RU2523669C1 - Scanning laser therapeutic apparatus - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: scanning laser therapeutic apparatus comprises an electronic unit with a power source, a pulse driving generator, a pulse router, a pulse former; the apparatus also accommodates an emitting therapeutic terminal having a body with a set of at least three semiconductor laser emitters connected to outputs of the pulse former; the terminal is provided with a radiation-transparent lid; the apparatus additionally comprises a multi-channel voltage regulator, an output of which is connected to an input of the pulse router and an input of which is connected to the power source. The pulse former and router are integrated into the body of the emitting therapeutic terminal, while the body is trapezium-shaped with a concave wide edge wherein the laser emitters are arranged along. Alternatively, axes of all the laser emitters are parallel to each other and to a long axis of the trapeze. According to the other version, an axis of each laser emitter is perpendicular to a tangent line to an arch of the concave portion of the body in the emitter axis point.

EFFECT: optimising the scanning nature of the laser light effect with regard to monitoring of its amplitude-frequency parameters and controlling the nature of distribution of a power flow depending on the nature of a radiation target.

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Description

The invention relates to medical equipment, namely to devices for laser therapy. Currently, laser therapy is widely used to treat various diseases associated with impaired blood flow, an inflammatory component, trophic disturbance, and pain. However, most modern laser therapy devices, although incorporating matrix elements consisting of a set of laser sources, act on a biological object statically, without taking into account the dynamic component inherent in all living tissues and organisms. Since all processes in a living organism occur in dynamics, dynamic radiation is more actively absorbed by them [1].

A well-known medical terminal containing a microcontroller, an indication unit and a control panel connected to it, an amplifier connected to an optical emitter and additionally a key amplifier, a transformer and electrodes that are exposed to electric current along with optical radiation [Certificate for utility model No. 40899 of 04/14/2004 ].

The disadvantage of this device is the static effect, the inability to dose the level of radiation and, as a consequence, low therapeutic activity.

Known emitting medical terminal [Certificate for utility model No. 23774 from 01/21/2002] for magnetic laser therapy, containing a pulsed laser emitter, infrared LEDs and additionally introduced at least one pulsed laser emitter. In this case, the radiation sources are located in the housing, which is equipped with a protective cover made of a material transparent to radiation.

The disadvantage of this device is also the static effect, low biotropic saturation of the used exposure factors and, therefore, the lack of effectiveness of treatment. The inability to vary the intensity of laser radiation does not allow to dose it, depending on the nature of the disease, the age of the patient and other factors.

Closest to the proposed device is a magnetic laser therapy containing a semiconductor laser emitter and interconnected communicator, synchronizer, LEDs and a photodetector installed in the nozzle, an indicator associated with a photodetector, a current adjustment unit connected to the LEDs and a communicator, connected in series with a pulse master a generator connected to the second output of the synchronizer and a modulator is a pulse shaper connected to a semiconductor laser radiation to the teacher [Patent for invention No. 2072879 dated 02/09/1990].

This device does not allow you to adjust the power of a set of laser emitters during their sequential switching and does not allow to implement the scanning mode of the laser beam with a change in its frequency-amplitude characteristics.

The task to which the invention is directed is to increase the efficiency of laser treatment, expand areas and ease of use in medicine.

The technical result consists in optimizing the scanning nature of the effect of the laser beam in terms of controlling its amplitude-frequency parameters and controlling the nature of the distribution of the power flux depending on the nature of the irradiation target.

To solve this problem, an apparatus for scanning laser therapy, consisting of an electronic unit with a power supply, a pulse master oscillator, a switch-distributor of pulses, a pulse shaper and a radiating treatment terminal, has its own housing with a set of at least three semiconductor laser emitters connected to the outputs of the pulse shaper and equipped with a cover transparent to radiation, an adjustable multi-channel voltage stabilizer, the output of which with It is connected to the input of the switch-distributor of pulses, and the input is connected to a power source, while the pulse shaper and the switch-distributor are located in the case of the radiating medical terminal, and the case itself has a flat trapezoidal shape with a concave wide face, along which the laser emitters are located one after another .

Alternatively, the axes of all laser emitters are parallel to each other and to the longitudinal axis of the trapezoid. In another embodiment, the axis of each of the laser emitters is perpendicular to the tangent to the arc of the concave part of the housing at the location of the axis of the emitter.

Introduction to the electronic unit of an adjustable multi-channel voltage stabilizer, the output of which is connected to the inputs of a communicator - pulse distributor, allows you to adjust the output power level of laser emitters when they are switched using a switch-distributor of pulses, realizing a scanning mode of laser exposure during treatment.

The location of the pulse shaper and the switch in the housing of the radiating medical terminal eliminates the inductive effect and losses in the conductors when the laser emitters are supplied with short pulses.

