Therapy of secondary lower limb lymphodema

FIELD: medicine.

SUBSTANCE: therapy of secondary lower limb lymphodema refers to medicine, namely to clinical lymphology. The oatient is exposed to laser light of wavelength 0.6328 mcm combined with intravenous laser irradiation of power 1.2 mW and exposition 90 minutes and intravenous introduction of medicine solutions: Trental, Actovegin, Pheopolyglukine, vitamin B, C complexes, 0.15% xantinol nicotinate. Procedures are daily at seven procedures per course.

EFFECT: therapy provides stable reduction of secondary lower limb lymphodema without therapeutic by-effects, prevents recurrence.

2 cl, 2 ex

 

The invention relates to medicine, to clinical lymphology, and in particular to methods of treatment of chronic lymphatic insufficiency of the lower extremities with the use of low-intensity helium-neon lasers.

Known "Method of treatment of vascular diseases" (Russian patent No. 2119361, A61N 5/06, priority 20.06.1995, publ. 27.09.1998,), in which extracorporeal irradiation of the blood of the patient in the amount of 2 ml per 1 kg of body weight in the section of the hose system of blood transfusion during her reinfused to the patient. Effects on blood provide radiation with a wavelength of 420-470 nm emitting narrow spectral region within 10 nm, a total dose of 15 j/cm2in a session at the speed of reinfused 5-10 ml/min rate in 6-8 sessions. The method is invasive.

For diseases of the vascular system, primarily characterized by the disruption of blood flow due to changes in the vascular wall (atherosclerotic plaques, inflammatory edema, thrombosis, abnormal spasm and others). However, no less important are the violations biophysical (rheological) properties of blood, in particular the increase in the viscosity of plasma and whole blood, the deterioration of the elastic properties of erythrocytes. These violations lead to reduced blood flow, reduced volumetric perfusion of organs and tissues, blocking the blood circulation in the system of microcirculation.

However, blood irradiation is carried out in vitro, with the ensuing consequences, i.e. by mechanical impact on the plasma, enzymes of blood.

Also known "Method of treatment of erysipelas" (Russian patent No. 2175871, A61N 1/30, A61N 5/067, prior. 27.12.2000, publ. 27.09.2001, by the introduction of the antibiotic against the background of traditional therapy. The antibiotic is administered by electrophoresis on the affected area, then the above introduction impose cuff (except for the head, trunk, and external genitalia) with a pressure of 40 mm Hg for 2 hours at the same time when the primary erysipelas spend the impact of low-energy laser radiation in a pulsed infrared range with a wavelength of 0,81-0.98 μm, a frequency of 10-100 Hz, 2.5 mW to inflammation and regional lymphonodi and lymph nodes for 20 minutes With repeated and recurrent spend intravenous laser irradiation of blood in the red range with a wavelength of 0.67 microns, the flow capacity at the end of the light guide 1-2 mW, and in the course of treatment prescribed 10 daily procedures.

However, this treatment eliminates only erysipelas and does not eliminate lymphodema lower limbs.

Also known "Method of partial laser infotemplate in treating lymphodema" (Russian patent No. 2166338, A61N 5/067, priority 2406.1998, publ. 10.05.2001 g), consisting of a helium-neon laser radiation on the area of edema. The radiation produces all major highways lymphatic drainage of the body in stages, with initial point irradiation of cutaneous projection of regional lymph node responsible for the proximal region of edema, and subsequent zonal irradiation proximal region of edema, border with healthy tissue, with the seizure of swollen tissue in a ratio of 2:1. Then spend a point exposure cutaneous projection of the lymph node responsible for the distal region of edema, and zonal exposure of the distal region of edema, border with healthy tissue, with the seizure of swollen tissue in a ratio of 2:1. With each subsequent session, the area of laser irradiation is shifted in the removal of the swelling.

Thus, the method of partial laser infotemplate enables effective treatment of common lymphatic swelling bodies for which treatment is often surgical intervention is needed. The method is conservative, non-invasive. It can be done on an outpatient basis, in the conditions of policlinic.

However, the method can be used in surgery in the treatment of lymph edema of various localization and severity, but not in the treatment of lymphedema.

The closest technical is usnote and achieved the effect of the claimed method is a Method of treating chronic lymphatic insufficiency of the lower extremities" (RF, patent for invention No. 2284838, A61N 5/067, priority 28.01.2005, publ. 10.10.2006, based on catheterization of the lymphatic vessels of the foot of the patient and the introduction into them of drugs. In lymphatic vessel once injected photosensitizer "Photoditazine" in a dose of 0.4-0.8 ml, after which produce the effect of laser radiation with a wavelength of 660 them, the power density of 2.5 W/cm2that energy from 200 to 600 j for each zone of maximum swelling of the lower extremities within 6-12 minutes

However, this method of treatment of chronic lymphatic insufficiency of the lower extremities is a complex process based on the operating catheterization lymphatic vessels of the foot of the patient and introducing medicinal chemicals, rather time-consuming and traumatic, can be performed in a hospital by a team of surgeons with a large number of related equipment. This fact limits the widespread dissemination of the methodology in practice. In addition, in this method, the irradiation with a high power laser.

