Method of treating varicose disease of lower extremities with application of endovenous laser vein coagulation

FIELD: medicine.

SUBSTANCE: invention relates o medicine and can be applied in treating varicose disease of veins of lower extremities with application of endovenous laser vein coagulation (ELVC). For this purpose skin area, which is subjected to operation, is processed with antiseptic solution. Under control of ultrasonic apparatus into vessel lumen introduced is catheter, through which light-conductor is passed to saphenofemoral fistula. After that, tumescent anesthesia is performed by creation of water "cushion", at that applying cold, ozonised 0.9% physiological solution with temperature 5-7C, ozone concentration 4-5 mcg/ml and time of saturation with ozone 5-8 minutes. Or ozonised 0.1% lidocaine solution with temperature 5-7C, ozone concentration 4-5 mcg/ml and time of saturation with ozone 5-8 minutes is introduced. After that, pathological vessel is exposed to laser energy. If necessary, applications of 50 ml ozonised heparin-containing gel are made after procedure in projection of coagulated vein with exposition 60-90 minutes until ozone concentration of gels reaches 6500-7000 mcg/ml.

EFFECT: method ensures effective treatment of said pathology due to selection of most optimal type of anesthesia and following therapy, which contribute to reduction of pains, local manifestations of inflammation, activation of processes of focal and marginal epithelisation processes.

2 cl

 

The invention relates to medicine, namely to the treatment of varicose disease of lower extremities using endovenous laser coagulation veins (MLC).

When the casualty operations, and chronic pain syndromes require anesthesia, such as conduction blockade on how modern component.

Conduction anesthesia, like any other medical procedure, is not without risk of complications. Depending on the type of procedure being performed and the localization of the nerve trunk complications may include: injury to adjacent blood vessels, nerve injury, infection of the puncture site, the toxic effects of local anaesthetics, allergic reactions to local anesthetics (http://www.esraeurope.org/, http://www.rusanesth.com/forum/) - [1].

Tumescent anesthesia is one of the important stages of MLK with varicose disease of lower extremities. Goal is to protect parabasal tissues and anatomical structures (lymphonodectomy, nerves)situated in the projection of coagulation trunk of one or another of Vienna, from damaging thermal effects.

Varicose veins is a pathology that is characterized by a thinning of the walls of veins, uneven expansion and the formation of specific nodes. Varicose veins are almost 27% of women, 15% men and is the most common vascular the disease. The most commonly affected vessels of the leg. Before her treatment was associated with surgical intervention.

Severe traumatic surgery in the past, and came the era of minimally invasive techniques. There is a method of treatment of varicose veins (varicose veins), easily portable and does not require the patient refuses the usual lifestyle is endovenous laser ablation (endovascular laser coagulation MLC (EVLK)), which is the technology of the XXI century. Treatment of varicose veins laser can successfully get rid of varicose veins, not off from life and work in normal mode. That is why laser coagulation was called "Office surgery" (www.club-spa.ru/evlk.html) - [2].

Treatment of varicose veins MLK performed under local anesthesia on an outpatient basis and takes about an hour. The area of skin subjected to a surgical procedure, treated with antiseptic solution. Using the ultrasonic device control the conduct of the catheter into the lumen of the vein. Through the catheter to the desired location passes the fiber, then the solution perform tumescent anesthesia, and laser energy begins to influence the pathological vessel. After the procedure, the patient's leg wear special operating elastic stockings.

During a session of laser photocoagulation using tumescent Annes is Ezio, in which the administration of anesthetic produced in parabasal fiber (around Vienna). It provides complete and quick pain relief. However, when the anaesthesia in the postoperative period patients have the appearance of bruises along the coagulated veins. The reason for the appearance of bruises lies in the perforations of Vienna at MLK and overly made tumescent anesthesia, when "crawling" infiltration under pressure breaks the subcutaneous tissue, in addition, on some remote time in the projection coagulated veins can occur pigmentation of the skin, the sense of "chord" along the thighs (about 20% of patients at 4-6 days after MLK can receive the pulling sensation along the coagulated veins, preventing the end to straighten the limb), as a rule, this feeling disappears at time 1.5-2 months, short-term temperature rise to subfebrile figures after conducting MLK. This temperature rise is due to pyrogenic action formed after EWLC products of protein degradation. All this reduces the effectiveness of the method of treatment of varicose disease of lower extremities using endovenous laser coagulation veins.

