Method for treatment of pneumonia patients

FIELD: medicine; pulmonology.

SUBSTANCE: intravenous laser irradiation of blood (ILIB) is carried out differentially depending on detected hemodynamic type of microcirculation and level of protein C system activity. In case of hyperemic, spastic and normocirculatory hemodynamic type of microcirculation and activity level of protein C system of 0.704±0.02 and higher, 7 sessions of ILIB are performed. In case of stasis and stagnant hemodynamic type of microcirculation and activity level of protein C system less than 0.704±0.02, 12 sessions of intravenous laser irradiation of blood. Length of wave is 0.63 mcm, intensity of irradiation at light guide end makes 1.5-2.0 mW, one procedure per day, duration makes 20 minutes.

EFFECT: lower demand in antibacterial therapy and in medicines of pathogenetic action, lower medicamental load on patient and reduction of disease clinical symptoms preservation duration.

5 tbl, 2 ex

 

The invention relates to medicine, namely to the section of pulmonology, and can be used in the treatment of patients with pneumonia.

The recent steady increase in the number of patients with nonspecific lung diseases causes increasing attention of clinicians to the problem of early diagnosis and treatment of these diseases. One of the leading places among the nonspecific lung diseases, as on the severity of the forecast, and the frequency occupied by pneumonia. To date, pneumonia refers to the number of common diseases (8-15:1,000) and takes 4-5 place in the structure of mortality in developed countries. The high incidence of pneumonia, lack of effectiveness of antibiotic therapy, a growing tendency towards prolonged course and significant economic losses determined at the present time a need for new, effective, non-drug methods of treatment of pneumonia, one of which is low level laser therapy (LLLT). Clinical and experimental studies suggest that LLLT has a positive impact on the dynamics of clinical symptoms, indicators of respiratory function, immune system and pulmonary blood flow in diseases of the bronchopulmonary system.

There is a method to comprehensively what about the treatment of pneumonia with the use of antibacterial, mucolytic, bronchodilators, anti-inflammatory, metabolic drugs, as well as laser therapy in the rehabilitation phase (Chuchalin A.G., Sinopalnikov A.I., Chernichovsky N.E. Pneumonia. - Moscow: Economics and computer science. - 2002. - S). Such integrated treatment is carried out before remitting signs of inflammation and is accompanied by a significant improvement in clinical symptoms.

The disadvantage of this method of treatment is the use of methods of laser therapy after the complex medical treatment (in the phase of constant aggravation), which slightly reduces the duration of patients ' stay in hospital, the lack of a comprehensive assessment of pathogenic efficacy of laser irradiation, an underestimation of the effect of laser irradiation on such an important pathogenetic links of pneumonia, as hemorheological disorders, disorders of systemic and pulmonary hemodynamics.

There is a method of treatment of patients with pneumonia method cutaneous exposure (Amirov NB Indicators of membrane permeability, circulation, respiratory function and micronutrient content of medical laser therapy pneumonia" - Ter. Archive, 2002, No. 3, pp. 40-43), leading to improvement of microcirculation (according to the conjunctival biomicroscopy), respiratory function, immune responsive ness going down the systematic status of patients to improve the effectiveness of traditional medical therapy.

The disadvantage of this method is using only cutaneous laser therapy, for which requires the use of additional methods of research in the form of x-ray computer tomography (CT images allow us to identify the shortest distance inflammatory lesion from the surface of the chest, the most appropriate location for the emitter of the laser apparatus, and the angle of slope), which increases the cost of used treatment method.

There is a method of treatment of pneumonia with the use of vlok (Geinitz AV, Moskvin SV, Azizov GA Intravenous laser irradiation of blood. - M.: Tver, LLC "Publishing house "Triad", 2006. - 144 C.). Recommended the appointment vlok patients with pneumonia rate 8-12 sessions, duration of treatment 10 minutes.

The disadvantage is the purpose of the procedures vlok excluding clinical and instrumental data and severity of pneumonia, i.e. there is no differentiated approach to the purpose of the course vlok.

The closest to the essential features of the claimed invention is a method of treatment of patients with pneumonia, taken as a prototype (Ajasin, Ayikoi, Bigelsen. Laser therapy in pulmonology. - Vladivostok: Dalnauka. - 1999. - S-179), including application of N. the cutaneous and intravenous laser irradiation of blood, depending on the severity of the pneumonia. The prototype has the following essential characteristics: it is used to treat patients with pneumonia cutaneous and intravenous methods of low-level laser therapy. When assigning laser therapy uses a different approach: for uncomplicated forms of pneumonia are recommended cutaneous methods of laser irradiation; in severe forms of pneumonia from 3 to 7 sessions of intravenous laser irradiation of blood with further transition to cutaneous methods exposure - to 14 sessions. This method of treatment leads to improvement of respiratory function, indicators of lipid peroxidation, normalization of immunological status of patients, increasing the effectiveness of traditional medical therapy, reduce medical patient load.

The disadvantage of the prototype is the lack of specific, objective clinical and laboratory evidence of assessment of the severity of pneumonia; the use of different methods of laser therapy, which requires additional hardware; underestimation of the effect of laser irradiation on such an important pathogenetic links in the development of pneumonia, as abnormalities in the microcirculation and hemorheology, dysfunction of platelets and erythrocytes.

The claimed invention is directed to solution of the problem consisting in the creation of a method of differential the new treatment of patients with pneumonia using objective laboratory and instrumental criteria for determining indications for the purpose of various methods of laser therapy.

The solution to this problem provides a reduction in the duration of clinical signs, reduced length of hospitalization of patients, expands the ability of non-drug methods of treatment, increases the effectiveness of conventional medical therapy and gives the rationale for the effectiveness of laser therapy in complex treatment of patients with pneumonia taking into account the most important pathogenetic links of development of this disease.

