Method of intergrated treatment of tuboperitoneal infertility

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to gynecology and concerns the integrated treatment of tuboperitoneal infertility. That is ensured by low-intensity infrared lasing at power 150 Wt, wave length 0.89 mcm of the inguinal lymph nodes and a skin projection of the lumbosacral plexus. The exposure time is 1 min for each region for 1st session. Thereafter, the exposure time is increased to 3 minutes during 10 sessions. It is combined with local intraendometrial introduction of an antibacterial agent and an immunomodulator. Besides the treatment involves a number of plasmapheresis sessions and introduction of nonsteroidal anti-inflammatory drugs, antioxidants, desensitisers, and vaginal sanitation.

EFFECT: method provides effective restoration of menstruation and reproductive function.

2 ex

 

The invention relates to medicine, namely to gynecology, and can be used for the treatment of chronic recurrent inflammatory diseases of the reproductive organs of small pelvis in women.

There is a method of treatment of chronic endometritis, described in p. the Russian Federation No. 2233186 on CL A61N 5/067, Z. 12.03.03, op. 27.07.04.

The known method is that the patient is injected intramuscularly 1 ml of 1%aqueous solution of nicotinic acid, over 15 min then at the bottom of the belly skin effect of low-intensity infrared pulsed laser radiation with a wavelength of 0.89 μm, a frequency of 600 Hz, a peak power of 5 W for 8-10 minutes each day, the treatment of 10-12 procedures.

The disadvantage of this method is its low efficiency.

There is a method of treatment of endometritis in postpartum period. described in paragraph (RF # 2268717 on CL AC 31/94, A61N 5/062, Z. 04.07.04, op. 27.01.06.

The known method is that intravenous Reamberin 1.5% to 400 ml per day, cutaneous effect of magnetic-infrared laser wavelength of 0.89 μm with a pulse power of IR radiation 4 watts, with a radiation frequency of 5 Hz and 50 Hz in the region of the uterus and appendages alternately with exposure time for 2-3 minutes on each zone, alternate every other day. From the second day of treatment additionally deliver laser light flux directly to the area of the uterus through the vaginal fornix for 1 minute at a frequency of 1000 Hz. The entire treatment lasts 5-7 days.

The disadvantage of this method is the complexity of its implementation.

Known as described in patent No. 2160136 (analog) a method of treatment of endometritis arising after or on the background of the use of intrauterine contraception (CMC) (see Gurtovoy B.L. and other "Use of antibiotics in obstetrics and gynecology", M, 1996).

The known method includes antibacterial, anti-inflammatory, detoxifying infusion-transfusion, antihistamine, analgesic therapy and physical treatment methods.

The disadvantage of this method is the long period of treatment, the high frequency of allergic reactions to antibiotics, the development of vaginal dysbiosis and intestinal dysbacteriosis after antibiotic treatment, recurrence and development of chronic disease.

Known way to restore patency of the fallopian tubes using laser radiation, described in the same patent number 2285493 on CL AV 18/24, 18/20, 61N 5/067, Z. 27.10.05, op. 20.10.06.

The known method is that enter the light guide into the lumen of the fallopian tube, leading him to the site of occlusion and act on it, thus also before the introduction of the fiber into the lumen of the fallopian tube perform remote influence within 1-3 minutes of laser radiation power is Yu 20-30 mW on its outer surface, positioning the optical fiber perpendicular to the treated surface, after exposure to the site of occlusion optional for 1-5 minutes to carry out the action of laser radiation with a capacity of 20-30 mW on the inner surface of this fallopian tube along its entire length, the laser power is 300-500 mW exposure with 30-40, and as a source of laser radiation using a diode laser with a wavelength of 980 nm.

The disadvantage of this method is its complexity and relatively low efficiency.

There is a method of treatment of female infertility caused by tubal obstruction inflammatory origin, described in C. No. 93048508 on CL A61N 5/06, AV 17/42, Z. 13.10.93, op. 10.02.95 and selected as the most similar in purpose and technical nature as a prototype.

