Wow, what a procedure. The use of ultraviolet irradiation in children and adults
The principle of the therapeutic effect of ultraviolet rays is due to their interaction with atoms and molecules, which is accompanied by the transition of the latter to an excited state. Photolysis of proteins and nucleic acids provokes the synthesis of neurotransmitters, cytokines, which, when released into the bloodstream, have a systemic effect. The positive effect of therapy on the human body is realized through several factors:
- UV erythema. Under the influence of irradiation, persistent vasodilatation and hyperemia of the skin are formed. At the same time, tissue trophism increases, the delivery of antibodies and active phagocytes to the focus of inflammation increases. Erythema also provides an analgesic effect.
- Metabolism regulation. Ultraviolet rays enhance the intensity of anabolic processes. Radiation stimulates the formation of vitamin D in the dermis.
- Bactericidal effect. The direct impact of UVR is realized through the destruction of the protein structures of the skin pathogenic microflora during irradiation. The indirect effect is due to an increase in general immunity.
- Changes in higher nervous activity. In small doses, UV rays stimulate blood circulation in the brain tissue, increase cognitive function. In patients, the tone of the parasympathetic and sympathetic nervous system is normalized.
Types of UV therapy
According to the number of treated areas and the technique of performing procedures, several varieties of physiotherapy techniques are distinguished. They differ in the strength and severity of the therapeutic effect and cost. The main options for ultraviolet radiation therapy:
- General UV therapy. It involves irradiation of the entire skin in special cabins with ultraviolet lamps. The technique has a powerful therapeutic effect, which is noticeable after the first physical procedure.
- Local UV therapy. To carry out therapy, small stationary emitters with special attachments are used. The procedure is used for somatic diseases affecting one anatomical area.
- OKUF therapy (quartz). The skin is irradiated with short-wave rays (180-280 nm), which have the most powerful bactericidal effect. To increase the therapeutic effect, small nozzles are used for insertion into the oral and nasal cavities and the external auditory canal.
- Ultraviolet blood irradiation (UFOI). An invasive technique that involves an express option for blood purification using a special system. The physiotherapy procedure has a general strengthening, anti-allergic and metabolic effect, and stimulates hematopoiesis.
Indications
Ultraviolet irradiation therapy has systemic effects on the human body, therefore it is recommended for use in many areas of medicine. Indications for ultraviolet light therapy are:
- Diseases of the genitourinary system. In men - prostatitis, urethritis, impotence. In women - chronic inflammation of the genital organs, vaginal candidiasis, late toxicosis. Ural irradiation increases the effectiveness of treatment of infertility and menopause.
- Skin diseases. Psoriasis, neurodermatitis, erysipelas, rosacea, acne. Allergic rashes - urticaria, eczema, atopic dermatitis.
- Endocrine disorders. Compensated diabetes mellitus, hypothyroidism, thyroiditis. Light therapy with ultraviolet radiation is also used for obesity.
- Damage to the gastrointestinal tract. Pancreatitis, gastritis, ulcerative colitis. Pathology of the biliary system - acalculous cholecystitis, biliary dyskinesia.
- Respiratory system diseases. Bronchial asthma, bronchitis, pneumonia. It is recommended as an auxiliary ultraviolet irradiation for lung abscess.
- ENT diseases. Rhinitis, sinusitis, pharyngitis, tonsillitis.
- Cardiovascular disorders. Angina pectoris, thrombophlebitis. UV light therapy slows down the development of cerebral atherosclerosis, chronic limb ischemia, and obliterating endarteritis.
- Surgical pathology. UV therapy is used to accelerate the healing of wounds, trophic ulcers, and bedsores.
- In pediatrics. Mastitis of newborns, staphyloderma, weeping navel. Ultraviolet irradiation reduces the signs of exudative diathesis.
Contraindications
During the procedure, the body experiences intense exposure, so the appointment of UV treatment has a number of limitations. There are absolute contraindications to the physiotherapeutic use of UV rays:
- systemic connective tissue diseases in the acute phase;
- circulatory failure 2-3 degrees;
- decompensated renal failure with uremia;
- photodermatoses;
- acute cerebrovascular accidents;
- active form of pulmonary tuberculosis;
- early post-infarction period;
- taking antibiotics from the tetracycline and chloramphenicol group.
General principles of ultraviolet therapy
Before carrying out a physical procedure, an individual biodose determination is required using a biological method. The results of the trial UV irradiation are assessed after 24 hours, after which the doctor prescribes a course of ultraviolet radiation therapy with an optimal erythemal dose. Therapy is started with small doses (1-2 individual biodoses), which, if the procedure is well tolerated, are gradually increased to 5-8.
For general therapy, special closed cabins are used, where light lamps are located in a certain order. The duration of the procedure ranges from 15 minutes for fair-skinned people to 30 minutes for dark-skinned patients. With local exposure, a limited area in the projection of the pathological focus or a reflex zone is irradiated. The standard course includes 10 sessions, which are performed at intervals of 1-3 days.
UVOC is distinguished by a more complex methodology and high cost. Under sterile conditions, a peripheral vein is punctured, the blood is gradually sent to the apparatus, where it is irradiated with an ultraviolet spectrum, and then flows back into the bloodstream. The duration of 1 session is from 40 to 60 minutes. The course of treatment includes 5-10 procedures, selected individually according to the patient’s condition.
Complications
Weak erythema that occurs after UV therapy in all patients and is not accompanied by pain indicates that the procedure was carried out correctly and the development of therapeutic effects. Specific complications occur extremely rarely:
- Burns. If the duration of the procedure is not observed or the biodose is increased too sharply, severe hyperemia with swelling, burning, and pain when touched is observed. The course of treatment is suspended until symptoms disappear, then lower doses of radiation are used.
- Photodermatitis. It develops when using photosensitizing drugs during a course of ultraviolet radiation therapy. It manifests itself as multiple itchy rashes and general malaise.
- Overheating. Sometimes it occurs after general exposure of the skin to ultraviolet rays. The patient experiences severe headache, nausea, and weakness.
A (nm) - long-wave UV radiation (LUV)
V (nm) - mid-wave (SUV);
C - (nm) - short-wave (SWF).
UV radiation is dosed using the Gorbachev-Dakfeld biological method. The method is simple and is based on the property of UV rays to cause erythema when irradiating the skin.
The unit of measurement in this method is one biodose. One biodose is taken to be the minimum time of irradiation of a given patient from a certain distance with a certain source of UV rays, which is necessary to obtain a weak, but clearly defined erythema. Time is measured in seconds or minutes.
General UFO is used for:
The face, chest and back are irradiated daily with erythema doses for 2-3 days. For catarrhal symptoms in the pharynx, the pharynx is irradiated for 4 days through a tube. In the latter case, irradiation begins with 1/2 biodose, adding 1-1/2 biodoses in subsequent irradiations.
Application of ultraviolet radiation to the skin of the chest using a perforated oilcloth localizer (PCL). The PCL determines the area to be irradiated (prescribed by the attending physician). Dose - 1-3 biodoses. Irradiation every other day, 5-6 procedures.