The goal towards which directed the establishment of this invention is to increase the effectiveness of treatment of chronic lymphatic insufficiency of the lower extremities.

The technical result that can be obtained when ispolzovanpokoleniya, is to simplify the method of treatment and the achievement of this persistent edema secondary lymphedema lower extremities, without the side effects from the treatment.

The problem is solved due to the fact that the method of treatment secondary lymphodema lower extremities based on the effects of laser radiation with wavelength 0,6328 μm and the introduction of drugs. In this first simultaneously through an intravenous laser irradiation of 1,2 mW with an exposure time of 90 minutes and intravenous medication in the form of solutions: trental, aktovegin, reopoligliukina, b vitamins, C, xantinol-nicotinate of 0.15%. Procedures carried out daily, seven procedures for the course. Then, when a specific clinical situation, conduct intra-articular exposure of the knee joint in knee injected quartz optical fiber with a diameter of 0.7 mm by a puncture of joint puncture needle with the subsequent connection of the helium-neon laser power of 1.2 mW, irradiation is carried out with an exposure time of 30 minutes, every day, seven procedures for the course. The difference of this method is that increased exposure to helium-neon laser on blood to 90 minutes, and intra-articular radiation through a puncture in the knee cost the VA. The set of essential features leads to the achievement of a qualitatively new results expressed in persistent mild secondary lymphedema lower extremities, the simplification of the treatment process used in this method. This was not observed any side effects from the treatment, which is confirmed by the dynamics of clinical observations, functional and laboratory research.

Treatment lymphodema today is a pressing issue. This fact can be explained by the fact that lymphedema usually is a complication and end-stage diseases of the venous and arterial systems, as well as a consequence of surgical infections, burns and injuries. The urgency of this problem for practical health is determined by the increase in the frequency of occurrence of lymphedema in all age groups of patients and unsatisfactory results of surgical treatment and the treatment of lymphedema. According to the leading vascular surgeons conservative treatment of chronic venous insufficiency (CVI) in conjunction with operative correction of lymphodema lower extremities in 50% of cases inefficient (world Congress of phlebology, 1996).

Chronic lymphatic insufficiency of the lower limbs is one of the most important practical and scientific significance section to onicescu globalimage. The urgency of this problem due to the extremely high prevalence of this pathology among the population of developed countries of the world. Diseases of the lymphatic system of the lower limbs suffers 10-12% of the adult population of the world.

Lymph circulation is vital for the normal functioning of all cells and tissues of the body, and if in the lymphatic system violation occurs, then develop complications leading to pathological changes. This disease is spread mainly among the working population and therefore leads to a high rate of temporary and persistent disability. Meanwhile, the results of surgical and conservative treatment of such patients are not always effective, and often lead to long-term permanent disability. Operative interventions on the lymphatic system are often ineffective, and their implementation requires the use of expensive equipment and supplies.

For the period 1995-2006, in medical institutions in St. Petersburg and the Leningrad region in this way were treated 107 patients aged from 29 to 82 years with lymphedema of various etiologies. Lymphedema stage 1 was observed in 17 patients, stage 2 - in 41 patients, stage 3A - 21 and 3b stage in 20 patients, stage 4 - the 8 patients. And CVI was observed in 64 patients, erysipelas in 37 patients, the injury - in 19 patients, burns in 3 patients and complex fractures of the ankle and the long bones in 8 patients. And 32 patients had comorbidity, including 23.6% of these were cases of combination of erysipelas and CVI.

The greatest interest is the group of patients with stages 3 and 4 lymphodema, which according to the who, the disease is not cured. So take a closer look at this category of patients. Their were a total of 28 patients. Of them postthrombotic disease of the lower extremities was observed in 13 patients, including 8 patients had ulcers, in 12 patients in the anamnesis there was erysipelas, 4 patients - injury, 3 patients - thermal burn the soft tissues of 3 degrees, and in one patient lymphedema stage 3b was formed as a result of cardiovascular disease. While 68% of patients had a combination of pathologies. Lymphodema in most cases was a complication of postthrombotic disease of the lower extremities or erysipelas.

At the preliminary stage and during treatment all patients underwent the necessary functional study of lower extremities vessels RVG or USDC and laboratory studies (CBC + trombone is s, blood clotting, prothrombin index, blood sugar). From a total of 10 patients underwent lymphoscintigraphy lower extremities. If necessary run triglycerides and immunological.