The design of the body of the radiating treatment terminal in the form of a flat trapezoid with a concave wide face, along which the laser emitters are located one after another, allows you to place the pulse shaper and switch circuit in this case, and on the other hand, makes the terminal ergonomically adapted to irradiate most parts of the body oval configuration (lower and upper jaw, cranium, large joints of the limbs).

The location of the laser emitters in the terminal housing parallel to each other and the longitudinal axis of the trapezoid allows you to get a poorly scattered energy flow during irradiation of bulk tissue.

The location of the laser emitters in the terminal in such a way that their axes are perpendicular to the arc of the concave part of the body at the location of the emitter allows you to get a converging energy flow in a localized area of the fabric, if necessary, exposure to a dense stream of radiation.

Figure 1 shows a block diagram of an apparatus for scanning laser therapy. Figure 2 shows the block design of the apparatus with a radiating treatment terminal, where the axes of all laser emitters are installed parallel to each other and the longitudinal axis of the trapezoidal body. Figure 3 shows an embodiment of the treatment terminal, in which the axis of each of the laser emitters is perpendicular to the tangent (not marked) to the arc of the concave part of the body at the location of the emitter axis.

The apparatus contains a radiating treatment terminal 1 and an electronic unit 2, the purpose of which is to form the initial pulses and control the radiation parameters of the treatment terminal. The treatment terminal 1 includes a short-pulse shaper 4 and a switch-distributor 3, the outputs of which are connected to a sequence of semiconductor laser emitters 8. The electronic unit 2 contains a master pulse generator 5, the output of which is connected to a short-pulse shaper 4 and their switch-distributor 3, a power supply 6 and an adjustable multi-channel voltage stabilizer 7, the output of which is connected to the output of the switchboard-distributor 3.

The treatment terminal is made in the form of a molded plastic box, consisting of two detachable parts fastened with screws. The box is made in the form of a trapezoid, the wide face of which has a concave surface, covered with a thin plate (thickness 1.5 mm) made of organic glass transparent to radiation. The thickness of the box is 19 mm, the transverse dimension is 71 mm, and the longitudinal (along the axis) is 65 mm. Inside the terminal 1 case there is a short-pulse shaper 4 circuit and their switch-distributor 3. To exclude inductive losses in the supply circuits, the semiconductor laser emitters 8 are located in close proximity to the shaper 4 and switch 3 along the generatrix of the wide face of the terminal 1 case. The total number of laser emitters - 6 pcs., Laser type - semiconductor infrared radiation range (λ = 880-960 nm). The diameter of the laser emitter body is 5.5 mm, the length is 7 mm.

The device operates as follows.

The treatment terminal 1 with a concave surface is contacted on the irradiated area of the patient’s body (projection of the teeth of the upper or lower jaw, projection of the cervical sympathetic ganglia, large joint - knee, thigh). They include a power source 6, which starts the pulse master oscillator 5 and an adjustable voltage regulator 7, assembled on the basis of a Schmitt trigger, the frequency of which is set by the RC circuit and forms the scanning frequency of the laser beam. From a pulse master oscillator 5, a train of pulses is supplied to a short pulse shaper 4, where short pulses with a given duty cycle are generated by delaying the train of pulses of a master oscillator 5 on chip elements by logical summation with pulses of a master oscillator 5. Short pulses with a given duration and duty cycle are fed to the switch a pulse distributor 3, which simultaneously receives pulses from a master oscillator 5 and a voltage from an adjustable stabilizer 7.

The switch-distributor of pulses 3 by decoding generates from a continuous sequence of pulses of the master oscillator 5 a per-channel distribution of pulses corresponding to the number of connected laser emitters 8. At the output of the switch-distributor 3 there are keys based on field-effect transistors that trigger a sequence of laser emitters 8. Voltage from an adjustable stabilizer 7, received on the keys of the switch-distributor 3, forms the corresponding power level of the laser emitters 8 minutes and lasers switching frequency (scanning frequency). A particular power level is established taking into account the severity, duration of the disease, the age of the patient, as well as the depth and anatomical features of the irradiated tissues. At the end of the procedure, the radiating treatment terminal is removed from the patient, and the device is put into standby mode or turned off.

The device can have two identical outputs for connecting simultaneously two medical terminals of different design. The treatment terminal shown in Fig. 1 can be connected to one output, the axes of the laser emitters 8 of which are parallel to each other and the axes of the treatment terminal 1. The treatment terminal shown in Fig. 3 can be connected to the second output, the axes of the laser emitters 8 of which are perpendicular to the tangent to arc of the concave part of the body at the point of location of the axis of the emitter. Such a treatment terminal forms a converging stream of laser energy with a maximum in the geometric center of the oval of building 1.