In the first days of the disease, ultraviolet irradiation of the nasal mucosa in suberythemal doses is prescribed, counting on the bactericidal effect of UV radiation.
UV irradiation of the plantar surfaces of the feet is prescribed. Dose 5-6 biodoses daily. The course of treatment is 4-5 procedures. UV irradiation through a tube of the nasal mucosa in the stage of attenuation of exudative phenomena. Irradiation begins with one biodose. By adding 1/2 biodose daily, the irradiation intensity is increased to 4 biodoses.
UV irradiation is carried out on the trachea area and on the skin of the back of the neck. Radiation dose - 1 biodose. Irradiation is carried out every other day, adding 1 biodose each, the course of treatment is 4 procedures. If the disease is prolonged, then after 10 days a UV irradiation of the chest is prescribed through an oilcloth perforated localizer. Biodoses daily. The course of treatment is 5 procedures.
UV irradiation is prescribed from the first days of the disease on the anterior surface of the neck, sternum, and interscapular region. Dosabiodoses. Irradiation alternates every other day on the posterior and anterior surfaces of the chest. Course of treatment 4 procedures.
UV irradiation of the chest is prescribed 5-6 days after the onset of the disease. UV irradiation is carried out through a localizer. Biodoses daily. The course of treatment is 5 irradiations. During the period of remission of the disease, general ultraviolet radiation is prescribed according to the basic regimen daily. The course of treatment is 12 procedures.
Both general and local irradiation can be used. The chest is divided into 10 sections, each measuring 12x5 centimeters. Every day, only one area is irradiated with erythema doses, limited by a line connecting the lower corners of the shoulder blades, and on the chest - by a line passing 2 cm below the nipples.
(Carried out in combination with UHF, SMV, infrared and magnetotherapy). In the early stage (before the formation of a purulent cavity), ultraviolet irradiation is prescribed. Dosabiodoses. Irradiation every other day. Course of treatment 3 procedures.
(In combination with SMV, UHF, infrared, laser and magnetotherapy). In the infiltration stage, ultraviolet irradiation of the axillary area every other day. The radiation dose is sequential biodoses. Treatment course: 3 irradiations.
Irradiation is carried out with a dose of 4-8 biodoses in order to create conditions for the best rejection of disintegrated tissues. In the second phase - in order to stimulate epithelization - irradiation is carried out in small suberythemal (i.e., not causing erythema) doses. The irradiation is repeated after 3-5 days. UV irradiation is carried out after primary surgical treatment. Dose - 0.5-2 biodoses, course of treatment 5-6 irradiations.
Irradiation is used in 2-3 biodoses, and the surface of undamaged skin surrounding the wound is also irradiated at a distance of 3-5 cm. Irradiation is repeated after 2-3 days.
UV irradiation is used in the same way as when irradiating clean wounds.
UV-bactericidal radiation of the fracture site or segmented zones is carried out after 2-3 days, each time increasing the dose by 2 biodoses, the initial one - 2 biodoses. Treatment course: 3 procedures for each zone.
General ultraviolet radiation is prescribed 10 days after the fracture according to the basic regimen daily. The course of treatment is 20 procedures.
Ultraviolet radiation after tonsillectomy of the tonsil niches is prescribed 2 days after the operation. Irradiation is prescribed with 1/2 biodose on each side. Daily increasing the dose by 1/2 biodose, the irradiation intensity is increased to 3 biodoses. The course of treatment is 6-7 procedures.
UFO begins with a suberythemal dose and quickly increases to 5 biodoses. Biodose radiation dose. The procedures are carried out after 2-3 days. The lesion is protected from healthy areas of the skin using a sheet or towel.
UV irradiation of the tonsils through a tube with a 45% cut bevel begins with 1/2 biodose, daily increased by 1/2 biodose every 2 procedures. Courses are held 2 times a year. A sterile tube is used to press the tongue through the patient’s wide open mouth so that the tonsil becomes accessible to UV irradiation. The right and left tonsils are irradiated alternately.
UV irradiation through the ear canal tube. Biodoses daily. The course of treatment is 6 procedures.
UV exposure of the nasal vestibule through a tube. Biodoses every other day. The course of treatment is 5 procedures.
UV irradiation with the long-wave part of the spectrum is prescribed according to a slow scheme. The course of treatment is 5 procedures.
UFO is prescribed according to the basic scheme daily. Course of treatment procedures.
Ural irradiation is prescribed as RUVA therapy (photochemotherapy). Long-wave UV irradiation is performed in combination with a photosensitizer (puvalene, aminefurin) taken by the patient 2 hours before irradiation at a dose of 0.6 mg per kilogram of body weight. The dose of radiation is prescribed depending on the sensitivity of the patient’s skin to UV rays. On average, ultraviolet radiation begins with a dose of 2-3 J/cm 2 and is increased to 15 J/cm 2 by the end of the course of treatment. Irradiation is carried out for 2 consecutive days with a rest day. The course of treatment is 20 procedures.
Ultraviolet radiation with a mid-wave spectrum (SUV) starts with 1/2 according to an accelerated scheme. Course of radiation treatment.
UV irradiation is prescribed for the anterior abdominal skin and skin of the back. UFO is carried out in zones with an area of 400 cm2. Biodoses for each area every other day. The course of treatment is 6 irradiations.
1. Ultraviolet irradiation of the external genitalia. Irradiation is carried out daily or every other day, starting with 1 biodose. Gradually adding 1/2 biodoses, the intensity of the effect is increased to 3 biodoses. The course of treatment is 10 irradiations.
2. General ultraviolet irradiation according to an accelerated scheme. Irradiation is carried out daily, starting with 1/2 biodose. Gradually adding 1/2 biodoses, the intensity of the effect is increased to 3-5 biodoses. Course of radiation treatment.
Ultraviolet irradiation of the external genitalia is prescribed. Biodose radiation dose daily or every other day. The course of treatment is 5-6 irradiations.
Ultraviolet irradiation using a tube is prescribed. Dose - 1/2-2 biodoses daily. The course of treatment is 10 procedures. Cervical erosion. Ultraviolet irradiation of the cervical area is prescribed using a tube and a gynecological speculum. Dose - 1/2-2 biodoses daily. Doses are increased every two procedures by 1/2 biodose. Course of treatment procedures.
Ultraviolet irradiation of the skin of the pelvic area in fields is prescribed. Biodoses for each field. Irradiation is carried out daily. Each field is irradiated 3 times with a break of 2-3 days. Course of treatment procedures.
Therapeutic physical factors have a homeostatic effect on various organs and systems, help increase the body's resistance to adverse effects, enhance its protective and adaptive mechanisms, have a pronounced sanogenic effect, increase the effectiveness of other therapeutic agents and reduce the side effects of drugs. Their use is accessible, highly effective and cost-effective.
ALGORITHM FOR CARRYING OUT THERMAL LIGHT IRRADIATION WITH A SOLUX LAMP
1. get acquainted with the doctor’s prescription, give the patient the desired position.