The known method is that the pre-defined by hysterosalpingography and bimanual vaginal study the topography impassable section of the fallopian tube, then sink the distal end of the optical fiber deep in the tissue of the vaginal fornix and bring it to the impassable area, which offers exposure to helium-ponovim laser LG-75-1 with a cyclic fluctuation in the density of the incident power first from 20 to 60 mW/ sq. cm back within 2-4 minutes with an energy density of 2.4-7,g/cm, a frequency of 1-2 Hz for 5 -7 sessions, then the treatment is carried out through the day with a density of incident energies from 1 to 10 mW/sq.cm and back (energy density of 0.1 to 1.2 j/cm), with the same frequency 6-8 sessions and alternate with local therapy conducted by gidroborudovaniya pipes under pressure of 120-130 mm Hg novocaine, kanamycin, lidsay course of 6-8 treatments.

The disadvantage of this method is its complexity due to the need for cyclical changes in the radiation power of the laser and holding gidroborudovaniya, lack of effectiveness and duration of treatment.

The task of the invention is to simplify the method and effectiveness of treatment.

The problem is solved in that in the method of complex treatment of tubal-peritoneal infertility, including the effects of low-intensity infrared laser radiation and the local introduction of antibacterial drug, according to the invention, on the area of the inguinal lymph nodes and the projection on the skin of the lumbosacral nerve plexus conduct the exposure radiation with a power of 150 W, a wavelength of 0.89 microns, at the time of impact on 1-m session 1 min for each region with increasing duration of exposure to 3 minutes for 10 sessions by contact with moderate pressure on the enclosed area, while local votrian metrolina enter antibacterial drug and immunomodulator, in the treatment process to perform several sessions of plasmapheresis, and also introduce non-steroidal anti-inflammatory drugs, antioxidants, desensibilization and conduct a vaginal cleansing. The claimed method of laser therapy is fundamentally different from previously proposed methods, the impact is to the inguinal lymph nodes. According to the literature in inflammatory lymph nodes perform filtration and detoxification function: they hold bacteria and viruses. Inguinal lymph nodes are involved in the establishment of lymph from the body of the uterus, ovaries and fallopian tubes (Sendvideo, Bamaw, Weslaco, 1973). The lymph nodes are involved in the regulation of the immune system. But in conditions of inflammation become toksemicheskim centers that actively multiplying organisms. Relapsing forms of genital herpes lead to the development of secondary immunodeficiency States, lymphadenopathy regional lymph nodes. Lumbosacral nerve plexus is also a place of permanent localization of latent virus and persistence of infection. The effect of low-intensity laser radiation on the area of the inguinal lymph nodes and lumbosacral plexus unloads the lymphatic system due to the bactericidal and virucidal properties of laser, stimuler the t immunological function of lymph nodes, improves microcirculation, positively affects the body of the patients.

The presence of infectious agents in the upper and lower sections of the reproductive organs in women with tubal-peritoneal infertility has been proven previously and confirmed in our work.

Therefore, the implementation of laser irradiation on the area of the inguinal lymph nodes, involved in the establishment of lymph from the uterus, ovaries and fallopian tubes running in inflammatory processes of filtration and detoxification function in terms of the retention of bacteria and viruses, and thus becoming the foci of infection, in combination with the irradiation of the laser projection on the skin of the lumbosacral nerve plexus, which is the permanent containment of latent virus and persistence of infection, in combination with a more complete survey provides an opportunity to eliminate toksemicheskim foci, which actively multiplying organisms, which together with local antibiotic and immunomodulatory therapy, as well as comprehensive therapy above, allows us to dramatically improve the effectiveness of the treatment.

In this course laser treatment for 10 sessions with gradual exposure from 1 to 3 minutes in conjunction with vnutriarterialnah therapy is compared with the prototype eno is but simple.