To achieve this, the technical result of the invention of the method of differential treatment of patients with pneumonia includes the following significant features: intravenous laser irradiation of blood administered early in the course of treatment; laser irradiation of the blood are produced in the course of 20 minutes, daily, specifications: wavelength of 630 nm, the emission mode continuous power at the end of the main optical path of 2.0 mW. The duration of a course of vlok is determined hemodynamic type of microcirculation (GEA) and the protein level With: when hyperemic, spastic and normalroutine GEA and protein levels With more 0,704±0,02 conducted 7 sessions vlok; stations.com and stagnant GEA and protein levels With less 0,704±0,02 is 12 daily sessions of intravenous laser irradiation of blood.

In relation to the prototype of the claimed izobreteniya the following distinguishing characteristics: the whole course of laser therapy is performed only in the form of intravenous laser irradiation of blood, the duration of intravenous laser therapy is determined by the degree of disturbances in the microcirculation and hemorheology, which are the main pathogenesis of pneumonia. It is noted that the completion of the inflammatory process in the lungs, as a rule, does not lead to a marked reduction in the severity of microcirculatory disorders. Demonstrative of the reduction of the alveolar blood flow persists in some patients for several months, correlating with the size and degree of impairment in the acute period, especially in protracted forms of pneumonia, which requires correction of disturbances of microcirculation and hemorheology in the early stages of treatment. As a result of application of the proposed method, there is a decrease pharmaco-economic burden on the patient, shorter hospital stay, increase the effectiveness of treatment.

Between the features and the technical result is the following causal relationship: intravenous laser irradiation promotes the elimination of secondary platelet disorders, normalization of functional activity of red blood cells, which leads to relief of the main pathogenetic mechanisms of development of pneumonia; in intravenous laser blood irradiation improves microcirculation, which improves perniciouspoints antibacterial drugs in the inflammation; increased sensitivity to the drug means that the joint appointment helps reduce single and daily doses of medicines, improvement of respiratory function. Vlok has a regulatory effect on the functional systems of the organism, resulting in the rebuilding of the hyperkinetic type of hemodynamics on better - normokinetic. For the correction of the listed impairments, drug load and reduce the length of hospitalization of patients with pneumonia need differentiated use of intravenous laser irradiation of blood from the first days of treatment based on objective laboratory and instrumental criteria.

According to the authors ' knowledge, the set of essential features that characterize the essence of the claimed invention, is not known, which allows to make a conclusion about conformity of the invention, the criterion of "novelty".

According to the authors, the essence of the claimed invention is not obvious from the prior art of medicine, because it has not detected above accounting pathogenetic mechanisms of the effectiveness of intravenous laser irradiation of blood in the treatment of pneumonia, which allows to make a conclusion about conformity of the invention, the criterion of "inventive step".

The set of essential features, Hara is terissa the invention, can be used repeatedly in medicine with the technical result consists in increasing the efficiency of the treatment of pneumonia, which allows to make a conclusion about conformity of the invention, the criterion of "industrial applicability".

This method is as follows.

All patients with pneumonia is a traditional medical therapy with simultaneous application of a course of intravenous laser therapy.

We offer a differentiated approach in the treatment of patients with pneumonia was used in 136 patients. All patients were divided into 2 groups: control and basic. In the control group (46 people) were used for treatment of traditional medical therapy. The control group was divided into 2 subgroups: 1-I subgroup - 29, 2nd subgroup of 17 patients with pneumonia.

Patients of the main group (90 people) in addition to traditional medical therapy received course vlok. The main group was divided into 2 subgroups: in the 1st subgroup of 54 patients, the duration of therapy was 7 days; in the 2nd subgroup of 36 patients, the duration vlok was 12 days on the above methodology. The main and control groups were comparable in age, sex, severity of condition, indicators of external respiration function, the Central and peripheral g is modynamic.

A course of intravenous LT was conducted by the wavelength 0.63 μm, the radiation power at the end of the fiber 1,5-2,0 mW, daily, the duration of the procedure is 20 minutes.

The state of microcirculation was investigated by laser Doppler flowmetry using a domestic appliance LACC-02, (SPE "Lazma", Russia). The patient was examined at the state of complete physiological rest when the air temperature is 20-22°in the supine position. For assessment of peripheral blood flow was used in the rear (outer) surface of the left forearm. Dynamics of microcirculation examined patients are presented in table 1. PM (microcirculation index) before treatment in all groups studied patients was significantly lower than normal (p<0,05), indicating that the reduction of the compensatory capacity of the microvasculature: the decrease in the number of functioning capillaries, reducing blood flow velocity in patients with pneumonia. It should be noted that PM 1-St and 2-nd sub-group as in the control and in the main group, significantly different (p<0,001).

To clarify the status of various parts of the microcirculation have been analyzing the amplitude-frequency spectrum of the PM. So ALF all examined patients before treatment was significantly reduced, reflecting the degree of violation of contractile activity and precapillaries and changes in the regulation of the tone of the arterioles. When studying changes in ACF option, reflecting primarily the state of tonus of vessels of microcirculation, there is a marked decrease in the amplitude of CARDIORHYTHM, as in the control group patients and in primary. Some researchers have attributed the decrease in ACF with stagnation of blood in the venous section, the stasis in the capillaries, disorders of hemostasis at the study of pathology.

We surveyed patients with established significant decrease in IEM, abuses vasomotor activity precapillary sphincter, changing the balance of passive and active mechanisms of blood flow regulation. When conducting occlusive samples observed a significant (p<0.05) reduction of ALAC in all groups of patients, reflecting the development of stasis and stagnation in postcapillary link microvasculature. Then there is a reduction in the number of capillaries, which under normal conditions do not participate in the microcirculation of blood.