2. inspect the irradiation area
3. warn the patient about the intensity of the sensation of heat
4. install the irradiator at a given distance
5. set the time and turn on the alarm clock.
6. turn on the irradiator
7. monitor the patient’s condition during the procedure.
8. turn off the device at the clock signal.
9. inspect and dry the irradiation area with a towel
10. mark on the procedure card.
ALGORITHM FOR CONDUCTING ULTRAVIOLET IRRADIATION
1. Before turning on the irradiator, lower the reflector smoothly down and move it to the side.
2. turn on the switch on the panel in the cabin where the emitter is installed
3. turn on the device, if the lamp does not light up, repeat turning it on and off several times
4. To establish the operating mode of the lamp, you must wait a minute after ignition.
5. familiarize the patient with the rules of behavior during irradiation. During local irradiation, do not turn over; during general irradiation, turn over after a period of time, at the command of the nurse.
6. The patient undresses partially or completely, puts on glasses, the nurse also wears glasses, lies down or sits on the couch.
7. To carry out local irradiation in an erythemal dose, limit the field of exposure with a sheet, cover the irradiated area of skin with a napkin.
8. Install the lamp at a given distance from the body surface and secure the reflector in the required position.
9. Remove the napkin from the area of the body being irradiated and note the start time of irradiation.
10. at the end of the exposure time, move the irradiator reflector aside, remove the sheet from the body, invite the patient to stand up, get dressed, remove safety glasses.
11. warn the patient about the appearance of erythema after a few hours and remind him about the time of visiting the office for the next irradiations.
Ultraviolet radiation in medicine, devices, indications, methods
Ultraviolet radiation in medicine is used in the optical range (integral spectrum), which is divided into short-wave region (C or AF) nm, medium-wave (B) nm and long-wave (A) nm (DUV).
The mechanism of action of UV radiation is biophysical, humoral and neuro-reflex:
Protein inactivation, denaturation and coagulation;
Photolysis - breakdown of complex protein structures - release of histamine, acetylcholine, biogenic amines;
Photooxidation - increased oxidative reactions in tissues;
Photosynthesis - reparative synthesis in nucleic acids, elimination of damage in DNA;
Photoisomerization is an internal rearrangement of atoms in a molecule, substances acquire new chemical and biological properties (provitamin D2, D3),
Erythema, with CUF develops 1.5-2 hours, with DUF hours;
Central and peripheral nervous system;
Autonomic nervous system;
All types of metabolism, mineral metabolism;
Respiratory organs, respiratory center.
Painkiller (A, B, C);
Epithelizing, regenerating (A, B)
Desensitizing (A, B, C);
Regulation of vitamin balance “D”, “C” and metabolic processes (A, B).
Injury to soft tissues and bones;
Burns and frostbite;
Diseases of the musculoskeletal system, joints, rheumatism;
Infectious diseases - influenza, whooping cough, erysipelas;
Pain syndrome, neuralgia, neuritis;
ENT diseases - tonsillitis, otitis, allergic rhinitis, pharyngitis, laryngitis;
Compensation for solar deficiency, increasing the stamina and endurance of the body.
Indications for ultraviolet irradiation in dentistry
Diseases of the oral mucosa;
Dental diseases - non-carious diseases, caries, pulpitis, periodontitis;
Inflammatory diseases of the maxillofacial area;
Predisposition to bleeding
Functional kidney failure,
Stage III hypertension,
Severe forms of atherosclerosis.
OKN-11M (DRT-230) - local irradiation
Mayachnye OKB-ZO (DRT-1000) and OKM-9 (DRT-375) - group and general irradiation
ON-7 and UGN-1 (DRT-230). OUN-250 and OUN-500 (DRT-400) - local irradiation
OUP-2 (DRT-120) - otolaryngology, ophthalmology, dentistry.
Tripod-mounted (OBSh) and mobile (OBP)
Local (BOD) with lamp DRB-8, BOP-4, OKUF-5M
For blood irradiation (AUFOK) - MD-73M “Isolde” (with low pressure lamp LB-8).
Suspended reflected distribution (OED)
Slow (from 1/8 to 2 biodoses, adding 1/8 each)
Accelerated (from 1/2 to 4 biodoses, adding 1/2 at a time).
Erythema small (1-2 biodoses)
Medium (3-4 biodoses)
Large (5-6 biodoses)
Hypererythemal (7-8 biodoses)
Massive (over 8 biodoses).
Direct radiation for a period of time, in the absence of people.
Algorithm for determining individual biodose during ultraviolet irradiation
1. Position the patient lying or sitting, wearing sunglasses.
2. A biodosimeter with closed windows is attached to the corresponding area of the skin; for general irradiation, it is placed on the lower abdomen.
3. Fix the biodosimeter on the patient’s body using ribbons.
4. Areas of the body that are not subject to irradiation are covered with a sheet.
5. The lamp is installed above the biodosimeter at a distance of 50 cm.
6. Plug in the lamp using the power cord, turn the switch knob to the on position, and warm up for 2 minutes.
7. Open the biodosimeter holes sequentially every 30 seconds and conduct irradiation.
8. After irradiating the 6th hole, quickly move the reflector with the lamp to the side.
9. Determine the biodose an hour after irradiation (erythema).
11. Calculate the biodose using the formula: X = t (m – n + 1), where X is the biodose value, t is the irradiation time of the last hole (30 sec), m is the number of biodosimeter holes (6 pieces), n is the number of erythema stripes that appear . The result is the formula : X = 30 (6 – n + 1).
12. After calculating the biodose, set the irradiation time for a certain area of the body.
Algorithm for conducting UV irradiation on the skin
Ultraviolet irradiator on a tripod.
Designed for individual local ultraviolet irradiation.
2. Set the power switch knob to the “On” position.
3. After lighting the lamp, wait 10 minutes to establish the operating mode.
4. Lay or sit the patient down and put on sunglasses.
5. Cover areas not exposed to radiation with a sheet or napkin.
6. Place the lamp in the desired position and perform irradiation (the lamp is installed on the side of the patient at a distance of cm.
7. Irradiate the skin. The time depends on the individual biodose.
8. The illuminator can be turned on again only after the lamp has completely cooled down in a minute.
9. Warn the patient not to go outside for min.
10. Mark the procedure performed on the procedure sheet.
Algorithm for conducting ultraviolet irradiation on a quartz tube
1. Read the doctor’s prescription.
2. Turn the power switch knob to the “On” position, and the signal light will light up.
3. Insert a removable tube (nose, ear, throat) into the reflector hole.
4. After warming up the lamp, sterile tubes are inserted to a depth of 2-5 cm into the mouth or nose area.
5. Irradiation is carried out according to the scheme, starting from 30 seconds, increasing the exposure time to 2-3 minutes.
6. Turn the power switch knob to the “Off” position.
7. Place the tubes in a container with a disinfectant solution.
8. Mark the procedure performed on the procedure sheet.
Algorithm for paraffin treatment
1. Read the doctor’s prescription.
2. Line the cuvette with oilcloth, protruding 5 cm along the edges.
3. Pour the melted paraffin into a cuvette 2-3 cm thick.
4. Allow the paraffin and ozokerite to cool to a temperature of one degree.
5. Give the desired position. Expose the area of the procedure.
6. Warn the patient about a feeling of warmth and slight pressure as it cools.
7. The frozen but still soft paraffin is removed from the cuvette along with the oilcloth and applied to the area of the body to be exposed to namin.