The claimed device has been tested in the treatment of dental diseases (periodontitis, periodontal disease, pain after dental implantation), neurological diseases (facial neuritis, partial atrophy of the optic nerve, vegetovascular dystonia).

In the treatment of dental diseases (60 patients, of which periodontitis - 36, periodontal disease - 6, pain after implantation - 18), a treatment terminal with parallel axes of laser emitters was superimposed on the projection of the irradiation zone so that the concave surface of terminal 1 fits the buccal surface in the projection of the irradiation zone. The radiation power level in the first procedures was set at 20 W per pulse at an average power of 5 mW. Scanning frequency - 10-20 Hz. During treatment, starting from the middle of the course (5th session), the pulse power increased to 40 W, and the scanning frequency of the laser beam - 70-80 Hz. Exposure time 5-7 minutes. Each group of patients had a control group with a similar pathology, age and severity of the disease. Patients in the control group were treated with a single laser emitter of the same modification as in treatment terminal 1 with a fixed power of 20 watts per pulse (Intradont apparatus). The movement of the laser emitter along the affected area of the jaw was carried out manually by reciprocating movements. Exposure time 5-7 minutes.

Comparison of treatment results in patients treated with the claimed device and using the Intradont apparatus revealed a significant (1.8 times) reduction in the term for the relief of inflammation in periodontitis, a decrease in the term for relief of pain after implantation by 2.1 times, while reducing the number of complications is 1.55 times.

In the treatment of patients with partial atrophy of the optic nerve (20 people), the projection of the optic nerve was subjected to bitemporal technique at the level of the temporal lobe of the cranium. The radiation power in the pulse was set at 60 W (average power - 12 mW), the scanning frequency of the laser beam - 160 Hz.

In this case, a higher value of the laser beam power is due to the significant absorptive capacity of the cranium and the depth of the optic nerve. The study of the absorption level of these structures using model experiments led to the choice of this (60 W) pulse power value. The choice of the laser beam scanning frequency (160 Hz) is dictated by the close value of the speed of the nerve impulse from the retina to the optic cortex along the optic nerve [2]. Treatment of partial atrophy of the optic nerve with the claimed apparatus and comparison of the results with the control group (10 people) revealed an increase in visual acuity by an average of 0.31 ± 0.05 units, an expansion of the visual field by 35 ± 2.3 degrees.

In the treatment of facial nerve neuritis (15 people) and vegetative-vascular dystonia (22 people), a treatment terminal with a converging radiation flux was used (Fig. 3), where the axis of each laser emitter is perpendicular to the arc of the concave part of the body at the location of the emitter axis. In the first case, the terminal was located so that the pain point of exit of the facial nerve coincided with the convergence zone of the laser beams, in the second case, with the projection of the cervical sympathetic node (right- and left-sided). The power of pulsed radiation was 20 W; the scanning frequency increased during the course of treatment from 10 to 50 Hz. Comparison of treatment results with control groups (10 and 12 people, respectively) revealed a 3.3-fold decrease in pain syndrome with facial neuritis on the visual analogue pain scale and a 1.4-fold decrease in the number of patients with hypersympathicotonia. Normalization of vegetative status was observed 1.62 times more often when using the claimed apparatus compared to the control group, where a single laser emitter from the Intradont apparatus was used.

The use of the claimed apparatus increases the effectiveness of treatment, expands the field and the convenience of its use in medicine.

LITERATURE

1. Catcher B.C. Theoretical and practical aspects of general magnetotherapy // Vopr. health resort. and fizioter. - 2001, No. 5, p. 3-8.

2. Hubel D. Eye, brain, vision. M. World. 1990, 239 p.

Claims (3)

1. The apparatus for scanning laser therapy, consisting of an electronic unit with a power source, a pulse master oscillator, a switch-distributor of pulses, a pulse shaper and a radiating medical terminal having its own housing with a set of at least three semiconductor laser emitters connected to the outputs of the pulse shaper and equipped with a cover that is transparent to radiation, characterized in that an adjustable multi-channel voltage stabilizer is additionally introduced into the electronic unit, the output to of which is connected to the input of the switch-distributor of pulses, and the input is connected to a power source, while the pulse shaper and switch-distributor are located in the housing of the radiating medical terminal, and the case itself has a flat trapezoidal shape with a concave wide face, along which the laser emitters. 2. The apparatus according to claim 1, characterized in that the axes of all laser emitters are parallel to each other and to the longitudinal axis of the trapezoid housing. 3. The apparatus according to claim 1, characterized in that the axis of each of the laser emitters is perpendicular to the tangent to the arc of the concave part of the housing at the location of the axis of the emitter.

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