RU2267340C1 - Method for treating patients for puerperal endometritis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves applying infrared low intensity laser daily twice a day during 5-10 days. The first 3 days, intravaginal treatment is applied via nozzle at modulation frequency being equal to 70 Hz, with light guide radiation power of 40 mW and exposure time being 5 min long. The modulation frequency is equal to 50 Hz and light guide radiation power of 35 mW. Treatment unit is set above the pubis in uterus projection zone of moderate soft tissue compression and in sacrum vicinity zone.

EFFECT: enhanced effectiveness of treatment; suppressed toxic free radical reactions.

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Description

The invention relates to medicine, and specifically to obstetrics and gynecology, and can be used in the complex treatment of endometritis in puerperas.

The frequency of purulent-inflammatory complications in the postpartum period varies widely and depends on the level of infection risk - up to 80.4%. The most common postpartum complication is postpartum endometritis, which accounts for up to 80% of all postpartum infections [1].

The influence of an infectious agent on the nonspecific resistance of an organism is known, which occurs due to the transformation of a number of biochemical reactions, depending in particular on oxygen homeostasis of an organism [2].

Data have been obtained on the beneficial effect of laser therapy on the course of purulent-inflammatory diseases in the postpartum period [3]. However, intracavitary and intrauterine irradiation, mainly used in puerperas with endometritis, as well as the interaction of the method with drugs reduce its effectiveness.

The prototype selected a method of treating postpartum endometritis with the Milta-F magnetic-ir laser apparatus.

The aim of the invention is to increase the effectiveness of therapy for postpartum endometritis by normalizing the state of lipid peroxidation processes, and therefore, suppressing the effects of toxic processes of free radical reactions in the body.

This goal is achieved by using infrared low-intensity laser radiation using the ALTO-05M device using ILPN-112 semiconductor laser diodes.

The method is as follows. For women with postpartum endometritis, laser therapy is carried out from the moment of diagnosis or from 2 days after curettage from the uterine cavity in order to achieve anti-inflammatory, analgesic and antispasmodic effects (against the background of adequate antibacterial treatment). The procedure is carried out daily 2 times a day with a break of 3 hours for 5-10 days. The first 3 days intravaginally through a special nozzle (modulation frequency of 70 Hz, radiation power of the fiber 40 mW, exposure 5 minutes). Then the treatment is performed percutaneously: the treatment terminal is placed over the pubis (uterine projection zone) with moderate compression of soft tissues, the zones in the sacral region (5 minutes per zone) have a modulation frequency of 50 Hz, and a fiber power of 35 mW.

Example 1. Patient T., 22 years old, was transferred to the gynecological department 1 ICD 05/17/99, IB 2377 with a diagnosis of "Late postpartum period. Endometritis. " The diagnosis was made on the basis of data from an objective examination and ultrasound of the pelvic organs. Upon admission, lipid peroxidation (LPO) indicators were determined: the level of lipid hydroperoxides (GPL) was 13.8 nmol / ml, diene conjugates (DC) 3.0 nmol / ml and malondialdehyde (MDA) 7.9 nmol / ml . The obtained indicators characterize the significant activation of LPO processes and, as a consequence, this increase in toxic processes of free radical reactions in the puerperal organism. Applying low-intensity laser therapy (LILT) according to the technique described by us, there was a decrease in LPO: GPL to 8.7 nmol / ml, DC - 16.5 nmol / ml and MDA - 4.0 nmol / ml, which was close to that in healthy puerperas. Further therapy was effective and the woman was discharged home on day 7.

Example 2. Patient S., 20 years old, was admitted to the gynecological department 1 ICD June 7, 1999, IB No. 2645, with sluggish endometritis after delivery. The diagnosis is confirmed by pelvic echography. Before LILT, the level of lipid hydroperoxides (GPL) was 14.3 nmol / ml, diene conjugates (DC) - 22.7 nmol / ml and malondialdehyde (MDA) - 8.1 nmol / ml, which also indicated an increase in toxic processes free radical reactions in the puerperal organism and the activation of LP. After applying LILT according to the method described by us, a decrease in the activity of LPO processes was noted, which was characterized by a decrease in GPL to 8.2 nmol / ml, DC to 15.8 nmol / ml and MDA to 4.1 nmol / ml. Thus, the use of LILT allowed us to normalize the state of membrane lipid peroxidation. The postpartum woman was discharged from the hospital for 7 days.

A comparative evaluation of the LPO indices in puerperas with endometritis, who received traditional treatment, and with the use of LILT in the postpartum period, the data are presented in the table.

Table Clinical group Qty GPL, nmol / ml DC, nmol / ml MDA, nmol / ml 1. Healthy puerperas twenty 4.7 ± 0.27 13.0 ± 0.95 2.4 ± 0.15 2. Endometritis before treatment fifty 13.9 ± 0.54 p _1.2 <0.001 22.0 ± 0.68 P _1.2 <0.001 7.8 ± 0.34 P _1.2 <0.001 3. After traditional therapy thirty 9.7 ± 0.54 p _2.3 <0.01 19.0 ± 0.65 p _2.3 > 0.05 6.1 ± 0.27 P _2.3 > 0.05 4. After applying NILT thirty 8.8 ± 0.46
P _2.4 <0.001 16.1 ± 0.34
p _2.4 <0.01
P _3.4 <0.05 4.1 ± 0.18
P _2.4 <0.01
P _3.4 <0.05

Thus, the proposed method for the treatment of postpartum endometritis normalizes the state of lipid peroxidation processes, which suppresses the effect of toxic processes of free radical reactions in the puerperas and allows to increase the effectiveness of complex therapy of endometritis.

Information sources

1. Obstetric and gynecological care (a guide for doctors). Ed. Acad. RAMP V.I. Kulakova. - Moscow, MEDpress, 2000 .-- 510 p.

2. Omelyanyuk E.V., Pokrovsky S.E. Comprehensive treatment of women with postpartum inflammatory diseases, taking into account the state of the antioxidant system // West. Ross assoc. obstetrician-gynec. - 1997. - No. 3. - P.82-83.

3. Pokrovsky S.E. The use of laser therapy with antioxidant drugs in the treatment of postpartum purulent-inflammatory diseases: Abstract. diss .... cand. honey. sciences. - SPb., 1998. - 17 p.

Claims (1)

A method for the treatment of postpartum endometritis, including the use of laser therapy, characterized in that they use the ALTO-05M infrared low-intensity laser daily 2 times a day for 5-10 days: the first 3 days intravaginally with a nozzle with a modulation frequency of 70 Hz, a light output of 40 mW, exposure time of 5 minutes, and then the treatment is carried out percutaneously for 5 minutes per zone, with a modulation frequency of 50 Hz, a radiation power of 35 mW: the treatment terminal is placed over the pubis - the area of the projection of the uterus with moderate compression of soft tissues her and the zone in the sacral region.