8. Cover the treatment area with a blanket.
9. At the end of the procedure, remove the blanket and remove the oilcloth with coolant.
10. After ozokerite, wipe the skin with a cotton swab moistened with Vaseline.
11. Warn the patient not to go outside for min.
12. Mark the procedure performed on the procedure sheet.
Ultraviolet irradiation (part 2). Mechanism of action.
Mechanism of therapeutic effects
When ultraviolet radiation quanta are absorbed in the skin, the following photochemical and photobiological reactions occur:
Destruction of protein molecules;
Formation of more complex molecules or molecules with new physicochemical properties;
The severity of these reactions with the manifestation of subsequent therapeutic effects is determined by the spectrum of ultraviolet radiation. Based on wavelength, ultraviolet irradiation is divided into long, medium and short wave. From the standpoint of practical physiotherapy, it is important to distinguish the zone of long-wave ultraviolet rays (DUV) and the zone of short-wave ultraviolet rays (SWUV). DUV and AF radiation are combined with medium wave radiation, which is not specially distinguished.
There are local and general effects of UV rays.
The local effect manifests itself in the skin (UV rays penetrate no further than 1 mm). It is noteworthy that UV rays do not have a thermal effect. Externally, their effect is manifested by redness of the irradiation site (with short-wave irradiation after 1.5-2 hours, with long-wave irradiation after 4-6 hours), the skin becomes swollen and even painful, its temperature rises, and redness lasts for several days.
With repeated exposure to the same area of skin, adaptation reactions develop, which is externally manifested by thickening of the stratum corneum of the skin and deposition of the melanin pigment. This, in its own way, is a protective-adaptive reaction to UV rays. The pigment is formed under the influence of DUV rays, which are also characterized by an immunostimulating effect.
The rays of the KUF zone have a powerful bactericidal effect. KUV rays are absorbed primarily by proteins contained in the cell nucleus, while DUV rays are absorbed by protoplasmic proteins. With sufficiently intense and prolonged exposure, destruction of the protein structure occurs, and as a consequence of this, the death of epidermal cells with the development of aseptic inflammation. The destroyed protein is broken down by proteolytic enzymes, biologically active substances are formed: histamine, serotonin, acetylcholine and others, and the processes of lipid peroxidation are enhanced.
UV rays stimulate the activity of cell division in the skin, as a result, wound healing processes are accelerated and the formation of connective tissue is activated. In this regard, they are used to treat slow-healing wounds and ulcers. Neutrophil and macrophage cells are activated, which increases the skin's resistance to infection and is used to treat and prevent inflammatory skin lesions.
Under the influence of erythemal doses of UV rays, the sensitivity of the nerve receptors of the skin decreases, so UV rays are also used to reduce pain.
The general effect, depending on the dosage, consists of humoral, neuro-reflex and vitamin-forming effects.
The general neuro-reflex effect of UV rays is associated with irritation of the extensive receptor apparatus of the skin. The general effect of UV rays is caused by the absorption and entry into the bloodstream of biologically active substances formed in the skin and stimulation of immunobiological processes. As a result of regular general exposure, local protective reactions are strengthened. The effect on the endocrine glands is realized not only through the humoral mechanism, but also through reflex effects on the hypothalamus.
The vitamin-forming effect of UV rays is to stimulate the synthesis of vitamin D under the influence of UV rays.
Ultraviolet irradiation also has a desensitizing effect, normalizes blood clotting processes, and improves lipid (fat) metabolism. Under the influence of ultraviolet rays, the functions of external respiration improve, the activity of the adrenal cortex increases, the supply of oxygen to the myocardium increases, and its contractility increases.
Therapeutic effect: analgesic, anti-inflammatory, desensitizing, immunostimulating, restorative.
Suberythemal and erythemal doses of ultraviolet radiation are used in the treatment of diseases such as acute neuritis, acute myositis, bedsores, pustular skin diseases, erysipelas, trophic ulcers, sluggish wounds, inflammatory and post-traumatic diseases of the joints, bronchial asthma, acute and chronic bronchitis, acute respiratory diseases, chronic tonsillitis, inflammation of the uterine appendages. Also to improve recovery processes - for bone fractures, normalize phosphorus-calcium metabolism
Short-wave ultraviolet irradiation is used for acute and subacute diseases of the skin, nasopharynx, inner ear, respiratory diseases, for the treatment of inflammatory diseases of the skin and wounds, skin tuberculosis, prevention and treatment of rickets in children, pregnant and lactating women, as well as for air disinfection.
Local UV irradiation of the skin is indicated:
in therapy - for the treatment of arthritis of various etiologies, inflammatory diseases of the respiratory system, bronchial asthma;
in surgery - for the treatment of purulent wounds and ulcers, bedsores, burns and frostbite, infiltrates, purulent inflammatory lesions of the skin and subcutaneous tissue, mastitis, osteomyelitis, erysipelas, the initial stages of obliterating lesions of the vessels of the extremities;
in neurology - for the treatment of acute pain syndrome in pathology of the peripheral nervous system, consequences of traumatic brain and spinal injuries, polyradiculoneuritis, multiple sclerosis, parkinsonism, hypertension syndrome, causalgic and phantom pain;
in dentistry - for the treatment of aphthous stomatitis, periodontal disease, gingivitis, infiltrates after tooth extraction;
in gynecology - in the complex treatment of acute and subacute inflammatory processes, with cracked nipples;
in pediatrics - for the treatment of mastitis in newborns, weeping navel, limited forms of staphyloderma and exudative diathesis, atopy, pneumonia;
in dermatology - in the treatment of psoriasis, eczema, pyoderma, herpes zoster, etc.
ENT - for the treatment of rhinitis, tonsillitis, sinusitis, otitis, peritonsillar abscesses;
in gynecology - for the treatment of colpitis, cervical erosion.
Contraindications to UV irradiation:
Irradiation should not be carried out at elevated body temperatures. The main contraindications to the procedure: malignant neoplasms, tendency to bleeding, active pulmonary tuberculosis, kidney disease, neurasthenia, thyrotoxicosis, photosensitivity (photodermatoes), cachexia, systemic lupus erythematosus, circulatory failure stage II-III, stage III hypertension, malaria, Addison's disease , blood diseases. If headache, nervous irritation, dizziness and other unpleasant symptoms appear during the procedure or after it, you must stop treatment and consult a doctor. If a quartz lamp is used to disinfect premises, then at the time of quartzing there should be no people or animals in it.
Using ultraviolet light, the room is disinfected. You can quartz a room, which is an effective method of combating and preventing various diseases. Quartz lamps are used in medical institutions, preschool institutions and at home. You can irradiate a room, children's toys, dishes, and other household items, which helps in the fight against morbidity during periods of exacerbation of infectious diseases.