Table 1
Dynamics of indicators of the LDF in pneumonia patients
The parameters MCExamination periodsThe control groupThe main group
1 subgroup (29 people -63,1%)2 sub-group (17 persons -36,9%) 1 subgroup (54 people -60%)2 subgroup (36 people. -40%)
PM (perf. units) of 5.40±0,32before the treatment4,14±0,232,87±0,11*4,07±0,182,54±0,09*
after the treatment4,95±0,214,08±0,115,30±0,20**to 5.21±0,30**
ALF perf. units) 1,26±0,08before the treatment0,63±0,070,37±0,04*0,64±0,060,41±0,04*
after the treatment0,72±0,130,51±0,021,18±0,08**0,98±0,06**
AHF (perf. units) of 0.45±0,08before the treatment0,61±0,070,72±0,02*0,62±0,020,68±0,02*
after the treatment0,58±0,090,60±0,090,46±0,03**0,49±0,08**
ACF (perf. units) 0,18±0,01before the treatment0,10±0,030,27±0,07*0,12±0,010,30±0,05*
after the treatment0,14±0,020,21±0,050,18±0,01**0,16±0,02**
IEM (%) 1,93±0,15before the treatment0,88±0,090,42± 0,03*0,90±0,070,48±0,06*
after the treatment1,00±0,120,97±0,041,89±0,12**1,86±0,10**
RSC (%)234,46±2,47before the treatment168,57±3,10162,17±2,21*161,38±3,12157,94±3,11*
after the treatment198,46±5,57186,52±3,76220,56±3,44**217,92±2,61**
* - p<0,05 when comparing subgroups of the study and control group
** p<0,001 when comparing subgroups of the study and control group before and after treatment

Thus, almost all the analyzed parameters of microcirculation in the control and main group before treatment were significantly reduced, with the exception of respiratory oscillations (AHF), the amplitude of compensatory increases. It should be emphasized that the comparison of the parameters of microcirculation of patients of the 1st and 2nd subgroups, both in main and in the control group, statistically significant differences. There is a decrease in most of the parameters of microcirculation by increasing the severity of condition of patients and a compensatory increase in the amplitude of respiratory oscillations. At the same time 2-the sub-group (control and main group) changes of microcirculation parameters are more pronounced, than in patients of the 1st subgroup control and main groups, which again emphasizes the need for a differentiated approach to the purpose of the course vlok.

Based on the results of the LDF, many authors have proposed to allocate several hemodynamic microcirculation: normocalcaemia, hyperemic, spastic, stationsi and stagnant. Normocalcaemia hemodynamic type of microcirculation (GEA) is observed in healthy individuals without human peripheral blood flow; hyperemic, while increasing blood flow in the ICR spastic - by reducing blood flow in the ICR due to spasm bringing vessels. Stationsi registered by reducing the speed of blood flow and stasis; stagnation is observed in patients with severe stagnation at the level of postcapillary and venules.

In groups of examined patients had attracted the attention of qualitative and quantitative differences in the mechanisms of formation of the pathological microcirculation. The ratio of the detected hemodynamic microcirculation in the studied groups of patients before treatment was as follows.

So in the 1st subgroup control and main groups normocalcaemia GEA was detected in 20.6% 22.2%; hyperemic 37.9% and 38.8 per cent; spastic 31.3% and 29.6%; stationsi 6.8% and 5.5%; congestive 3.4% and 3.7% of cases in the control and main groups with whom responsibly. It must be emphasized that in patients of the 1st sub-group, both the control and main groups, prevails hyperemic, spastic and normocalcaemia GTO. In the 2nd subgroup control and main groups were defined 52,9% and 55.5% of stationsi GEA and in 47.1% and 44.5% of stagnant GEA, respectively.

The data obtained indicate that in patients with pneumonia 1st subgroup control and main groups dominated by normocalcaemia, hyperemic and spastic GEA, while in the 2nd subgroup control and main groups revealed only stagnant and stationsi GTO. Given that the 1st and 2nd subgroups of both groups identified various hemodynamic microcirculation, and the approach to the correction of these disorders must be differentiated.

The LDF study in patients with pneumonia after treatment revealed the following regularities of the dynamics of the main study parameters depending on therapy (see table 1). In pneumonia patients in the control group, 1-St and 2-nd sub-group (receiving only traditional drug therapy) after treatment dynamics LDF was minimal, almost all indicators LDF were very far from normal. Thus, changes in the parameters of microcirculation after conducting traditional IU comentsno therapy are mostly unreliable character: remains reduced the volumetric rate of flow; saved phenomena of stagnation of blood in the venous section of the microvasculature, violation of the regulation of contractile activity of precapillaries.

Patients of the 1st and 2nd subgroups of the main group on the background conducted endovenous laser therapy (ILIB) by the proposed method has a positive dynamics of the parameters of the LDF, and these changes are statistically reliable. PM in this group of patients after treatment was significantly (p<0.001) and increased (4,07±0,18 of perf. units to 5.30±0,20 perf. unit 1-th subgroup and with 2,54±0,09 of perf. units to 5.21±0.30 perf. units in the 2nd subgroup). However, in terms of pathology, the increase in PM as a positive phenomenon can only be considered in conjunction with the increase of another important indicator - amplitude slow oscillations (ALF) peripheral blood flow. In the group of patients who received traditional medical treatment and course vlok, initially reduced the amplitude of vasumati (0,64±0,06 perf. units and 0.41±0.04 perf. unit 1-th and 2-th subgroup, respectively) significantly increased after treatment (to 1.18±0.08 perf. units and 0.98±0,06 perf. units, respectively, p<0,001). Indicators of heart rate (ACF) also significantly increased (from 0.12±0.01 perf. units to 0.18±0.01 perf. unit 1-th subgroup and 0,30±0.05 perf. units to 0.16±0.02 perf. units in the 2nd subgroup after treatment, p<0,001). This dynamic pulse of colemani is evidenced by a decrease in spastic phenomena in bringing microvessels. There is a decrease in the amplitude of respiratory oscillations (AHF) with 0.62±0.02 perf. units to 0.46±0.03 perf. unit 1-th subgroup and 0,68±0.02 perf. units up to 0,49±0.08 perf. units in the 2nd sub-group after therapy (p<0,001). The increase of IEM in both subgroups of the main group to normative values indicates the improvement status of perfusion in the capillary system as a whole. In these groups of patients have a statistically significant (p<0.001) increase in ALAC (161,38±3,12% to 220,56±3,44% in 1 subgroup and 157,94±3,11% to 217,92±2,61% in the 2nd subgroup after treatment).

