09:57 min:sec; top speed aggregation - 21,7%/min; platelet - 227,8 thousand/ál.

On the control EGDS No. 63 from 20.03.03, - healed ulcer of the duodenal bulb.

In this clinical example, we consider the case of a first-diagnosed peptic ulcer, and ulcer of the duodenal bulb was accompanied by erosive gastritis. During exacerbation YAB showed signs of hyperaggregation: increasing extent, the maximum velocity of the aggregation. In the process of treatment was hypogranulation the effect of cutaneous LT method, a positive effect on the clinical signs of acute illness, to the end of treatment, there was a complete healing of the ulcer of the duodenal bulb, and erosions of the gastric mucosa.

Example 2.

Sick, ,, 48 years old, medical history, No. 179, received 22.01.03, Patient admission complained of severe pains in the epigastrium after about 30 minutes after eating, night pain, heartburn, nausea, dry mouth, vomiting eaten food that brings relief, decreased appetite, sleep disorder, irritability. From history revealed that over 20 years suffers YAB. In 1998, the patient underwent surgery - closure ulcers about gastrointestinal bleeding. Last exacerbation notes for 1 week before admission.

Objective examination: the language of low humidity, cover the n to the root of white bloom. On palpation, percussion, and palpation tenderness in the epigastrium and left hypochondrium. Liver and spleen not palpable. From other organs and systems without pathological changes.

At endoscopy from 16.01.03 g: gastric contents - turbid liquid, the shape of the deformed, usual folds, peristalsis saved, in the middle third of the body of the stomach lumen is narrowed, the mucosa is hyperemic, thickened. On the lesser curvature of the stomach ulcer to 1.0 cm, covered with fibrin. The bulb of the duodenum without features. Conclusion: gastric Ulcer.

The results of cytological and histological examination (biopsy 3 piece) OK not detected.

Due to the long ulcer history, frequent relapses (3-4 times per year), the large size of the ulcer (1.0 cm), localization of the ulcer on the lesser curvature was appointed by the combined method LT - General and local effects (ILIB - 7 sessions and cutaneous method - 12 sessions).

The results of immunological blood tests for admission from 23.01.03, in serum - IgA - 2,94 g/l, IgG - 23,0 g/l, IgM - 0.96 g/l; in the saliva - IgG - 38 mg/l, IgA - 85 mg/l, s-IgA - 120 mg/l; phagocytosis indices - 30 minutes incubation at 58%, PHI 5,2, 90 minutes incubation - 52%, PHI 6,3, ISP - 0,82; nst-test - QI in the “About” sample - 6,0, QI in the “To” sample - 2,1, IA - 2,85.

The results of immunological blood tests after treatment 08.04.03 g: serum IgA - 1.54 g/l, IgG - 20,0 g/l, IgM - 1.12 g/l; in the saliva - IgG - 80 mg/l, IgA - 140 mg/l, s-IgA - 168 mg/l; phagocytosis indices - 30 minutes incubation at 60%, PHI 9,6, 90 minutes incubation at 45%, PHI 3,1, ISP - 1,5; nst-test - QI in the “About” sample is 6.4, QI in the “To” sample - 2,1, IA - 3.04 from.

In this clinical example, the heavy flow of YAB revealed changes of humoral General and local immunity and phagocytic activity of leukocytes. As can be seen from the above observations, combined treatment with the use of LT had immunocorrigirutee influence, to a greater extent in relation to phagocytosis and the General humoral immunity.

Clinical and laboratory studies of the proposed method of treatment of patients with ulcerative diseases of the stomach and duodenum, in comparison with the known method (prototype)showed the effectiveness of the proposed method of treatment, improve treatment, reduce the time of hospitalization, reduce the frequency of exacerbations, increase the length of remission.

Method for the treatment of patients with peptic ulcer of stomach and duodenum, including the use of drugs and laser therapy, characterized in that laser therapy is prescribed differentially: cutaneous exposure is performed by the wavelength of 0.89 μm, a pulse power 5-7 W, pulse frequency 80-150 Hz contact-stable methods on the standard field exposure time is February impacts on one field with 64-128, the course of 10-12 treatments when first diagnosed pathology or duration of disease less than 10 years, rarely recurrent form and the presence of significant pain syndrome, intravenous laser irradiation produces a wavelength of 0.63 µm, the radiation power at the end of the disposable intravenous fiber 1-1,5 mW, the duration of the treatment 20 min, treatment 7 procedures with duration of disease more than 10 years, the older age groups when expressed asteno vegetative syndrome and the absence or unexpressed pain syndrome combined method, which is prescribed daily sequential intravenous or cutaneous exposure by the above method when the duration of disease more than 10 years, chastoretsidiviruyuschey form, the presence of multiple or multiple ulcers, the patients with more than two comorbidities.