The inventive method has the novelty in comparison with the prototype, differing from it in such essential characteristics as an additional use in the diagnosis manipulation diagnostic laparoscopy and hysteroscopy, influence of laser radiation on the area of the inguinal lymph nodes and the projection on the skin of the lumbosacral nerve plexus with a laser with the parameters indicated above, gradually increasing the exposure time from 1 to 3 minutes for 10 sessions, conducting local therapy, which consists in vnutriarterialno the introduction of antibiotic and immunomodulator, and the use of adjuvant therapy, including the use of extracorporeal detoxification in several sessions of plasmapheresis, non-steroidal anti-inflammatory drugs, antioxidants, desensibilization and sanitation of the vagina, providing collectively achieve the specified result.

The applicant did not know the technical solutions with the set of distinctive features that collectively achieve the specified result, he felt, therefore, that the claimed method meets the criterion of "inventive step".

The inventive method can be widely used in gynecology, and therefore meets the criterion of "the industry is owned by the application".

The inventive method of applying low-intensity laser radiation in complex treatment of tubal-peritoneal infertility is as follows.

Pre-determined by bimanual vaginal examination, hysterosalpingography, manipulation diagnostic laparoscopy and hysteroscopy condition of the reproductive organs of small pelvis, the severity of adhesions. Then carry out the action of laser radiation on the area of the inguinal lymph nodes and the projection on the skin of the lumbosacral nerve plexus using laser radiation power of 150 W, a wavelength of 0.89 microns. At the 1st session irradiation duration is 1 minute on each area with increasing duration of exposure to 3 minutes for 10 sessions by contact with moderate pressure on the enclosed region. While conducting local therapy by vnutriarterialnah injection of antibiotic and immunomodulator-poludana. The treatment is complemented by the use of complex therapy, including extracorporeal detoxification in the form of several sessions of plasmapheresis, the use of non-steroidal anti-inflammatory drugs, antioxidants, desensibilization and sanitation of the vagina.

The inventive method is carried out as follows.

Spend ISS is adowanie condition of the reproductive organs of a small pelvis and fallopian tubes using a bimanual vaginal studies hysterosalpingography, manipulation diagnostic laparoscopy and hysteroscopy. Carry out the effect of low-intensity laser radiation on the area of the inguinal lymph nodes and the projection on the skin of the lumbosacral nerve plexus for the effects on the lymphatic system of the uterus and appendages. Used for treatment of the radiation power of 150 W, a wavelength of 0.89 μm, the exposure time at the 1st session of 1 minute for each area in the next 2 min (max 3 min). In the course of 10 treatments. The methods of contact, with a moderate pressure on the enclosed region.

While conducting local therapy by vnutriarterialnah injection of antibiotic and immunomodulator as inducer of interferon Alfa - poludana for the treatment of chronic endometritis and oophoritis. Treatment is also used complex therapy, including extracorporeal detoxification in the form of 3 sessions of plasmapheresis in a day, the use of non-steroidal anti-inflammatory drugs, antioxidants, desensibilization and sanitation of the vagina.

Just using the proposed method treated 25 patients.

The indications for therapy were:

- tubal-peritoneal infertility associated with chronic recurrent inflammatory diseases of the uterus and appendages;

- violation of the functions I have nikov on the background of chronic oophoritis;

- recurrent genital herpes.

All patients after treatment noted a significant improvement in General condition, the removal of local symptoms, normalization of the menstrual cycle. 8 women pregnancy. Relapses of chronic endometritis, oophoritis was absent for 8-12 months of follow-up patients.

The results of treatment of recurrent genital herpes evaluated in 11 patients: relapse rate decreased on average 3 times. Duration of relapse was reduced to 2-3 days. Significantly reduced the severity of clinical manifestations of relapse.

Clinical example 1.

Patient A., 42 years. Appealed with complaints about secondary infertility, menstrual disorders, periodic nagging pains in the lower abdomen, inguinal region, lumbar region, periodically Beli, recurrent genital herpes severe course (6-10 more recurrences per year). Sex life of 23 years. Married (second marriage). Contraception previously hormonal. History of treated chlamydia, Miko-Ureaplasma infection. Long-term current chronic inflammation in the uterus and appendages, acute type subacute inflammation (without symptoms of intoxication) to 3-4 times per year. The menstrual cycle-type optimizarea (cycle longer than 35 days), light to vanitie the selection to the period within 3-4 days. Screened for the sexually transmitted infections: in the cervical canal revealed a Ureaplasma urealiticum. Blood high titers of IgG antibodies to herpes simplex virus 1, 2 and cytomegalovirus. Histological examination of aspirate from the uterus, a chronic endometritis moderate activity. According to manipulation diagnostic laparoscopy: chronic bilateral salpingitis violation of the fallopian tubes.