The results of our study suggest that the inclusion in the complex of therapeutic measures of low-intensity laser irradiation of blood using a graded approach is accompanied by normalization of indicators of terminal blood in pneumonia patients with varying degrees of disturbances in the system microvasculature. Under the influence vlok normalized volumetric rate of blood flow, increases the contribution of the active mechanisms of regulation in the microvasculature, increase backup capabilities of capillary blood flow, eliminates the phenomenon of stasis in the venous section of the microcirculation. At the same time, the traditional combination therapy does not contribute to the elimination of disturbances in the microcirculation system.

The study of humoral star is and the blood clotting system was carried out by determining the activity system of protein C expressed as normalized ratio (Berkovsky A.L., Vasiliev S.A., Kolchanov N, Y.V. Sergeev // Clinical laboratory diagnostics. - 2001. No. 3. - P.36-37), anti-thrombin III (ATIII), thrombin time (TT), prothrombin time (PT), APTT, fibrinogen. In the study of indicators of plasma hemostasis in most patients with pneumonia before treatment was noted hypercoagulation shifts (table 2). This was manifested in the reduction of the anticoagulant capacity of the blood, namely the reduction of system activity of protein C. however in the 2nd subgroup control and main groups activity of protein C was significantly lower than in the 1st subgroup of both groups. To establish the relationship between indicators of system activity of protein C and clinical signs of pneumonia, we performed correlation analysis, which revealed a strong inverse correlation between the level of system activity of protein C (BUT) and the severity of the clinical condition of patients (r=-0,73). According to the data obtained at lower system activity of the protein increases With the severity of the clinical condition.

Table 2
Comparative analysis of blood coagulation in patients with pneumonia in the course of the entered therapy
The rate of hemostasis (N)The treatment timeThe control groupThe main group
1-I Podger.2-I Podger.1-I Podger.2-I Podger.
APTT (s) 34,8±2,2before the treatment27,3±1,124,1±1,326,7±0,924,7±1,0
after the treatment30,3±1,227,3±1,433,6±1,1**32,7±1,8**
RT (C) 26,5±0,4before the treatment19,2±1,017,4±0,818,1±1,11B,7±0,9
after the treatment21,0±0,520,1±0,425,0±1,01**24,3±0,7**
TT (C) 12,2±0,2before the treatment11,3±0,910,2±0,612,5±0,811,1±0,4
after the treatment13,5±0,913,3±0,713,3±1,0812,5±0,3
AT III % 100±17,4before the treatment88,6±1,385,7±1,090,1±1,182,3±1,5
the village is e treatment 97,14±2,792,11±2,2109,6±3,2**102±2,1**
The activity of protein C (BUT) 1,02±0,03before the treatment0,704±0,020,524±0,04*0,708±0,030,511±0,05*
after the treatment0,749±0,060,612±0,03is 0.998±0,02**0,982±0,02**
* - p<0,05 when comparing subgroups of the study and control group
** p<0,001 when comparing subgroups of the study and control group before and after treatment

Based on data from table 2, the patients of the 1st main subgroups and the control group, the protein level was not less 0,704=1=0,02, while in patients of the 2nd subgroup and control group indicator protein C activity was significantly below the specified value.

As the normalization of the clinical condition of the patient occurs and normalization system activity of protein C, which indicates the increase anticoagulation of blood potential. However, the only application in complex therapy of intravenous laser irradiation of {1-I 2-I subgroup of the main group) contributes to the normalization of system activity of protein C in the form of DOS is evernogo increase BUT {see table 2).

Intravenous laser irradiation of blood contributed to the normalization and other parameters of humoral hemostasis. So, if the source in patients with pneumonia were observed phenomena hypercoagulability and amplification of the coagulation properties of blood, after treatment increased blood clotting time in the stages of clot formation, while in the main group (1st and 2nd subgroup) positive dynamics was expressed more clearly and was statistically reliable in nature. The most vivid dynamics APTT test (characterizes the initial stages of coagulation, the internal mechanism of the formation of thromboplastin) was in the main group of both subgroups. In this group there was a clear positive dynamics of prothrombin time (PT). A control group of patients (in both groups)who received only traditional drug therapy, changes in coagulation tests was negligible.

In the conducted study we investigated the effect of the proposed method of intravenous laser irradiation of blood on the deformability of erythrocytes (DE) in pneumonia patients with a variety of well intervention and the level of system activity of protein C. We used the method of assessment TE in the degree of their aquamost by centrifugation. The basis of the method is the comparison of aquamost experienced of red blood cells to the control as a 100% hard red blood cells obtained by the method of W. Reinhart and Shu Chein. The coefficient of deformability was estimated as follows: at lower deformation capacity of erythrocytes ratio deformability is close to 1; the smaller the value of the coefficient of TE, the better viscosity-elastic properties of erythrocytes.

