RU2175871C1 - Method for treating the cases of erysipelatous inflammation - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves administering antibiotic into injured area by means of electrophoresis. Cuff is applied above the zone of treatment (with the exception of head, trunk and external genital organs) under pressure of 40 mm of mercury column for 2 h. Primary erysipelatous inflammation being the case, low power laser radiation is concurrently applied in pulsating mode in infrared bandwidth with wavelength equal to 0.81-0.98 mcm, 10-100 Hz frequency, 2.5 mW power to inflammation focus and regional lymph vessels and lymphatic nodes for 20 min. Secondary or recurrent erysipelatous inflammation being the case, intravenous laser radiation is applied in red bandwidth with wavelength being equal to 0.67 mcm, power flux being equal to 1-2 mW at the light guide end. The total treatment course is 10 daily procedures long. EFFECT: enhanced effectiveness of treatment.

Description

 The invention relates to medicine, namely to infectious diseases, and can be used to treat erysipelas of various localization.

 The prototype of the invention is a method of treating erysipelas (RV) of the lower extremities using indirect endolymphatic therapy (NET) "Bicillin-3" (magazines: "Antibiotics and chemotherapy" N 6, 1992, pp. 24-26, "Clinical surgery" N 1, 1987, p. 67, "Clinical Medicine" N 4, 1998, p. 17-20). However, this treatment method does not cover other localizations of RV, except for the lower extremities, limits the choice of antibiotics, and can also lead to complications in the form of necrosis of the skin and subcutaneous tissue at the injection site (Journal of Soviet Medicine N 3, 1988, p. 102- 104).

 EFFECT: coverage of various localizations of RV, widening of the choice of antibiotics used, prevention of complications.

 A method of treating RV is as follows: by electrophoresis on the affected area of the skin, mainly by the transverse technique, an antibiotic is administered from the anode or cathode, depending on the polarity of the active part of it during dissociation or from both electrodes simultaneously, the exposure is from 15 to 300 minutes, 6- 10 sessions with a gradual increase in exposure time. The pads on both sides of the electrodes are moistened with distilled water, and on the side of the medication, 3-4 layers of gauze moistened with an antibiotic solution. When applying an electrode to damaged skin (bullous form of PB with opened bubbles) after treating the wound with a 3% solution of hydrogen peroxide and furacilin (1: 5000), sterile gauze with an antibiotic solution is used. For electrophoresis, the POTOK-1 galvanizer GE-50-2 is used. Above the injection site of the antibiotic by electrophoresis, a cuff is applied from the Riva-Rocci apparatus with a cuff pressure of 40 mm Hg. for 2 hours in a horizontal position of the patient. Thus, electrophoretic saturation with the antibiotic of the lymphatic system (ENALS) is carried out due to the difficulty of venous outflow and stimulation of lymphogenous absorption in the RV zone. The cuff is not used in those parts of the body where it is impossible (trunk, external genitalia) or dangerous to health (head). The antibiotic is selected depending on the frequency of the disease (primary, repeated, recurrent) and allergic history. For primary and repeated PB, benzylpenicillin sodium salt is used at 1 million per cathode; for recurrent PB - cefamesin sodium salt is 0.5 g each, from the cathode dissolved in water for injection or distilled water. Simultaneously with ENALS, low-energy laser radiation (NELI) is used by the AKLR-01M and ALTO devices (therapist). The method of treatment of NELI is chosen depending on the frequency of the disease, the severity of local manifestations, the severity of the condition and the condition of the blood coagulation system. Indications for the use of NELI according to the severity of the condition and condition of the coagulation system are generally accepted for laser therapy. In primary RS, local exposure to NELI by the AKLR-01M apparatus in the pulsed infrared (I-IR) range (wavelength 0.81-0.98 μm) with a frequency of 10 to 100 Hz, installed with a power of 2.5 mW at inflammation and regional lymphatic vessels and lymph nodes 1 time per day for 20 minutes for 10-15 days. In case of repeated and recurrent RV - intravenous laser blood irradiation (VLOK) with the ALTO device (therapist) in the red range (wavelength 0.67 μm), power flux at the end of the optical fiber 1-2 mW, exposure time 20 min 1 time per day within 10 days. In some cases, RV use the combined treatment of NELI (local and VLOK). Vitamin Aevit or Triovit is prescribed to all patients receiving NELI treatment 2 hours before laser therapy 2/3 of the therapeutic dosage and after 6 hours 1/3, alkaline mineral water without gas up to 1.5-2.0 liters per day. After laser therapy, bed rest is prescribed for 2 hours.