Before using a quartz lamp at home, you should definitely consult your doctor about contraindications and appropriate dosage, since there are certain conditions for using special equipment. Ultraviolet rays are biologically active and can cause serious harm if used improperly. The sensitivity of the skin to UV radiation varies among people and depends on many factors: age, skin type and its qualities, general condition of the body and even the time of year.
There are two basic rules for using a quartz lamp: you must wear safety glasses to prevent eye burns and do not exceed the recommended exposure time. Safety glasses are usually included with the UV irradiation machine.
Conditions for using a quartz lamp:
Areas of skin that are not irradiated should be covered with a towel;
Before the procedure, it is necessary to let the device work for 5 minutes, during which time a stable operating mode is established;
The device must be located at a distance of half a meter from the irradiated skin area;
The duration of irradiation increases gradually - from 30 seconds to 3 minutes;
One area can be irradiated no more than 5 times, no more than once a day;
At the end of the procedure, the quartz lamp must be turned off; a new session can be carried out 15 minutes after it has cooled;
The lamp is not used for tanning;
Animals and domestic plants should not enter the irradiation zone;
Turning the irradiator on and off must be done wearing light-protective glasses.
Some treatment methods:
In order to prevent viral diseases, the mucous membrane of the nose and the back wall of the pharynx are irradiated through tubes. Procedures are carried out daily for 1 minute for adults (0.5 minutes for children), for one week.
Acute respiratory diseases, pneumonia, bronchitis, bronchial asthma:
Thus, irradiation of the chest for pneumonia is carried out over 5 fields using a perforated localizer. First and second fields: half of the back surface of the chest - right or left, upper or lower. The patient's position is lying on his stomach. Third and fourth fields: lateral surfaces of the chest. The patient's position is lying on the opposite side, with his arm thrown behind his head. Fifth field: the anterior surface of the chest on the right, with the patient lying on his back. Irradiation time is from 3 to 5 minutes per field. One field is irradiated on one day. Irradiation is carried out daily, each field is irradiated 2-3 times.
To make a perforated localizer, you need to use a medical oilcloth measuring 40*40cm and perforate it with 1.0-1.5 cm holes. At the same time, you can irradiate the plantar surfaces of the feet from a distance of 10 cm for 10 minutes.
In the initial period of the disease, ultraviolet irradiation of the plantar surfaces of the feet is performed. Distance 10cm for 10 minutes, 3-4 days.
UV irradiation of the mucous membrane of the nose and pharynx is carried out using a tube. Dose from 30 seconds with daily gradual increase to 3 minutes. The course of irradiation is 5-6 procedures.
The area of the external auditory canal is irradiated through a 5mm tube for 3 minutes, the course of irradiation is 5-6 procedures.
Acute pharyngitis, laryngotracheitis:
UV irradiation of the anterior surface of the chest, trachea, and posterior surface of the neck is performed. Dose from a distance of 10 cm for 5-8 minutes; as well as ultraviolet radiation of the posterior pharyngeal wall using a tube. During the procedure, you must pronounce the sound “a-a-a-a”. Dose 1 min. The duration of irradiation increases every 2 days to 3-5 minutes. A course of 5-6 procedures.
Ultraviolet radiation of the palatine tonsils is performed through a tube with a ring cut. The procedure is performed with the mouth wide open and the tongue pressed to the bottom, and the tonsils should be clearly visible. The irradiator tube, with a cut towards the tonsil, is inserted into the oral cavity at a distance of 2-3 cm from the surface of the teeth. The UV ray is directed strictly to one tonsil. During the procedure, you must pronounce the sound “a-a-a-a”. After irradiation of one tonsil, the second is irradiated. Start with 1 minute after 1-2 days, then 3 minutes. Course of treatment procedures.
Chronic periodontal disease, acute periodontitis:
UV irradiation of the gum mucosa is carried out through a tube with a diameter of 15 mm. In the irradiation zone, the lip and tongue are moved to the side with a spatula or spoon so that the beam falls on the mucous membrane of the gums. By slowly moving the tube, all mucous membranes of the gums of the upper and lower jaw are irradiated. Duration of irradiation during one procedure: min. The course of irradiation is 6-8 procedures.
UFO is carried out in turn: the first day is the face, the second day is the front surface of the chest, the third is the scapular area of the back. The cycle is repeated 8-10 times. Irradiation is carried out from a distance of cm, the duration of irradiation is minutes.
After cleansing a purulent wound from necrotic tissue and purulent plaque, UV irradiation is prescribed to stimulate wound healing, immediately after treating the wound. Irradiation is carried out from a distance of 10 cm, time 2-3 minutes, duration 2-3 days.
UFO continues before and after independent or surgical opening of the abscess. Irradiation is carried out from a distance of 10 cm, duration of procedures. Course of treatment procedures.
Ultraviolet irradiation (UV)
Ultraviolet irradiation of the child's body and indoor air are important for the health of children. UVR has a stimulating effect on all processes in the body, increases its defenses, causes rearrangement in the electrolyte system and intensifies oxidative processes in the body. With quartz irradiation, the greatest effect is achieved in the early stages of influenza disease. Irradiation of the tonsils, in addition to general ultraviolet irradiation, significantly increases the effectiveness of treatment.
E.Ya. Ginzburg was the first to establish that physiotherapy is irritation therapy designed to stimulate the body's response. He was the first to describe an algorithm for preventive ultraviolet radiation in children. General irradiation of children should be carried out every other day, but exceptions to the rules are quite acceptable. The total number of sessions per course is 20. The course can be repeated after 2–3 months. It is advisable that the duration of the last sessions for children of all ages does not exceed 20 minutes (10 + 10 minutes front and back). If you miss 2-3 sessions, you should start irradiation with the last dose. If the child received 15 or more sessions before missing it, then this can be limited.
Currently, preventive ultraviolet irradiation of children in preschool educational institutions is a planned health procedure that should be carried out in two 20-day courses of increasing biodose in the fall and spring. However, such a UFO scheme is difficult to implement in full in practice, so in most preschool institutions they are limited to two 10-day cycles. Preference is also given to a simpler method of quartz irradiation of the premises of group preschool educational institutions with bactericidal lamps BUV-15 or BUV-30, irradiation of children with the long-wavelength UV spectrum from lamps EUV-15 and EUV-30, placed in fittings together with fluorescent lamps and allowing highly effective irradiation of children all day, as well as short courses of UV prophylaxis. Preventive ultraviolet radiation in kindergarten reduces the incidence of colds by more than 1.5 times, leads to improved indicators of physical development, reduces the number of streptococci in the nasopharynx, and increases phagocytic activity in 4/5 of irradiated children.
In recent years, ultraviolet irradiation is increasingly used in combination with other health-improving measures: ultraviolet irradiation + balneotherapy + quartz tube of the upper respiratory tract; UV irradiation + inhalation and gargling with infusions of calendula, eucalyptus and St. John's wort as a means of preventing colds in the autumn-winter period; UV irradiation + electrophytoaerosol + underwater shower-massage + laser prophylaxis + UHF inductothermy of the projection of the roots of the lungs. But such a comprehensive use of ultraviolet irradiation is possible only in the conditions of specialized preschool educational institutions that have a well-equipped medical and physiotherapeutic base.