The impact of low-intensity infrared laser radiation was performed on the area of the inguinal lymph nodes and the projection on the skin of the lumbosacral nerve plexus. The radiation power was 150 W, the wavelength of 0.89 μm, the exposure time at the 1st session of 1 minute for each area in the next 2 min). In the course of 10 treatments. The methods of contact, with a moderate pressure on the enclosed region. At the same time were carried out by local therapy by vnutriarterialnah injection of antibiotic and immunomodulator, which was used dalacin and Poludan (in the course of 10 injections).

Conducted comprehensive anti-inflammatory therapy: plasmapheresis 3 sessions, polyoxidonium 6 mg/m, day, No. 5 injections, vitamins b, E, hepatoprotectors, probiotics, treatment of the cervical canal and vagina with an antiseptic solution (Miramistin) followed by treatment of the cervical canal the tampon into the vagina with the "mash", composed of the following medications: doxycycline 0.5 g, trichopol 1.0 g, nystatin 500 thousand to 15 PL., Derinat of 0.25%-10,0 ml, sea buckthorn oil 30,0 ml olive oil to 50.0 ml.

There were no complications. After treatment, the patient noted improvement in General condition, the absence of pain, normalization of the menstrual cycle. Recurrences of genital herpes was reduced in 3 times and clinically manifested only easy neuralgia. Stopped Beli. Planned ECO.

Clinical example 2.

Patient S., aged 32. Suffer from chronic recurrent endometritis, bilateral oophoritis for more than 7 years. Secondary infertility 5 years.

History of treated Miko - Ureaplasma infection, ITCH. Sex with 18 years of remarriage. Contraception - condoms, hormonal.

The treatment was carried out by exposure to low-intensity infrared laser radiation on the area of the inguinal lymph nodes and the projection on the skin of the lumbosacral nerve plexus. The radiation power was 150 W, the wavelength of 0.89 μm, the exposure time at the 1st session of 1 minute for each area in the next 2 minutes On a course of 10 treatments. The methods of contact with moderate pressure on the enclosed region. There was vnutriarterialno introduction of gentamicin and poludana (in the course of 10 injections).

Conducted comprehensive protivo palatella therapy: plasmaforez 3 session polyoxidonium 6 mg/m, day, No. 5 injections, vitamins b, E, hepatoprotectors, probiotics, treatment of the cervical canal and vagina with an antiseptic solution (Miramistin) followed by treatment of the cervical canal and the tampon into the vagina with the "mash", which consists of the following medications: doxycycline 0.5 g, trichopol 1.0 g, nystatin 500 thousand to 15 PL., Derinat of 0.25%-10,0 ml, sea buckthorn oil 30,0 ml olive oil to 50.0 ml.

There were no complications. After treatment, the patient noted improvement in General condition, the absence of pain, normalization of the menstrual cycle.

One month after treatment pregnancy. Pregnant registered in female consultation. Currently, the gestation of 36 weeks.

In comparison with the prototype of the proposed method is simpler and more efficient.

Method of complex treatment of tubal-peritoneal infertility, including the effects of low-intensity infrared laser radiation and the local introduction of antibacterial drug, characterized in that on the area of the inguinal lymph nodes and the projection on the skin of the lumbosacral nerve plexus conduct impact radiation power of 150 W, a wavelength of 0.89 microns, at the time of impact on 1-m session 1 min for each region with increasing duration of exposure to 3 m is n for 10 sessions by contact with moderate pressure on the enclosed region, while local vnutriarterialno impose an antimicrobial agent, and an immunomodulator in the treatment process to perform several sessions of plasmapheresis, and also introduce non-steroidal anti-inflammatory drugs, antioxidants, desensibilization and conduct a vaginal cleansing.