The technical result, which directed the claimed invention is to improve the quality of the implemented method for MF is t effective ongoing anesthesia, providing: subsequent more rapid recovery of the physiology of the surrounding tissues and the whole body due to the pain subsided, reducing the feeling of heaviness in the affected limb, burning and itching, reduction of local manifestations of inflammation, a gradual process of focal and epithelialization, in addition, improving the overall health of patients, stabilization pattern of lipid profile, activation of the antioxidant enzymatic system by using ozonated cold anesthetic.

The technical result is achieved in that the method of treatment of varicose disease of lower extremities using endovenous laser coagulation of the veins, by which the area of skin subjected to a surgical procedure, treated with antiseptic solution, an ultrasonic device to control the introduction into the vessel lumen of the catheter, through which conduct the light to the sapheno-femoral anastomosis, perform tumescent water cushion saline solution, after which the laser energy impinges on the pathological vessel, what is new is the fact that to create water "cushion" use cold ozonated of 0.9% saline solution, and the solution temperature is 5-7C, the concentration of ozone 4-5 g/ml, and the feeding of the ozone 5-8 minutes.

For reinforced what I analgesic effect when performing endovenous laser coagulation veins as physiological solution using ozonated 0.1% lidocaine solution with a temperature of 5-7C, ozone concentration to 4-5 mg/ml and the time of saturation of ozone 5-8 minutes.

After the procedure in the projection coagulated veins perform the application of ozonized Eparistera gels, exposure time of 50 ml which is 60-90 minutes before reaching the ozone concentration gels 6500-7000 g/ml.

Any disease begins and progresses in terms of violations peroxidation and ischemia, microvascular processes, and disorders of metabolism. It is known that ozone is a powerful oxidant: joining cells, it breaks on active oxygen and free radicals. Pathogenetic effect of ozone therapy is achieved through the accumulation of oxygen molecules. With ozone therapy can achieve recovery at the microsomal level. Ozone is used in the form of ozonated solutions, it restores oxygen transport, eliminates toxins, stimulates regeneration, bacteriostatic, bactericidal and antiviral effect, analgesic and anti-inflammatory effect, helps to restore adequate blood flow and metabolism, releases oxygen, normalizes metabolism, hormones, relieves toxicity, it will expand the vessels, improve microcirculation, has immunostimulant, antibacterial, antiviral and anti-inflammatory dei is a journey, prevents thrombus formation.

Cool the solution initially causes spasm of the blood vessels, which increases thermogenesis and stimulation of blood vessels, facilitates venous return. All this is very helpful rehabilitation after trauma to the surrounding tissue with laser energy.

The method of treatment of varicose veins using endovenous laser coagulation veins is as follows.

The area of skin subjected to a surgical procedure, treated with antiseptic solution, under control of the ultrasonic apparatus is introduced into the vessel lumen catheter, through which conduct the light to the sapheno-femoral anastomosis, perform tumescent water cushion saline solution, after which the laser energy impinges on the pathological vessel. To create water "cushion" use cold ozonated of 0.9% saline solution, and the solution temperature is 5-7C, the concentration of ozone in solution 4-5 g/ml, and the feeding of the ozone 5-8 minutes.

To enhance the analgesic effect when performing endovenous laser coagulation veins as a solution for anesthesia can be used ozonated 0.1% lidocaine solution with a temperature of 5-7C, the ozone concentration to 4-5 mg/ml and the time of saturation of ozone 5-8 minutes.

After the procedure in the projection of COAG the isolation of the veins perform the application of ozonized Eparistera gels, exposure time of 50 ml which is 60-90 minutes, before reaching the ozone concentration gels 6500-7000 g/ml.