In accordance with the proposed method of treatment all patients underwent endovenous laser therapy with helium-neon laser with a wavelength of 0,6328 μm and an output power of 1.2 mW, with an exposure time of 90 minutes, and at the same time, intravenous infusion of drugs: trental, aktovegin, reopoligliukina, b vitamins, C, xantinol-nicotinate of 0.15%. The total number of procedures - 7 daily. After that 23 patients underwent intra-articular laser irradiation of the knee of the affected limb. Exposure time was 30 minutes. The number of treatments on the course of treatment was 7 days. The necessity of deciding on laser radiation in the cavity of the knee joint was determined by the specific clinical situation.

The effect of the treatment was observed in 97,7% of patients, which resulted in the relief of lymphodema 80-90%, the disappearance of pain and muscle cramps, which was confirmed uzdg vessels of the lower extremities, including microvasculature stop.

The duration of treatment from 3 to 12 months. A course of laser therapy were carried out with an interval of 3-4 months. Remote PE is ulitity treatment tracked from 1 to 7 years. At the control examination in dynamics from 1 to 14 months was carried out functional studies USDC vessels of the lower extremities, including 12 patients studied micro circular flow stop. Relapse a single patient is not revealed. In addition, 12 patients underwent laboratory analysis of blood: blood, intravascular activation of thrombosis, adhesion and aggregation, thrombosis, screening coagulation hemostasis. Significant violations are also not detected.

Thus, the distinctive essence of this method lies in the fact that increased duration of exposure to helium-neon laser in the blood for up to 90 minutes and, at the next stage, is intra-articular radiation through a puncture of the knee joint and injection into the joint cavity of a quartz optical fiber with a diameter of 0.7 mm can be achieved persistent mild secondary lymphedema lower extremities without any side effects from the treatment, which is confirmed by the dynamics of clinical observations, functional and laboratory studies. Also the proposed method is simplicity, which allows it to carry out on an outpatient basis.

It should be noted that none of the patients was not observed recurrence of lymphodema. Effect of helium-neon what about the laser radiation on the tissue in this way is probably because of the impact on the exudative phase of inflammation and relieves her, which leads to active tissue regeneration and normalization of lymphogenic and recovery properties of lymph. Research and monitoring in the implementation of this method of laser treatment confirm the emergence of a diuretic effect, which depends directly proportional to the exposure level and from the point of establishment of laser exposure. In this case, as expected, there was a direct relationship between the amount of printing fluid and reduce swelling of tissues. However, this effect did not lead to violations of electrolytic metabolism and disappeared as knocking lymphodema.

Example 1.

Pack-th L.D., 55 years. With complaints about lymphedema right Shin with the presence of trophic changes. First erysipelas of the leg moved 30 years ago. Disease recurrence after 5 years. As a result of therapy (bicillin - 5 over 1 month over 3 years), remission lasted 5 years. Since 1995 relapse was observed after 1.5 years. Swelling of the right foot appeared after the first relapse (25 years), who were stopped and grew after each exacerbation. Of comorbidities should be noted GB-2, ICB, obesity - 2, a history of cholecystectomy. Objective: determines expressed lymphodema - 3 degrees of right Shin (swelling dense, painful to palpation trophic changes in the skin of the right tibia in the form of ulcers in diameter 2×3 cm with a flat bottom, covered with fibrinous flight).

Patients received the appropriate treatment course, which are as follows: introduction intravenous (IV) solutions: trental, aktovegin, b vitamins, C, xantinol-nicotinate. Both conducted intravenous laser irradiation of blood helium-neon laser 1.2 mW with an exposure time of 1.5 hours (90 minutes), No. 7 daily.

We then conducted the following procedure: in the right knee joint was injected quartz optical fiber with a diameter of 0.7 mm by a puncture of the joint with a needle and a connecting HeNe laser power of 1.2 mW and the exposure of the joint within 30 minutes, every day, No. 7.

The effect of the treatment was observed on day 6, which was reflected in a partial relief of lymphedema, the cleansing of the ulcer crater from fibrinous plaque. Fully lymphedema were stopped after 20 days after the end of treatment, trophic ulcer was closed.

The patient was followed for 4 years, no complaints, lymphodema, trophic changes of the skin not found.

It is noted that during the treatment, the patient had increased diuresis. Daily urine volume was increased to 3 liters, had low urine specific gravity, pale yellow color. This effect was observed until complete relief of lymphodema.

Performed a number of laboratory and functional investigations in the first days after the completion by the PCA. Clinical blood analysis: hemoglobin 144 g/l; erythrocytes - 4,8·1012/l, Col. index of 0.90, the platelets of 249.6·109/l, leukocytes 6,1·109/l, s-65, e-1, l-30, m-4, ESR-17, coagulation tests: hematocrit 0,38, the activated time rekaltsifikatsii 68 seconds, index coagulation 0,92, tolerance to heparin 7 minutes 0.5 seconds, INR - 1,05, prothrombin index 96%, prothrombin time 12,45 seconds, fibrinogen 2.3 g/l, antithrombin 3-26 seconds - 104%.