However, in the methodological literature we did not find a theoretical justification for either a 20-day alternate day or a 10-day daily cycle of ultraviolet radiation. Most often, a hall for physical education or music classes is allocated for these radiation courses, through which all groups are held daily. These days, the schedule of physical education or music classes at the preschool educational institution, the work schedule of the group, and additional psycho-emotional and physical stress are experienced by the health worker and all teaching staff. Since the stimulating effect of ultraviolet radiation is noted only at the time of its implementation, it is not subject to cumulation, and it is not at all necessary to subject all children to prolonged stimulation at the same time. It makes more sense to carry out this work in short courses throughout the year and often.
It is more rational to conduct short-term stimulating courses of ultraviolet radiation (5 days each), but with a greater frequency throughout the year (5-6 times). Such a scheme for a 6-group preschool educational institution is presented in table 13. Its advantages:
Allows you to more evenly distribute the biological effect of irradiation in the autumn-winter-spring period;
Technically, it is easier to implement, since the irradiation is carried out in each group in turn and takes only 10–15 minutes from a health worker every day.
When using the UGD-2 lamp, irradiation is carried out directly in a group, immediately after daytime sleep, followed by a recreational play hour;
By the time the UFO was carried out, the nurse had already been freed from other duties;
When irradiation is carried out in a group after sleep, children do not need to undress;
Does not affect the institution-wide and group daily routine;
In a 12-group kindergarten, you can use one UGD-2 lamp per day in 2 groups (in one before bedtime, in the other after sleep), or irradiation with two lamps can be carried out in different groups.
Scheme of general ultraviolet radiation in continuous mode using the UGD-2 lamp
Methodology for conducting general education in preschool educational institutions. For general ultraviolet radiation, the most widely used irradiators are currently lighthouse-type irradiators UGD-2 with DRT lamps (PRK-2) with a power of 400 W and UGD-3 with DRT lamps (PRK-7) with a power of 1000 W. From our point of view, UGD-2 lamps are more convenient for continuous irradiation mode, which can be used directly in group rooms, which is especially convenient when irradiating children of toddlers and preschool age. The use of more powerful UGD-3 lamps is possible only in halls for music and physical education classes, which make it possible to place children around the irradiator within the required radius.
Skin sensitivity to ultraviolet radiation varies. Delicate white skin is the most sensitive. It should also be remembered that blue-eyed children often do not tolerate ultraviolet radiation well. Therefore, from the first sessions they should be placed 0.5 m further from the lamp. If they tolerate the first procedures well, you can place them at the same distance as everyone else.
Due to the varying sensitivity of the skin to ultraviolet radiation during individual irradiation, it is recommended to determine the biodose in children. However, with mass irradiation, determining the biodose for each child is almost impossible, so they use the average initial exposure, which is well tolerated by the vast majority of children.
We recommend using the following irradiation scheme: 1.5 min – 2 min – 2.5 min – 3 min – 3 min on the front and then on the back surface of the body. Due to the average nature of exposure to ultraviolet radiation, slight redness of the skin in some children is possible, and sometimes a slight increase in body temperature. The latter is not a reason to remove a child from a preschool educational institution.
If redness of the skin is not accompanied by an increase in body temperature, the child is not removed from the UV irradiation, but is placed 0.5 m further from the source and irradiation continues according to the scheme. Children with fever are exempted from ultraviolet radiation, and after the temperature drops, irradiation continues according to the scheme from the time the procedure was interrupted.
To relieve erythema, you can lubricate the skin with goose fat, baby cream, boric vaseline, but not before the procedure!
When using lamps of the UGD-2 type, children are located in a circle within a radius of 1–1.5 m from the lamp in shorts (children can be irradiated completely undressed). When using the UGD-3 lamp, children are placed within a radius of 2 m from the irradiator located in the center. Irradiation begins 5-10 minutes after turning on the lamp (by this moment the maximum intensity of its radiation is reached and the lamp operates in a steady state).
During the procedure, especially with long-term irradiation modes (2-2.5-3 minutes), children should be fascinated by games involving raising their arms, half-turns, etc. for a more uniform exposure to UV rays on the body.
When using the UGD-3 lamp, children can be undressed in a group, and brought into the room for irradiation in bathrobes or capes.
The presence of a nurse at the Ural Federal District is mandatory, since it is necessary to examine children before the procedure and make the necessary changes to the radiation regimen.
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PURPOSE OF QUARTZEVENTER OUFK-01
1.1 Ultraviolet irradiator OUFK-01 is designed for therapeutic use for general, local and intracavitary irradiation with an effective integrated radiation spectrum in the range of 230-400 nm. with infectious, infectious-allergic, inflammatory, post-traumatic diseases and injuries in medical institutions (hospitals, clinics, etc.), sanatoriums, dispensaries, as well as at home.
1.2 Irradiation is carried out according to the following methods:
- irradiation of the mucous membranes of the nose, oral cavity, external auditory canal, vagina in inflammatory, infectious-allergic, infectious diseases;
- local irradiation of the skin in diseases and traumatic injuries of the skin;
- general irradiation in case of skin diseases, disorders of phosphorus-calcium metabolism in case of injuries of the musculoskeletal system, rickets;
- sterilization of the room with ultraviolet (UV) radiation, incl. to prevent the spread of acute respiratory infections and influenza at home.
OPERATING PROCEDURE
1 Procedure for carrying out local intracavitary irradiation
1.1 For local irradiation, install the necessary sterile tube into the opening of the irradiator screen.
1.2 Connect the power cord of the illuminator to a 220V 50 Hz network. The lamp should light up within 1 minute. If the lamp does not light up, reconnect the illuminator to the network.
1.3 Irradiation must be started after the lamp warms up for 5 minutes, since during this time the lamp parameters stabilize.
1.4. After completing the procedure, disconnect the irradiator from the power supply.
2. Procedure for carrying out general irradiation and quartz treatment.
2.1 The procedure for turning on the irradiator for general irradiation and quartzization is carried out in the same way as for local irradiation. In this case, the screen in which the replacement tubes are mounted must be removed.
2.2 The duration of quartzization is determined depending on the size of the room: 15-30 m2 are quartzized for 15-30 minutes.
2.3 When carrying out general and local skin irradiation, the irradiator is placed at a distance of 10-50 cm from the irradiated surface, having previously removed the protective screen in which the tubes are attached. When carrying out local irradiation of the skin, the focus of the disease is limited from healthy areas of the skin using a towel and sheet.
PRIVATE TECHNIQUES FOR LOCAL UV IR irradiation of the skin and mucous membranes
1. Flu
Flu- This is an acute viral infection that easily spreads from person to person through airborne droplets.
Seasonal influenza is characterized by a sudden onset of high fever, cough (usually dry), headache, muscle and joint pain, severe malaise (feeling unwell), sore throat and runny nose. But the flu can cause severe illness or death in people at higher risk (see below). The period between infection and illness, known as the incubation period, lasts about two days.