In both groups of patients with pneumonia before treatment there is a decrease in TE, which is one of the causes of disturbances in the microcirculation system and regulation of the aggregative state of the blood (see table 3). In addition, in patients with pneumonia 2nd subgroup control and main groups observed a more marked reduction in viscosity-elastic properties of erythrocytes than in the 1st subgroup of both groups. So, in the 1st subgroup TE was 0,679±0.03 in control and 0,665±0,05 in the main group, which was significantly (p<0,05) differs from TE in the 2nd subgroup, both the control and the main group (0,798±0.02 and 0,867±0.04 in the control and main group, respectively). I.e. in pneumonia patients of the 1st and 2nd subgroups of the main and control groups observed varying degrees of violations TE that requires differentiated methods of correction of detected changes.

Table 3
Comparative Hara is the statistics of TE in patients with pneumonia before and after treatment
The ratio TE(N-0,511±0,04)Examination periodsThe control groupThe main group
1-I Podger.2-I Podger.1-I Podger.2-I Podger.
before the treatment0,679±0,030,798±0,02*0,665±0,050,867±0,04*
after the treatment0,634±0,050,521±0,040,518±0,02**0,526±0,03**
* (p<0,05 when comparing subgroups of the study and control group
** p<0,01 when comparing subgroups of the study and control group before and after treatment

After treatment in the control group patients (in 1-St and 2-nd sub-group) had a tendency to normalization of deformability erythrocytes, however, the performance of TE did not reach normal values. In patients not receiving vlok, after treatment there are significant violations of the viscosity-elastic properties of erythrocytes. At the same time in the main group of patients receiving a course vlok on the proposed methodology as part of a comprehensive treatment indicator TE significantly decreases and reaches a normal C is acini. Presents data again confirm the effectiveness of the proposed methodology and its applicability in patients with pneumonia.

Investigated the aggregation properties of platelets. During studies in patients with pneumonia we identified diverse (hyperaggregation, hypoactivation, normal) indicators of platelet aggregation with a predominance of hyperaggregation dysfunction in both groups of studied patients (see table 4).

Data analysis table 4 shows that the performance of the aggregation capacity of platelets in the patients with pneumonia before treatment (control and main group) significantly different from normal values.

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Table 4
The aggregation capacity of platelets in patients with pneumonia before the treatment
The rate of aggregation and its rateThe group of patientsThe aggregation capacity of platelets
the giperagregatsiyunormalhypogravity
The degree of aggregation, 61,0±2,5%counter1-I subgroup80,6±4,562,1±1,327,0±2,4
2nd subgroup96,8±2,3*-16,1±1,9*
VI1-I subgroup82,1±3,160,3±1,529,2±1,8
2nd subgroupof 98.2±3,2**-17,4±2,2**
The rate of aggregation,16,1±1,3%/mincounter1-I subgroup40,1±3,515,5±1,49,0±0,6
2nd subgroup44.1kHz±2,8-8,3±0,2
VI1-I subgroup40,8±4,116,3±1,19,3±0,4
2nd subgroup46,2±3,1-8,6±0,4
Time aggregation, 8,3±1,2 mincounter1-I subgroup5,9±0,68,0±0,89,45±0,1
2nd subgroup5,3±0,3-of 9.55±0,3
VI1-I subgroup5,7±0,48,2±1,19,3±0,3
2nd subgroup5,6±0,5-a 9.5±0,4
* - p<0,05 when comparing subgroups (1 and 2) the study and control group
** p<0,01 when comparing subgroups (1 and 2) the study and control group

When comparing the aggregation of platelets 1st and 2nd subgroups in the control and main group are indicated statistically significant differences. Revealed a strong positive correlation between giperagregatsiyu platelets and the severity of the clinical condition of patients. However, 68% of the patients of the 1st subgroup of the control group and 65% of patients 1-th subgroup of the main group was observed giperagregatsiyu platelets, 17% of patients in the control group and 19% of the group 1 subgroup - hypogravity; 17% of the control and 16% of the group 1 subgroups - normal aggregation function. In 2 subgroups of the control and main groups noted the following distribution on the aggregation of platelets: 74% of the control and 76% of patients of the main group - giperagregatsiyu; 26% and 24% in the control and main groups, respectively hypogravity platelets. It should be noted that in the 2nd subgroup, as in the control and in the study group, there were no patients with normal aggregation capacity of platelets.

Dynamic study of the aggregation activity of platelets was performed di is terenziano depending on the source of the aggregation disorders: from the source increased aggregation, with baseline normal aggregation with the original suppressed the aggregation ability.

Change the aggregation of platelets in the main and control group of patients with pneumonia on a background of treatment are presented in table 5. As can be seen from table 5, a higher degree of aggregation decreased to normal values only in patients of the main group and the 1st and 2nd subgroups (up to 62.1±1.4 and 64,6±and 2.1, respectively), which was significantly lower baseline rates in these sub-groups before treatment. Significantly decreased and the rate of aggregation in the 1st and 2nd subgroup of the main group. Time has increased platelet aggregation to 8.1±1,1 min in the 1st subgroup and to 8.0±1,3 min in the 2nd subgroup of the main group (p<0,05). The qualitative analysis of the aggregation curves, we observed a decrease in the level and slope of the lift curve, the restoration of normal, two-humped structure with clearly defined phases aggregation

Table 5
Changes of parameters of the aggregation capacity of platelets in patients with pneumonia with the original giperagregatsiyu
The rate of aggregation and its rateExamination periodsThe control groupThe basis is e
1-I Podger.2-I Podger.1-I Podger.2-I Podger.
The degree of aggregation, 62,0±1,5%before the treatment80,6±4,5*96,8±2,3*82,1±3,1*of 98.2±3,2*
after the treatment76,±2,681,2±2,762,1±1,4**64,6±2,1**
The rate of aggregation, 16,1±1,3%/minbefore the treatment40,1±3,5*44.1kHz±2,8*40,8±4,1*46,2±3,1*
after the treatment32,8±1,735,4±2,517,0±0,9**17,8±1,4**
Time aggregation, 8,3±1,2 minbefore the treatment5,9±0,6*5,3±0,3*5,7±0,4*5,6±0,5*
after the treatment6,5±0,36,3±0,58,1±1,1**8,0±1,3**
* - p<0,01 when comparing subgroups of the study and control group with normal
** p<0,05 when comparing sub-groups before the treatment

In pneumonia patients with initial hypoagregative platelets there is a decrease in all indicators is her aggregation, indicating pathologically depressed platelet functional activity level of regulation of the state of aggregation of blood.