 When PB is localized on the foot, the medial and lateral part of the lower leg, and the inner surface of the thigh, one of the electrodes with the antibiotic solution is applied to the back side with the capture of the entire diameter of the foot, and the second electrode to the sole. The patient is placed in a horizontal position with a slightly elevated leg end with a cuff from the Riva-Rocci apparatus on the lower third of the thigh.

 When RV is localized on the posterior surface of the lower leg, inner surface of the thigh, one electrode with an antibiotic solution is applied to the posterior surface of the lower third of the lower leg, the second electrode is placed on the front surface, and the Riva-Rocci apparatus is placed on the lower third of the thigh.

 When RV is localized on the outer thigh, one electrode with an antibiotic solution is applied to the lower third of the outer thigh, the second electrode to the inner part, and the cuff from the Riva-Rocci apparatus to the upper third of the thigh.

 When PB is localized on the hand, forearm, and inner shoulder surface, one electrode with an antibiotic solution is applied to the back of the hand, the second to the palmar side, and the cuff from the Riva-Rocci apparatus to the lower third of the shoulder.

 When localized on the outside of the shoulder, one electrode is applied to the outside of the lower third of the shoulder, the second to the inside, and the cuff from the Riva-Rocci apparatus to the upper third of the shoulder.

 When PB is localized on the face, one electrode is applied to the affected side, the second to the occipital part of the head or the outer surface of the shoulder.

 When PB is localized on the scalp, one electrode is applied to the affected area, the second to the occipital part of the head or the lateral surface of the neck, or the outer surface of the shoulder.

 When the PB is localized on the trunk, one electrode is applied to the lesion area, the second transversely to the other side.

 When RV is localized on the external genitalia in men with a predominant lesion of the scrotum skin, one electrode with an antibiotic solution is placed on the scrotum, and the second above the womb. When PB is localized on the skin of the penis, one electrode with an antibiotic solution is applied to one side of the penis, the second to the opposite.

 When RV is localized on the external genitalia in women, one electrode with an antibiotic solution is applied to the skin of the external genital organs, the second above the bosom.

Example 1. Patient Za F.M. 40 years. Complaints of pain, swelling, itching, burning, redness of the skin of the left leg, general weakness. She fell ill acutely from 11.19.99, felt weakness, chills, fever, body aches. November 22, 1999, there was redness, swelling of the left lower leg and pain in the inguinal region and the inner surface of the thigh on the left. I went to the surgeon at the place of residence, local treatment was performed with dressings with Vishnevsky ointment. November 24, 1999, in connection with the deterioration of her condition, she was sent to 4 City Clinical Hospital for Infectious Diseases, was hospitalized at 18.00. Upon admission, the condition is serious, intoxication is expressed, temperature 38.5 ^o C, swelling in the left lower leg region, skin hyperemia with clear contours, uneven borders, pale formations with serous-hemorrhagic contents in the ankle region, regional lymphadenitis. A history of erysipelas of the left tibia in 1995. Diagnosed with repeated erysipelas of the left lower leg bullous-hemorrhagic form. November 26, 1999 notes increased pain and swelling in the left lower leg, the bubbles opened, temperature 38.0 ^o C. On November 26, 1999 the patient began ENALS of the affected limb by applying electrodes to the foot: cathode with a solution of benzylpenicillin 1 million units . on the back of the foot, the anode on the plantar.