At the end of the holding means at the patient's legs to put on a special operating elastic stockings.

Before anaesthesia ozoneresistant cold anesthetic prepared immediately before the procedure. For ozone using setup "MedozonsBM". What for 5-8 minutes, cooled sterile 0.1% solution of lidocaine or saline 0.9% in a tightly closed bottle 400 ml saturated with ozone-oxygen mixture until the desired ozone concentration to 4-5 mg/ml, the Temperature of the solution in the vial to achieve the goal should be from +5 to +7C. Further, the area of skin subjected to a surgical procedure, treated with antiseptic solution. Ultrasound monitors the catheter, which is introduced through the skin into the lumen of the vessel. Through the catheter to the desired location passes the fiber is then performed tumescent anesthesia cold ozonated 0.1% solution of lidocaine or saline 0.9% parabasal fiber (around Vienna) 400-600 ml In the process of discharge is very clear, as the solution compresses the lumen of the vein before its complete closure. Around the trunk is formed circular "water pillow", which will allow absolutely bezbolez the NGOs to carry out laser coagulation of the lumen of the trunk of the great saphenous vein, without damaging adjacent soft tissue and nerve bundles, after anesthesia laser fiber pull outward while the laser energy affects the pathological vessel. After the procedure in the projection coagulated veins perform the application of ozonized Eparistera gels and legs of the patient is put on operational elastic stockings. The exposure time 50 ml Eparistera gels (Lioton gel", "Heparin ointment and the like) is 60-90 minutes and reaches concentrations of ozone 6500-7000 g/ml.

Thus, used ozonated solution improves microcirculation and tissue oxygenation of the whole body, to optimise its oxygen homeostasis and causes the restructuring of compensatory reactions in pathology at different levels of the vascular system, which is manifested in the restoration of functions of the peripheral circulation due to start functioning collaterals, ensuring regional action all therapeutic properties of ozone. Cold, in addition, which increases thermogenesis and stimulation of blood vessels, facilitating venous return, cause a spasm of the vessel, subjecting the latter closer contact with the wall with the light guide, respectively, and with the laser energy, thereby leading to a more guaranteed absence of recanalization of the trunk that t is aetsa one of the reasons recanalization coupled with inadequate selection of used laser power at the time of execution of MLK. Positive dynamics in the patient's condition comes much earlier than with conventional anesthesia during MLK. So managed to avoid the development of a typical MLC complications such as redness, swelling, achimota, pastos. In addition, the use of ozonated Eparistera gels contributed to the rapid recovery of sensitivity when parastasi. The method of solution preparation and anesthesia simple, fairly cheap, can be used on an outpatient basis, and the carrying out of the method of treatment of varicose disease of lower extremities using endovenous laser coagulation veins generally provides faster recovery and return patients to a normal life, not requiring hospitalization in the surgical hospital, in addition, when a simple count of all treatment costs, MLK be more advantageous economically.

1. The method of treatment of varicose disease of lower extremities using endovenous laser coagulation of the veins, by which the area of skin subjected to a surgical procedure, treated with antiseptic solution, an ultrasonic device to control the introduction into the vessel lumen of the catheter, through which conduct the light to the sapheno-femoral anastomosis, perform tumescent water "cushion" the physiological the practical solution then the laser energy impinges on the pathological vessel, characterized in that to create tumescent water "cushion" use cold ozonated of 0.9% saline solution with the solution temperature 5-7C, the ozone concentration to 4-5 mg/ml and the time of saturation of ozone 5-8 minutes or ozonated 0.1% lidocaine solution with a temperature of 5-7C, the ozone concentration to 4-5 mg/ml and the time of saturation of ozone 5-8 minutes.

2. The method according to claim 1, characterized in that after the procedure in the projection coagulated veins perform the application of ozonized Eparistera gels, exposure time of 50 ml which is 60-90 minutes, before reaching the ozone concentration gels 6500-7000 g/ml



 

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