To illustrate the effectiveness of the proposed method of treatment of patients with pneumonia here is a brief extract from a case history No. 2457 (main group 2 sub-group).

Patient C-VA, 24 years of age, was treated in the 1st therapeutic Department CBSP about community-acquired left pleuropneumonia localized in the lower lobe. NAM II. Admitted with complaints of shortness of breath mixed, growing at light load; cough with yellow sputum; chest pain associated with the act of breathing; fever up to 39.5°; pronounced weakness, dizziness.

Pain in acute, about 4 days ago when for the first time after fever noted the increased body temperature up to 39°, cough, joined shortness of breath.

At admission the patient's condition is severe. During the physical examination of the left lower angle of the scapula heard wet large bubble wheezing. The frequency of respiratory movements 26-28 min, BP - 90/60 mm RT. senior HR - 102 in minutes heart sounds rhythmic, heard the accent of II tone on the pulmonary artery. Data spirographis studies indicate a decline in VC and violation of the airway. And the Alize blood at admission: er 3,7× 1012/l, Hb 103 g/l; colour index 0,9; lake 11,7×109/l; p 12%, 62%, limp 18%, mono 6%, e 2%, ESR 26 mm/h On the x-ray of the chest: to the left of the anterior segment of the third rib is marked inhomogeneous medium intensity dimming.

The patient against medical therapy (antibiotics, mucolytics, detoxification activities) took the course vlok duration of 12 sessions.

The microcirculation before treatment should be attributed to the stagnation of the GTO. So, PM before treatment was 3.6 perf. units, ALF - 0,49 of perf. unit, the amplitude of cardiorenal (ACF) was 0.10 perf. units, was observed a compensatory increase in AHF to 0.72 perf. units, IEM was significantly reduced - 0,89%, RSC - 172,4%, which was significantly lower than normal.

It was noted marked improvements in the performance of plasma hemostasis in the examined patient: so, the activity of protein C was 0,534, APTT - 25,3, RT - 20, TT - 11 C. Thus, the patient before the treatment took place phenomena hypercoagulation.

Indicators of platelet aggregation before treatment were the following: the degree of aggregation 89.4 per cent, the rate of aggregation of 38.4%/min, time aggregation and 6.3 minutes were visualized pathological deformation of the aggregation curve in the form of sudden and excessive increase in the degree of light transmission of the investigated plasma after making induct the RA platelet aggregation, the time curve of the plateau faster.

The rate of deformability erythrocytes was 0,863 that shows the reduction of viscosity-elastic properties of erythrocytes.

After treatment revealed positive dynamics of clinical and laboratory parameters. So the microcirculation has changed significantly: there is a growing PM with 3.6 perf. units to 5.03 of perf. units, decreases the activity of passive mechanisms of modulation of capillary blood flow, increases the amplitude of the slow oscillations (ALF) to 1.04 of perf. units, normalized amplitude kardiogramm (ACF) - 0.16 perf. units after treatment, reduced the amplitude of respiratory oscillations (AHF) to 0.47 of perf. unit, as a result of increases IEM to 1,55% and ALAC to 220,4% after therapy.

In the used method of treatment there was a statistically significant change in plasma hemostasis: increased activity of protein C to 1.02, APTT increased to 34.0 C RT up to 25 C, TP - 15 C. the Aggregation capacity of platelets after treatment normalized: the degree of aggregation of platelets dropped to 63.1 per cent, the rate of aggregation - 16,3%/min, time aggregation increased by 1.3 min and was 8.2 minutes

Improved viscosity-elastic properties of red blood cells and increasing their deformability (coefficient deformable the activity of erythrocytes was 0,524, which corresponds to the normal range).

In this example, it is noted normalizing effect method used vlok on the state of cellular and plasma hemostasis, as well as on the characteristics of the microvasculature.

The following clinical supervision is an extract from a case history No. 136 (main group 1 sub-group).

EXAMPLE 2.

Patient T., aged 32, was treated at therapeutic Department CBSP with a diagnosis of community-acquired left-sided pneumonia, localized in the lower part.

Admitted with complaints of shortness of breath, increased body temperature up to 38°, cough with a small amount of mucopurulent sputum, weakness, malaise. The smoker.

When the objective of the study was observed shortening of percussion sound in the lower left in a limited area, there are heard the wet fine basal rales. NPV - 24 min, AD - 110/60 mm RT. senior HR - 98 minutes ECG signs of moderate overload of the right departments of heart. In radiography of the chest at the bottom left of the departments of intensive heterogeneous dimming without clear contours due to inflammatory infiltration.

Conducted a comprehensive treatment using amoxicillin application, Ceftriaxone, Ambroxol, detoxification therapy, has been used intravenously La the black blood irradiation, the course duration was 7 days.

Prior to treatment in a patient with T-VA was observed pathological hypoactivation type curve, which was reflected in the extremely low degree of transmittance of the plasma after making the inductor (low rise curve), a slow increase of the degree of rise of the aggregation curve, the absence of normal "dvugorboy"reflecting the first and the second phase of the aggregation process, the lack of a "plateau" of the aggregation curve. After comprehensive treatment using vlok using the proposed methodology, it was noted fundamentally different aggregation curve - grade and the slope of the curve is sufficient and appropriate norm, is the phase of "plateau" and phase of the aggregation process, which indicates a normal reaction to the introduction of the inductor. Indicators of platelet aggregation before and after treatment were: the degree of aggregation of 33.6% and 58.8% respectively (degree of aggregation is increased by 25.2%), the rate of aggregation of 6.8%/min and 15%/min (increase of 7.2%/min), time aggregation of 9.7 min and 7.6 min (reduced by 2.1 min).