 The exposure time gradually increased from 15 to 30 minutes. Immediately after the procedure, a cuff was placed on the lower third of the thigh from a blood pressure measuring device with a pressure of 40 mm Hg. for 2 hours. The patient was laid horizontally with a slightly elevated leg end. In parallel, local laser therapy was performed with the AKLR-01M apparatus in I-IR mode with a frequency of 100 Hz, a time of 2 min 10 fields per lesion area and regional lymph nodes. After the treatment was started the next day, the temperature returned to normal, my health improved, the pain and swelling in my left leg somewhat decreased, and the hyperemia was bright. Hyperemia disappeared after the 3rd session, and after the 8th - significant positive dynamics, in the place of the opened bubbles epithelizing crusts, there is no pain and swelling. The patient was discharged in satisfactory condition.

 KLA on admission (11/25/99), ESR = 27 mm / hour, lake. = 7.6 • 10, Tr = 181 • 10, lymph. = 15.7%, neutr. = 84.3% conv. = 4 min 30 sec according to Sukharev, IPT = 89%.

 OAC during treatment (12/03/99) ESR = 22 mm / hour, lake. = 8.0 • 10, Tr = 387 • 10, lymph. = 23.7%, neutr. = 76.3%.

 KLA at the end of treatment (12/9/99), ESR = 15 mm / hour, lake. = 6.2 • 10, Tr = 322 • 10, lymph. = 27.4%, neutr. = 72.6%.

Example 2. Patient K-in A. Century 24 years. Complaints of pain, swelling, redness of the right hand, swelling of the forearm, shoulder. He became acutely ill on 12/08/99, with chills, fever up to 39.0 ^o C, aches in the whole body, malaise. Then there was swelling, redness of the right hand, pain in the hand, right axillary. The temperature was kept at high numbers before arrival. He went to the doctor on December 8, 1999, took aspirin, and on December 10, 1999 was hospitalized in 4 GKIB. Upon admission, a moderate condition, a temperature of 37.2 ^o C, the right hand is swollen, the skin is hyperemic with palpation soreness, lymphangitis, regional lymphadenitis. In the history of similar symptoms was in the summer of 1999, for honey. I didn’t apply for help. Diagnosed with recurrent erysipelas of the right hand - erythematous form 12/15/99, the beginning of the ENALS of the affected limb by applying electrodes to the right hand: cathode with a solution of benzylpenicillin 1 million units. on the back of the hand, the anode on the palmar surface. Exposure time from 15 to 20 minutes. Immediately after the procedure, a cuff was applied from the blood pressure measuring device with a pressure of 40 mm Hg. for 2 hours, the patient’s position is horizontal with a slightly raised right hand. In parallel, general laser therapy was performed with the ALTO apparatus (therapist) in the red spectrum of VLOK, a power flux of 1 mW, a treatment time of 20 min. The next day, hyperemia disappeared, swelling and pain in the right hand decreased, the temperature returned to normal. After the second session of the combined treatment, there are no complaints, the temperature is normal, there is no swelling and soreness, the skin of the brush is peeling. After the 6th session, the patient was discharged home in satisfactory condition.

 In the KLA at the beginning of treatment: ESR = 25 mm / hour, lake. = 5.8 • 10, Tr = 196 • 10, lymph. = 43%, neutr. = 57%.

 In the jab at the end of treatment: ESR = 9 mm / hour, lake. = 7.9 • 10, Tr = 273 • 10, lymph. = 41%, neutr. = 59%.

 In this way, 11 patients were treated, 7 of them with erysipelas of the lower extremities, 1 of the upper limb, and 3 faces. There were no complications when using this technique, positive clinical and laboratory dynamics were noted.

Claims (1)

 A method of treating erysipelas by administering an antibiotic against a background of traditional therapy, characterized in that the antibiotic is administered by electrophoresis on the affected area, after which a cuff is placed above the injection site (except for the head, trunk and external genital organs) with a pressure of 40 mmHg. Art. for 2 hours and at the same time with primary erysipelas, they are exposed to low-energy laser radiation in a pulsed infrared range with a wavelength of 0.81 - 0.98 μm, a frequency of 10 - 100 Hz, and a power of 2.5 mW per inflammation site and regional lymph vessels and lymph nodes in for 20 minutes, and with repeated and relapsing, intravenous laser blood irradiation is performed in the red range with a wavelength of 0.67 μm, a power flux at the end of the fiber 1 to 2 mW, and 10 daily procedures are prescribed for the course of treatment.