TREATMENT: During an influenza epidemic, irradiation of the face and through tubes of the mucous membrane of the nose and the back wall of the pharynx are carried out for preventive purposes. Irradiation duration 3 min. for each area, total time 15 minutes.
During the height of the disease, irradiation is not carried out.
During the period of reverse development of the disease (or during the recovery period), in order to prevent the development of complications (addition of a secondary infection), ultraviolet irradiation of the nasal and pharyngeal mucosa is performed. Dose 1 min. for each zone, after 3 days the irradiation is increased by 1 minute to 3 minutes. The course of irradiation is 10 procedures.
2. Acute respiratory diseases
Very common diseases primarily affecting the respiratory tract. Caused by various etiological agents (viruses, mycoplasmas, bacteria). Immunity after illness is strictly type-specific, for example, to influenza virus, parainfluenza, herpes simplex, rhinovirus. Therefore, one and the same person can get acute respiratory disease up to 5-7 times during the year. The source of infection is a person with clinically expressed or erased forms of acute respiratory disease. Healthy virus carriers are less important. Transmission of infection occurs predominantly through airborne droplets. Diseases occur in the form of isolated cases and epidemic outbreaks.
Symptoms and course. ARI is characterized by relatively mild symptoms of general intoxication, a predominant lesion of the upper respiratory tract and a benign course. The defeat of the respiratory system manifests itself in the form of rhinitis, nasopharyngitis, pharyngitis, laryngitis, tracheolaryngitis, bronchitis, pneumonia.
TREATMENT: In the first days of the disease, ultraviolet irradiation of the thorax of the posterior (interscapular) surface and anterior (sternum, trachea) surface through a perforated localizer is used.
To make a perforated localizer, you need to take a medical oilcloth measuring 40x40 cm and perforate it with 1.0-1.5 cm holes. Radiation dose from a distance of 10 cm. 10 min. The next day, the localizer is moved and new areas of the skin are irradiated with the same dose. A total of 5-6 procedures are prescribed per course of treatment. At the same time, you can irradiate the plantar surfaces of the feet from a distance of 10 cm for 10-15 minutes.
3. Acute rhinitis
Acute rhinitis is a common runny nose, and it is one of the most common colds and is familiar to almost every person firsthand.
This is an acute inflammation of the nasal cavity, accompanied by a disorder of its functions - breathing, smell, tear production, etc.
As a rule, rhinitis is caused by viruses and bacteria, but the onset of a runny nose is sudden severe irritation of the nasal mucosa - for example, dust or chemicals, as well as hypothermia - general or of individual parts of the body, most often the legs.
In the initial period of the disease, ultraviolet irradiation is performed on the plantar surfaces of the feet. Dose from a distance of 10 cm for 10-15 minutes. within 3-4 days.
In the stage of attenuation of exudative phenomena in the nasal mucosa (end of rhinorrhea), to prevent the addition of a secondary infection and the development of complications in the form of sinusitis, otitis, etc., UV irradiation of the mucous membrane of the nose and pharynx is prescribed using a tube. Dose 1 min. with a daily gradual increase to 3 minutes. The course of irradiation is 5-6 days.
4. Acute inflammation of the maxillary sinuses
Acute sinusitis often occurs during acute runny nose, flu, measles, scarlet fever and other infectious diseases, as well as due to disease of the roots of the four upper back teeth.
Clinical picture. Feeling of tension or pain in the affected sinus, impaired nasal breathing, nasal discharge, impaired sense of smell on the affected side, photophobia and lacrimation. The pain is often diffuse, vague or localized in the forehead, temple and occurs at the same time of the day.
On examination: mucous or mucopurulent discharge in the middle nasal passage (the place where the sinus communicates with the nasal cavity), less often - swelling of the cheek and swelling of the upper or lower eyelid; pain is often felt when palpating the facial wall of the maxillary sinus. Body temperature is elevated, and chills are common. During posterior rhinoscopy, purulent discharge is often found on the back wall of the pharynx.
TREATMENT: After performing diagnostic and therapeutic punctures and washing the sinuses, UV irradiation of the mucous membrane of the nasal passages is prescribed through a tube with a diameter of 5 mm. Dose 2 min. with a daily increase in duration by 1 minute. up to 4 minutes, irradiation course 5-6 minutes.
5. Acute tubo-otitis
The pathology is an acute inflammatory process of the middle ear. In this case, there is damage to the auditory tube, tympanic cavity and air cells of the mastoid process. The etiological factor is a bacterial infection: staphylococci, streptococci, Escherichia coli, Proteus, Klebsiella.
The inflammatory process leads to swelling of the mucous membrane of the auditory tube, which ultimately impairs the ventilation of the middle ear. The pressure in the tympanic cavity drops, the eardrum retracts, the blood supply to the vessels increases and part of the liquid component of the blood leaves the vessels - transudation occurs. Next, an inflammatory component is mixed into the transudate.
Patients with acute tubo-otitis are bothered by a feeling of discomfort and congestion in the ear, noise and the sensation of iridescent fluid when changing the position of the head. Autophony is often observed - increased perception of one's own voice in the affected ear.
TREATMENT: The disease develops as a complication of acute respiratory disease, acute rhinitis. UV irradiation of the mucous membrane of the posterior wall of the pharynx and nasal passages is prescribed through a 15 mm tube. in a dose of 1 min. with a gradual increase to 2-3 minutes. At the same time, irradiation is carried out through a 5 mm tube. external auditory canal for 5 minutes, course of irradiation 5-6 procedures.
Ultraviolet radiation is carried out on the anterior surface of the chest in the area of the trachea and the posterior surface of the neck. Dose from a distance of 10 cm for 5-8 minutes, as well as ultraviolet irradiation of the posterior pharyngeal wall using a tube. Dose 1 min. The duration of irradiation increases every 2 days to 3-5 minutes. A course of 5-6 procedures.
6. Acute tracheobronchitis, acute bronchitis
Acute tracheobronchitis, or simply acute bronchitis, is an acute diffuse inflammation of the mucous membrane of the respiratory tract. Among the causes contributing to the occurrence of the disease, acute bronchitis, are factors that reduce the body’s protective properties to the effects of pathogens of acute respiratory diseases. Such factors are chronic upper respiratory tract infection and hypothermia. Also, the cause of the disease is an epidemic situation, i.e. being in contact with sick people. The etiology of bronchitis is infectious; the disease occurs in acute respiratory diseases of viral etiology. Acute bronchitis is a common disease.
TREATMENT: UV radiation is prescribed from the first day of the disease. The anterior surface of the chest in the area of the trachea, sternum and interscapular area is irradiated through a perforated localizer, which is moved daily to non-irradiated areas of the skin. Duration of irradiation from 10 cm. 10 min. The course of irradiation is 5-6 procedures.