Indicators hemocoagulation tests had the following dynamics: system activity of the protein before treatment was 0,754 and 1.03 after the treatment; TT - 26,9 with and 34.1 after treatment; PT - 19,9 with and 24.3 with before and after therapy, respectively; the level of anti-thrombin III - 95% to 105% after treatment.

Deformable the TB red blood cells before treatment was somewhat reduced, which was reflected in the increase of the coefficient of deformability to 0,652. However, the inclusion in the complex of therapeutic measures vlok contributed to the normalization of the viscosity-elastic properties of erythrocytes (deformability erythrocytes after treatment - 0,512).

The parameters of microcirculation in a patient with T-VA before treatment corresponded hyperemic GEA: PM - 7.2 perf. unit, the amplitude of the slow oscillations (ALF) to 0.44 of perf. unit, the amplitude of cardiorenal (ACF) - 0.96 perf. units, IEM - 0,89%, RSC - was reduced to 210,4%. After the course of treatment including vlok parameters of microcirculation has changed significantly and reached normal levels: PM - 5,10 to perf. unit, the amplitude of the slow oscillations (ALF) - 1.00 perf. unit, the amplitude of cardiorenal (ACF) - 0.16 perf. units, IEM - 1,89%, ALAC was 223,4%.

Thus, in a patient with T-VA source hypoagregative platelets, with hyperactively plasma hemostasis and pathological GEA (hyperemic) inclusion in the complex of therapeutic measures vlok on the proposed methodology contributed to the normalization of initially reduced the extent and speed of aggregation, normalization of time aggregation, the elongation time was shortened to ensure hemocoagulation tests, activation anticoagulation of the blood system, as well as normalization of the microcirculation.

Clinical and laboratory studies offer what about the treatment of patients with pneumonia compared with the known method (prototype) showed the effectiveness of the proposed method of treatment, correction of functional changes that occur with this disease, improving the results of ongoing drug therapy, reducing treatment time.

A method for the treatment of patients with pneumonia, including concurrent comprehensive medical therapy and laser therapy, characterized in that the patients with pneumonia prescribed intravenous laser irradiation of blood (ILIB) differentially depending on the detected hemodynamic type of microcirculation and activity level system protein: when hyperemic, spastic and normalroutine hemodynamic type of microcirculation and the level of system activity protein With 0,704±0.02 and spend more 7 sessions vlok; stations.com and stagnant hemodynamic type of microcirculation and the level of system activity of protein With less 0,704±0,02 held 12 sessions of intravenous laser irradiation of blood in length wave 0.63 µm, the radiation power at the end of the fiber 1,5-2,0 mW, according to one procedure per day with a duration of 20 minutes



 

Same patents:

FIELD: medicine; gynaecology.

SUBSTANCE: solution of photosensitiser "Photoditazine" is introduced intravenously in dose of 0.5-1.0 mg/kg. As soon as 1.5-2 hours have elapsed after infusion, intrauterine light guide is inserted into uterine cavity, and uterine cavity is radiated with laser in fractions at wave length of 662 nm and density of supplied energy of 200 - 350 J/cm2 for 30-45 minutes. After uterine cavity has been radiated, cervical channel is radiated in fractions by laser with application of cylindrical light guide at wave length of 662 nm and density of supplied energy of 200-250 J/cm2 for 15-30 minutes.

EFFECT: highly selective removal of functional and basal layer of uterus mucous layer.

3 ex

FIELD: medicine; oncology.

SUBSTANCE: method includes introduction of solution of chemical compound of amino acid L-phenylalanine with gold or silver nanoparticles intravenously prior to radiation. At that minimum concentration of nanoparticles is 108 cm-3, and maximum concentration is 1012 cm-3. Plasma resonance of nanoparticles has spectral maximum in the area of biotissues transparency at the wave length of 750-1200 nm. These nanoparticles are gold or silver nanoshells with core of silicon dioxide or nanorods. Radiation of melanoma is performed at least after 1 hour and not more than after 4 hours after solution introduction, laser beam with length of radiation wave that coincides with spectral maximum of nanoparticles plasma resonance absorption. At that radiation is done by sequence of laser impulses with duration of laser impulse in the range of 10 microseconds - 100 ns at minimum porosity of three and higher, at energy density of at least 20 J/cm2, but not more than 200 J/cm2.

EFFECT: local performance of melanoma destruction with minimum destruction of surrounding healthy cells.

10 dwg

FIELD: medicine; therapy and cardiology.

SUBSTANCE: biophysical indices are determined in points of heart and pericardium meridians acupuncture. Corporal points of heart and pericardium meridians acupuncture are exposed to laser radiation with wave length of 0.63 mcm with outlet power density of 0.1-10 mW/cm2 and beam diameter of 1.5-0.1 mm. Radiation is dosed according to dynamics of electropotential value in every point of acupuncture. Laser therapy is carried out in combination with intake of activated acid and alkaline water according to regimen that provides rise in consumption of acid water from 1/3 of glass to 1/2 of glass - in the end of treatment, and alkaline water from 1 to 7-8 glasses accordingly. The whole course is realised against the background of diet with reduction of food calorie and fat content and graduated physical exercise.

EFFECT: normalisation of vessel walls elasticity, better tolerance of physical activity.

1 ex

FIELD: medicine.

