RU2255776C1 - Method for treating gestosis - Google Patents

Abstract

FIELD: medicine, obstetrics.

SUBSTANCE: the present innovation deals with treating light-degree gestosis. One should perform percutaneous laser irradiation of renal area at pregnancy terms being 30-33 wk at impulse power of 10 W and frequency of impulse sequence of 80 Hz. Laserotherapy course consists of about 7-10 procedures to be carried out daily. The method enables to interrupt gestosis symptomatology after therapy, decrease the risk for the development of severe forms of the present complication at terms of mature pregnancy and necessity in medicinal therapy and, also, achieve better perinatal results, that is, to increase the number of healthy babies born.

EFFECT: higher efficiency of therapy.

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Description

The present invention relates to medicine, namely to obstetrics.

State of the art

Analogs: percutaneous methods of laser therapy in pregnant women are known to treat intrauterine bacterial infection and bacterial amnionitis (Artemyev V.E., Etsko L.A., 1996, 1997), in the complex treatment of gestational pyelonephritis (Nagornaya V.F., 1998, Kurbanov S.D., Khadzhimetov A.A., Shomirov A.K., 1997), therapy of fetoplacental insufficiency (Vasilieva O.A., Kartelishev A.V., 1999) laser puncture for the treatment of preeclampsia (Dzhvebenava G.G., 1984 ) Percutaneous techniques of low-intensity laser radiation (LILR) were used to influence the microcirculation system, activate mechanisms of nonspecific immunity and metabolic processes.

Evaluation of the detoxification effect of the used laser therapy modes was not carried out.

The prototype is the technique of intravenous laser irradiation of blood (VLOK) in pregnant women with gestosis of varying degrees, the main effect of which was the effect on endotoxicosis (A.S. Bednarsky, 1995). The positive effect of the therapy was evaluated by clinical and laboratory parameters: clinical symptoms and laboratory criteria for endogenous intoxication and antioxidant protection. However, the invasiveness of the laser therapy technique does not allow its widespread use.

SUMMARY OF THE INVENTION

The purpose of the invention is to develop a non-invasive method of laser therapy for the treatment of mild gestosis, which allows a systemic detoxification effect on the pregnant woman. This goal is achieved by exposure mode, taking into account the features of microcirculation of the kidneys. The safety of the technique and detoxification effect were proven in a previous experimental study in laboratory rats.

The advantage of using a transdermal technique of low-intensity laser radiation is ease of use, safety and non-invasiveness for the patient.

The method is as follows.

A course of percutaneous laser therapy (7-10 procedures) for the kidney area is carried out during pregnancy for 30-33 weeks for patients with mild gestosis (scale of the Ministry of Health of the Russian Federation, 1999), including in case of edematous and edematous hypertension in the conditions of the department of pregnancy pathology of an obstetric hospital .

Before starting the procedures, pregnant women with a mild degree of gestosis are examined for markers of endotoxemia: the level of CEC, triglycerides, creatinine, platelets, LII, HCT test; an ultrasound examination of the pregnant kidney is performed to exclude anomalies in the location and presence of urolithiasis, to clarify the condition of the fetus by standard methods of ultrasound scanning and cardiotachography. If a urogenital infection is detected, sanitation is undertaken prior to the start of laser therapy.

Before the first procedure, blood is drawn from a peripheral vein to determine sensitivity to laser irradiation according to the technique developed at the Laser Medicine Center based on Clinical Hospital No. 7. The technique, based on the determination of the optical density of plasma using refractometry, allows you to choose an individual exposure time for each patient. For this, the patient’s plasma in an amount of 1-2 ml is placed in a Petri dish. Using a refractometer, the initial optical density of the plasma is determined. Then the plasma is irradiated in a Petri dish for 1 minute and the optical density value is determined, each time increasing the exposure duration by 1 minute. Thus, the results of the optical density of the plasma are obtained under laser irradiation for 1, 2, 3 minutes, and so on up to 10 minutes. The results are recorded in the form of a graph, the exposure time at which the maximum deviation of the optical density of the plasma from the initial value occurs, is considered optimal for this patient. The total time of the procedure is divided in half, taking into account two locations.

Laser therapy sessions are carried out in a physiotherapy cabinet using a Mustang model 024 with the MLO1K radiating terminal from Technika (No. 95 / 311-211 in the State Register of Medical Products, 1997). The power of low-intensity laser radiation (LLLT) at the end of the fiber is set to 10 W, the pulse repetition rate is set to 80 Hz. The procedure is carried out daily (for example, a break of no more than 1-2 days) according to a contact stable technique in the amount of 7-10 per course. In the pregnant position, sitting on the kidney area (level T10 - T-L), the laser therapy session is carried out alternately on the paravertebral lines using the MLO1K emitter on the right and left lines.

The clinical standards for the management of women with gestosis (blood pressure, diuresis, weight) and laboratory standards: leukocyte intoxication index (LII), leukocyte count, platelet count, triglycerides, β-lipoproteins, circulating immune complexes (CIC), HCT test, leukocyte stimulation coefficient. After the end of the complex treatment, the patients are discharged from the hospital with the recommendation of a control turnout in a one-day diagnostic hospital at 34-35 weeks and prenatal hospitalization at 38 weeks.