 

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2 cl

FIELD: medicine.

SUBSTANCE: method involves introducing 0.1-0.3 ml of photosensitizing gel preliminarily activated with laser radiation, after having removed neovascular membrane. The photosensitizing gel is based on a viscoelastic of hyaluronic acid containing khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-2% by mass. The photosensitizing gel is in vitro activated with laser radiation having wavelength of 661-666 nm during 3-10 min with total radiation dose being equal to 100-600 J/cm2. The gel is introduced immediately after being activated. To compress the retina, vitreous cavity is filled with perfluororganic compound or air to be further substituted with silicon oil. The operation is ended with placing sutures on sclerotomy and conjunctiva areas. Compounds like chealon, viscoate or hyatulon are used as viscoelastic based on hyaluronic acid. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity.

EFFECT: excluded recurrences of surgically removed neovascular membrane and development of proliferative retinopathy and retina detachment; retained vision function.

3 cl, 5 dwg

FIELD: medicine.

SUBSTANCE: method involves making incision in conjunctiva and Tenon's capsule of 3-4 mm in size in choroid hemangioma projection to sclera 3-4 mm far from limb. Tunnel is built between sclera and Tenon's capsule to extrasclerally introduce flexible polymer magnetolaser implant through the tunnel to the place, the choroid hemangioma is localized, after performing transscleral diaphanoscopic adjustment of choroid hemangioma localization and size, under visual control using guidance beam. The implant has permanent ring-shaped magnet in the center of which a short focus scattering lens of laser radiator is fixed. The lens is connected to light guide in soft flexible envelope. The permanent implant magnet is axially magnetized and produces permanent magnetic field of 2-3 mTesla units intensity. It is arranged with its north pole turned towards the choroid hemangioma so that extrascleral implant laser radiator disposition. The other end of the implant is sutured to sclera 5-6 mm far from the limb with two interrupted sutures through prefabricated openings. The implant is covered with conjunctiva and relaxation sutures are placed over it. Light guide outlet is attached to temple using any known method. 0.1-1% khlorin solution is injected in intravenous bolus dose of 0.8-1.1 mg/kg as photosensitizer and visual control of choroid hemangioma cells fluorescence and fluorescent diagnosis methods are applied. After saturating choroid hemangioma with the photosensitizer to maximum level, transscleral choroid hemangioma laser radiation treatment is carried out via laser light guide and implant lens using divergent laser radiation at wavelength of 661-666 nm with total radiation dose being equal to 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 intraocular neoplasm, repeated laser irradiation of the choroid hemangioma is carried out with radiation dose of 30-60 J/cm2.

EFFECT: enhanced effectiveness of treatment.

4 cl

FIELD: medicine.

SUBSTANCE: method involves creating tunnel between sclera and Tenon's capsule in intraocular neoplasm projection. Intraocular neoplasm localization and size is adjusted by applying transscleral diaphanoscopic examination method. 0.1-0.3 ml of photosensitizing gel based on viscoelastic of hyaluronic acid, selected from group containing chealon, viscoate or hyatulon, is transsclerally introduced into intraocular neoplasm structure using special purpose needle in dosed manner. The photosensitizing gel contains khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-1% by mass. Flexible polymer magnetolaser implant is extrasclerally introduced into the built tunnel in intraocular neoplasm projection zone under visual control using guidance beam. The implant has permanent ring-shaped magnet axially magnetized and producing permanent magnetic field of 3-4 mTesla units intensity, in the center of which a short focus scattering lens of laser radiator is fixed. The lens is connected to light guide in soft flexible envelope. The implant is arranged with its north pole turned towards the intraocular neoplasm so that implant laser radiator lens is extrasclerally arranged in intraocular neoplasm projection zone. The implant light guide is sutured to sclera 5-6 mm far from the limb with single interrupted suture. The implant is covered with conjunctiva and relaxation sutures are placed over it. Light guide outlet is attached to temple using any known method. 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, transscleral intraocular neoplasm laser radiation treatment is carried out via laser light guide and implant lens using divergent laser radiation at wavelength of 661-666 nm. The treatment course being over, 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, neodymium-iron-boron or samarium-iron-nitrogen. 0.1-1% khlorin solution as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is additionally intravenously introduced in 2-3 days at a dose of 0.8-1.1 mg/kg and repeated laser irradiation of the intraocular neoplasm is carried out with radiation dose of 30-45 J/cm2 15-20 min later during 30-90 s.

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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