 

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1 tbl, 1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to dermatology and is designed for laser treatment of various forms of psoriasis. Daily intravenous blood irradiation with laser radiation with a wavelength in the range of 0.63-0.89 microns is conducted, with a power of 1-2 mW, exposure time 10-30 minutes a day, total dose rate of 8-39 J. In case of limited psoriasis vulgaris the total dose rate is 8-10 J, with exposition is 10 min. In case of widespread psoriasis vulgaris the total dose rate is 19-23 J, exposure is 15 min. In case of exudative psoriasis the total dose rate is 17-19 J, exposition is 20 min. In case of psoriasis arthropica the total dose rate is 33-39 J, exposition is 30 min.

EFFECT: method provides stable, long-term remission, within a shorter time, in case of different clinical forms of psoriasis.

5 cl, 3 ex

FIELD: medicine.

SUBSTANCE: invention refers to laser medicine. Aspiration of the cyst content is carried out and it is induced with diode laser at ultrasound control. After aspiration photosensitiser of chlorin series, with only half the amount of aspirated content with exposure for 2 hours is injected to the cyst cavity. Then the remnants of a photosensitiser are aspirated and an influence on the cyst wall with laser light with a wavelength of 1264 nm with pulse width 0.1-0.5 seconds at radiated power of 0.8-2 W is carried out up to formation of ultrasound image of inflammatory rim around the cyst walls. The method enables to prevent possible tumor proliferation of cells forming the walls and the contents of the cyst cavity, strong bonding of cyst cavity walls throughout their length.

EFFECT: development of an effective method of treatment thyroid cysts.

3 cl, 1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to gastroenterology. The method includes transcutaneous impact which is performed using a laser device "ADEPT-Euro". The impact is exerted at frequency of 30000 Hz with power of 17 W per pulse, with the dose of radiation 20 J per procedure. During the first 3-5 days of laser irradiation is conducted 2 times a day from 8 to 12 hours and from 16 to 18 hours, with an interval between procedures 4-6 hours. During consecutive days the irradiation is conducted every day during a period from 8 to 12 hours. The duration of the course is 8-10 days. In addition, transcranial electrotherapy is conducted using the apparatus "Transair-02" at classical electrodes spacing. The current is determined individually according to patient perceptions. In this case during the first 3-5 days the impact is exerted 2 times a day with an interval of 4-6 hours, duration of procedure is 30 minutes. In the next few days it is exerted once a day. The duration is 10 days.

EFFECT: method shortens the treatment time due to improving activity of autonomic nervous system and normalisation of content of lactoferrin, C-reactive protein and tumor necrosis factor in blood serum.

2 ex, 9 tbl

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery and intensive therapy, and can be used in treating endotoxicoses caused by septic conditions. That is ensured by removal of a destruction area to be thereafter sanitised and drained. It is followed with lymphostimulating therapy by introduction of 0.25% Novocaine 60 ml with dissolved 0.1 g of Lydase and 1.0 ml of Pentoxifylline into the interspinous spaces in number of 1-3 injections. Further, discrete plasmapheresis in amount 400 ml for severe patients and 800 ml in moderate patients is applied in number of 1-8 procedures. The lymphostimulating therapy is alternated every second day with lymphotropic extracorporal pharmacoimmunotherapy with using a medicated mixture prepared by incubation of 40-60 ml of the patient's plasma with received plasma of the patient with Roncoleukin in dosage 500-1 million UN and Cefabol in dosage 1 g for 45 min at 37°C. In peritonitis and peritoneal sepsis, the medicated mixture is introduced in the bolus form in the retroperitoneal fat. The destructive processes in the pleural cavity require introduction of said mixture in the axillary cavity.

EFFECT: method provides endotoxin weakening in the bloodstream, intertissue spaces and cavities due to combined multidirectional local and system effect on the lymphoid system.

3 cl, 8 tbl, 3 ex

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