Examples.

1. In the patient T-th, 19 years old, with vegetative-vascular dystonia of the hypertonic type, the course of pregnancy was complicated by the early onset of gestosis. During 32 weeks of gestation, the weight gain was 15 kg. The examination revealed markers of endogenous intoxication: the level of blood triglycerides of 2.04 mmol / L, β-lipoproteins 1164 mg / L.

A course of LLLT was carried out in the complex of gestosis therapy (7 procedures). Starting from the first procedure, an increase in diuresis, weight stabilization was noted, and at the end of the course of treatment, the edematous syndrome stopped. According to laboratory studies, a decrease in the level of endotoxemia indicators was noted: triglycerides amounted to 0.94 mmol / L, β-lipoproteins 898 mg / L. Further progression of gestosis was not noted. In the term of full-term pregnancy upon admission to antenatal hospitalization, the patient retained a mild severity of gestosis. The level of blood pressure was within normal values, there was no need for basic magnesia or planned antihypertensive therapy. The patient independently delivered at full term with a girl weighing 3,700 g and a height of 50 cm, with an Apgar score of 8/9 points.

2. The patient R-va, 31 years old, somatically suffers from arterial hypertension of 1 degree. Of the obstetric history, the complicated course of the previous pregnancy deserves attention - preeclampsia in the term of a premature pregnancy (31-32 weeks), in connection with which an operative delivery was undertaken. In this pregnancy, an early onset of GH gestosis was recorded - from 24 weeks, which required the use of antihypertensive drugs (Lomir 7.5 mg per day). During the gestation period of 30-32 weeks, 10 laser therapy sessions were carried out in the treatment complex. After completion of the course, stabilization of weight was noted, the symptom of “numbness of the fingers” stopped. From laboratory criteria, a decrease in LII from 1.52 to 1.21, as well as a decrease in the level of CEC from 48.0 to 31.5 srvc. units If the patient had a scar on the uterus, the pregnancy ended at the time of full term pregnancy (37-38 weeks) by cesarean section in a planned manner by the birth of a child weighing 3250 g, height 50 cm, with an Apgar score of 8/9 points.

Thus, low-intensity laser radiation helps to stop the symptoms of gestosis after the end of the course of procedures, and also prevents the progression of this complication and the development of severe forms of gestosis. A non-invasive laser therapy technique for the kidney area is effective in the treatment of mild gestosis and is safe for the fetus.

Sources of information

1. Artemyev V.E., Butsko L.A. Some features of the course of the infectious process during infrared laser irradiation in pregnant women with bacterial amnionitis // New directions in laser medicine: Materials of an international conference. - M., 1996. - P.118-119.

2. Artemyev V.E., Butsko L.A. Polylaser radiation and immunity in pregnant women with intrauterine infection // Problems of Laser Medicine: Materials of the 4th International Congress. - Prominent, 1997. - S.112-113.

3. Bednarsky A.S., Chaika N.A., Yaroslavsky V.K., Danilova L.A., Reznikov L.L. The use of endovascular laser therapy in the complex treatment of OCG-gestosis // Akush. and gin. - 1995. - No. 5. - S.18-22.

4. Vasilieva O.A., Kartelishev A.V. The therapeutic possibilities of low-intensity laser radiation during pregnancy with placental insufficiency of infectious origin // Laser and Health-99: Materials of the International Congress. - M., 1999 .-- S.139-140.

5. Gazazyan M.G., Vasilyeva O.A. The effect of low-intensity laser irradiation of the blood of pregnant women on the condition of the fetus and newborn in placental insufficiency. // Laser medicine. - 2000. - No. 4 (1) - S.7-11.

6. Dzhvebenava G.G., Didia C.G., Bakradze M.M. The use of laser beams in obstetrics. - Tbilisi, 1984. - 154 p.

7. Itskovich A.I., Ponomarenko T.N., Osin A.Ya. Laser therapy in neonatology. - Vladivostok: Dalnauka, 1999 .-- 221s.

8. Kurbanov S.D., Khadzhimetov A.A., Shomirov A.K. The effect of low-intensity laser beams on the performance of CBS in pregnant women suffering from chronic pyelonephritis. Laser and Health-97. Materials of the 1st international congress. Cyprus. - 1997. - P.75.

9. Nagornaya V.F., Ivanov A.N. The use of infrared laser radiation in the prevention of late gestosis // Medical rehabilitation, balneology, physiotherapy. - 1998. - No. 2 (14). - S.30-32.

10. Peshev L.P., Kildyushov A.N., Solovieva E.P., Paramonov T.K. et al. Optimization of gestosis therapy using percutaneous laser irradiation of blood. Problems of laser medicine. Materials of the 4th international congress. Prominent. - 1997. - S. 130-131.

Claims (1)

A method for the treatment of gestosis by laser therapy, characterized in that the exposure is carried out in the period of 30-33 weeks of gestation on the region of the kidneys with a radiation power of 10 W at the end of the fiber, a pulse repetition rate of 80 Hz daily for 7-10 days, the exposure time is selected individually after determining the sensitivity to laser exposure.