SUBSTANCE: treatment of glial brain tumours is ensured by partial tumour extraction. During operation photosensitiser is delivered in the cavity formed by partial tumour extraction. Photodynamic laser therapy implies using diode laser of cylindrical diffuser with spherical radiation pattern. Wavelength is 660 nm, power is 100-200 mW.

EFFECT: higher concentration of photosensitiser in cavity of partially extracted tumour, reduced amount of introduced photosensitiser, more uniform radiation of tumour tissue, lower probability of postoperative complications and length of hospital stay.

3 ex

FIELD: medicine; ophthalmology.

SUBSTANCE: invention can be used for surgical treatment of central vein thrombosis of retina (RCV). Induction of chorioretinal anastomosis (CRA) is performed by laser radiation of RCV of the third order with wave length 532 nm, four coagulates in number, radiation power density 500 mW/cm2, pulse duration 1 second, spot diameter 50 mcm. Vitrectomy is preliminary carried out with removed posterior hyaloid membrane of vitreous body. It is followed with perioperative endolaser CRA induction and, additionally paravasal endolaser retina coagulation at wave length 532 nm, 500-600 coagulates in number, radiation power density 120-200 mW/cm2, pulse duration 0.1-0.2 seconds, spot diameter 50-200 mcm.

EFFECT: higher efficiency of surgical treatment of RCV thrombosis based on combined vitrectomy, removal of posterior hyaloid membrane of vitreous body (PHMVB), perioperative endolaser CRA induction and paravasal panretinal endolaser retina coagulation.

3 ex

FIELD: medicine.

SUBSTANCE: invention refers to development of noninvasive selective optical haemodialysis of human blood elements based on offered photothermolysis of sickle cells conjugate with negative golden nanoparticles exposed to lasing at wave length coinciding with plasmon nanoparticles resonance. Blood is introduced with golden nanoparticles and exposed to lasing at wave length coinciding with spectral maximum absorption of plasmon nanoparticles resonance and causing cell photothermolysis. Before blood is introduced with nanoparticles, their surface is negative charged comparable to membrane potential of normal erythrocytes to provide physical adhesion to plasma membrane of pathologic cells, specifically of sickle-cell erythrocytes, of nanoparticles concentration in pH neutral physiological solution with erythrocyte concentration order. Venous blood running through catheter and containing human sickle-cell erythrocytes is exposed to radiation. Herewith nanoparticles is characterised with plasmon resonance within human tissue transmission region 700-1100 nm. Laser pulse duration is to be within 10 mcs-100 ns at energy density in laser pulse not exceeding 100 mJ/cm2 and laser pulse porosity at least 3. Nanoparticles represent silica nuclei in diameter 50-140 nm of silicon dioxide coated with a gold or silver of thickness within 2-20 nm, or gold or silver nanorods characterised by length to diameter ratio within 2.5 to 5 and diameter 10-40 nm.

EFFECT: selective disintegration of pathologic human blood erythrocytes not capable for oxygen migration based on selective laser photothemolysis of sickle-cell erythrocytes connected to nanoparticles during pulse lasing of blood stream in vivo.

3 cl, 6 dwg

FIELD: medicine; endocrinology.

SUBSTANCE: cold scattered laser radiation is used at wave length 0.89 mcm and power 2 Wt. Contact cutaneous technique is used for irradiation in projection of lobes of thyroid gland at exposition 3-4 minutes per each lobe. According to disease severity level, for the first 5-10th sessions radiation 3000 Hz is used, while thereafter till the last procedure, radiation frequency is reduced to 300 Hz. For the patient with mild severity level of disease, laser therapy is applied as independent method of treatment. Though for the patient with moderate severity level of disease, laser therapy is combined with nonsteroid anti-inflammatory preparations (NAIP). Thus to patients with moderate severity level of disease, Ortofen dosed 3 ml 1-2 times a day is intramuscularly injected as NAIP. For the patient with severe disease, laser therapy and NAIP is added with introduction into thyroid gland of Kenalog dosed 20 mg per each lobe dissolved 1:1 with 0.5% novocaine solution 1 to 3 times every 5-7 days.

EFFECT: reduced treatment time.

3 ex

FIELD: medicine.

SUBSTANCE: PS is chlorophyll derivatives. PS is activated by light with oxygen, preliminary or in one stage introduced to organism using wave energy sources. Herewith radiation power is 0.1-20000 Wt, with dose 1-100000 J.

EFFECT: higher specificity of antibody response, suppression of pathological centre, activation of cell exchange processes, higher immune protection of organism in whole, improvement of life quality and tumour operability.

3 cl, 11 dwg, 1 tbl, 3 ex

FIELD: medicine; surgery.

SUBSTANCE: from the instant of complication detection, postoperative suture area, as well as subjacent tissues and organs, are exposed to two-channel magnetic-laser radiation of constant red and pulse infrared light with wavelength 640±10 nm and 850±70 nm, laser impulses frequency 28-30 kHz; constant axial magnetic field with intensity 160-190 mTl being applied. Seance dose of laser radiation amounts to 0.50-0.55 J/cm2.

EFFECT: tissue regeneration process acceleration, increase of therapy efficinency.

4 ex

FIELD: medicine; ophthalmology.

SUBSTANCE: to the patient intravenously enter a solution of chlorine family, in a dose of weight of 0.8-1 mg/kg: 50% of a dose is administered driply within 10 minutes one hour prior to the laser transpupillary irradiation, the remained 50% of a dose - for 10 minutes. Transpupillary irradiate all surface of angiomatous formation with laser radiation concentric from the centre to periphery with density of energy 100-120 J/cm2 on one field at irradiation in the centre and 50-80 J/cm2 - on periphery, irradiation spend with overlapping of the next fields on 15-20% of the area.

EFFECT: method allows reaching full resorption of angiomatous formation, provides absence of relapses in the remote postoperative period.

1 ex

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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