Lymphocytes abs of 1.52·109/l, RSD + lymphocytes (T-lymphocytes)%74, SRS + lymphocytes (T-helpers) abs 0,78·109/l, CD8 + lymphocytes (cytotoxic T lymphocytes)%19, CD8 + lymphocytes (cytotoxic T lymphocytes) abs 0,29·109/l, CD4/CD8 srvc. Ed. 2,6, SD + lymphocytes (b-lymphocytes)% - 10, abs - 0,15·109/l, the adsorption activity of neutrophils %94, IGA-0,57g/l, IGM - 0,9g/l, IgG 6,52g/l, which is also made of UZDG vessels of the lower limbs and feet.

Conclusion: Lymphodema not identified. The functional activity of platelets in normal limits.

Example 2.

The Dre-L.G., 65. The diagnosis of CVI 3 degrees, varicose disease of the lower extremities 2-3 degrees. Lymphodema left tibia 3 degrees, trophic changes of the medial surface of the lower third of the left tibia. Filed a complaint in November 2003 swelling, pain in both shins more pronounced on the left, trophic changes of the left tibia, varicose veins of the lower extremities. When inspecting the neck is Lena lymphodema 3 degrees of left tibia closed trophic ulcer of the medial surface of the lower third of the left tibia, varicose veins in the basin of the great saphenous vein of the left tibia and small saphenous vein of the right tibia. Surveyed:

the clinical analysis of blood Hb - 123g/1, Er - 4,5 10 12/1, ESR - 16 mm·h, prothrombin index 79%. According to rheovasography (RVG) revealed violations of the main venous drainage of both legs, more pronounced on the left.

The patient completed the treatment: intravenous solutions: trental, aktovegin, b vitamins, C, xantinol-nicotinate. Both conducted intravenous laser irradiation of blood helium-neon laser 1.2 mW with an exposure time of 90 minutes, the course of the seven daily treatments.

We then conducted the following procedure: in the right knee joint was injected quartz optical fiber with a diameter of 0.7 mm by a puncture of the joint with a needle and a connecting HeNe laser power of 1.2 mW and the exposure of the joint within 30 minutes, a day, a course of seven treatments.

In the following was performed sclerotherapy varicose sites of the venous system of the lower parts.

Control examination after a month: no complaints, lymphodema and varicose veins were stopped. Trophic changes of the left tibia was copolovici 80%. Completed the survey. Triglycerides - APTT - 28 seconds, prothrombin index 94%, the BUT - 1.07, and fibrinogen - 3.4 g/l, Ethnology and Naftowy test is negative. CBC - er. of 4.4·1012/l, platelets - 250·109/sheet Indicators of intravascular platelet activation in platelet shape in % - discocyte 85, discogenic 14, ferocity 1, shareability 0, bipolar form 0, the amount of active form of platelets in 15%, the number of platelets involved in the units of 9.3, 100 free platelets, the number of small aggregates of 5.0, the number of medium and large units 0. Also made USDG feet and shins.

Conclusion: Moderately increased intravascular platelet aggregation. Peripheral arterial blood flow to the legs and feet - trunk, within normal limits. Signs of venous valve insufficiency was not detected.

The method is based on the use of minimally invasive technologies and belongs to the most effective modern methods of treatment. This invention is achieved by increasing the efficiency of treatment of chronic lymphatic insufficiency of the lower extremities and persistent mild secondary lymphedema lower extremities, without the side effects from the treatment, which is confirmed by the dynamics of clinical observations, functional and laboratory studies. It should be noted that none of the patients was not observed recurrence of lymphodema lower limb is her. Treatment is possible and appropriate to apply in the outpatient setting due to the simplicity of its execution. Thus, all the listed indicators lead to more effective treatment of this common disease, such as secondary lymphedema lower limbs.

1. A method of treating secondary lymphodema lower limbs, based on the effects of laser radiation with wavelength 0,6328 μm and the introduction of drugs, characterized in that at the same time spend intravenous laser irradiation of 1,2 mW with an exposure time of 90 min and intravenous medication in the form of solutions: trental, aktovegin, reopoligliukina, b vitamins, C, xantinol - nicotinate of 0.15%, spend every day in the seven procedures for the course.

2. A method of treating secondary lymphodema lower limbs according to claim 1, characterized in that it further carried out after intravenous laser irradiation and injection of drugs conduct intra-articular exposure of the knee joint in knee injected optical fiber with a diameter of 0.7 mm by a puncture of the joint with a needle and subsequent connection of the helium neon laser power of 1.2 mW and carry out the irradiation with the exposure time to 30 minutes a day seven procedures for the course.



 

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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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