7. Bronchial asthma
Bronchial asthma- chronic inflammatory disease of the respiratory tract involving a variety of cellular elements. The key link is bronchial obstruction (narrowing of the lumen of the bronchi), caused by specific immunological sensitization and allergies) or nonspecific mechanisms, manifested by repeated episodes of wheezing, shortness of breath, chest congestion and cough
TREATMENT: UV irradiation is carried out using two methods. The chest is divided into 10 sections, along the line below the nipple, each measuring 12x5 cm. 1 section is irradiated daily. Either the anterior and posterior surfaces of the chest are irradiated through a perforated localizer. Dose from 10 cm 10-12 minutes during one procedure. The course of treatment is 10 irradiations.
8. Chronic tonsillitis
Chronic tonsillitis is a chronic inflammation of the tonsils. The palatine tonsils are an organ that takes an active part in the formation of the body’s immunobiological defense mechanisms.
The greatest activity of the tonsils in these protective mechanisms manifests itself in childhood, and the inflammatory processes occurring in them lead to the development of stable immunity.
However, frequently recurring inflammation of the tonsils due to bacterial infection inhibits the development of immunity and causes the development of chronic tonsillitis. In addition, the development of immunity is sometimes delayed due to improper treatment with antibiotics, as well as the unreasonable use of drugs that reduce body temperature when it is not high (37-37.5).
The development of chronic tonsillitis is also facilitated by persistent impairment of nasal breathing (adenoids in children, deviated nasal septum, enlargement of the inferior turbinates, nasal polyps, etc.). Local causes are often infectious foci in nearby organs: carious teeth, purulent sinusitis, chronic adenoiditis.
TREATMENT: Ultraviolet radiation of the palatine tonsils is carried out through a tube with an oblique cut. The effectiveness of treatment depends on the correct technique for performing the UV therapy procedure. With the mouth wide open and the tongue pressed to the bottom of the mouth, the tonsils should be clearly visible. The irradiator tube, with a cut towards the tonsil, is inserted into the oral cavity at a distance of 2-3 cm from the surface of the teeth. The UV beam is strictly directed to the irradiated tonsil. The nurse monitors the correct execution of irradiation of the tonsil. The patient can independently carry out irradiation, monitoring the correctness of the procedure using a mirror. After irradiation of one tonsil, the other is irradiated using the same technique. Radiation dose. Begin irradiation of each tonsil for 1 minute; after 1-2 days, increase the duration of irradiation by 1 minute, bringing it to 3 minutes. The course of treatment is 10-12 procedures.
The effectiveness of treatment increases significantly if the treatment complex includes washing the lacunae from necrotic masses. Washing is performed before ultraviolet irradiation of the tonsils.
The same technique is used to wash the tonsil niche after tonsillectomy.
9. Chronic periodontosis, acute periodontitis
Periodontal disease is a dental disease of a primary dystrophic nature. This means that with periodontal disease, there is a violation of the trophism (nutrition) of the jaw bone tissue and periodontal tissue (impaired tissue renewal, impaired blood supply to the gums, impaired mineral metabolism). The causes of periodontal disease are changes caused by diseases of internal organs and systems (atherosclerosis, hypertension, vegetative-vascular dystonia), as well as bone lesions (osteopenia). Periodontal disease does not cause pain or other sensations, so patients, as a rule, do not consult a doctor. In advanced stages, periodontal disease is complicated by inflammation of the gums and is called periodontitis.
TREATMENT: UV irradiation of the gum mucosa is carried out through a tube with a diameter of 15 mm. In the area of irradiation of the gum mucosa, the lip and cheek are moved to the side with a spatula (a spoon at home) so that the UV ray falls on the gum mucosa. Slowly moving the tube, we irradiate all the mucous membranes of the gums of the upper and lower jaw.
The duration of irradiation during one procedure is 10-15 minutes. The course of treatment is 6-8 procedures.
10. Clean wounds
All open wounds (cuts, lacerations, bruises, etc.) are microbially contaminated. Before primary surgical treatment, the wound and surrounding skin are treated for 10 minutes. irradiate with ultraviolet radiation taking into account its bactericidal effect. In the following days of dressings and removal of sutures, UFO is repeated in the same dose.
11. Purulent wounds
After cleansing a purulent wound from necrotic tissue and purulent plaque, ultraviolet irradiation is prescribed to stimulate healing (epithelialization) of the wound. On the days of dressing, after treating the wound (wound toilet), the very surface of the purulent wound and the edges are irradiated with UV radiation. Dose: distance from the wound surface of the emitter is 10 cm, irradiation duration is 2-3 minutes. After 1-2 days, the duration of irradiation is increased by 1 minute to 10 minutes. The course of treatment is 10-12 procedures.
12. Acne vulgaris
Acne vulgaris is a common skin disease that is accompanied by rashes on the face and upper body (back, shoulders, chest). Acne most often appears during puberty, both boys and girls. However, according to statistics, in men the disease occurs more often and occurs with more pronounced clinical manifestations.
TREATMENT: UV irradiation is carried out in turn: the first day is the face, the second is the anterior surface of the chest, the third day is the posterior surface of the chest. The cycle is repeated 8-10 times. Irradiation is carried out from a distance of 10-15 cm, the duration of irradiation is 10-15 minutes.
13. Lactational mastitis
Lactation mastitis is an inflammation of the parenchyma and interstitium of the mammary gland that occurs in the postpartum period during lactation.
Lactation mastitis is fraught with the formation of cosmetic defects of the mammary gland, affects the mental state of a woman, and can create disharmony in family life. In addition, a decrease in the level of lactation and contamination of milk with microflora negatively affects the development and health of the newborn.
TREATMENT: The nipple and mammary gland are irradiated with UV radiation from a distance of 10 cm for 6-8 minutes. Irradiation is repeated after 1 day. The course of treatment is 10 procedures until nipple cracks heal and inflammatory reactions in the mammary gland reverse.
14. Furuncle, carbuncle, abscess
Furuncle (boil) is an acute purulent-necrotic inflammation of the hair follicle and surrounding connective tissue, caused by pyogenic bacteria, mainly Staphylococcus aureus.
Carbuncle is an acute purulent-necrotic inflammation of several hair follicles and sebaceous glands with the formation of a general infiltrate and extensive necrosis of the skin and subcutaneous tissue. Most often it is solitary.
Abscess, or abscess, focal purulent inflammation, which is characterized by the formation of a cavity filled with pus, consisting mainly of white blood cells (leukocytes), blood serum and debris of destroyed tissue.
TREATMENT: UV radiation begins at the beginning of the disease, during the period of hydration and continues after independent or surgical opening of the abscess. Dose: irradiation is carried out from a distance of 10 cm, duration 10-12 minutes. The course of irradiation is 10-12 procedures.
15. Erysipelas
Erysipelas (a special clinical type of cellulite) is an acute bacterial infection of the dermis and subcutaneous tissue. Caused almost exclusively by streptococci. The entry points for infection are lesions with athlete's foot, ulcers, trophic disorders with venous insufficiency and superficial wounds. Skin changes in certain diseases (lymphoedema, diabetes mellitus, alcoholism) are risk factors for the development of erysipelas.
The lesion is represented by a tense plaque with clear edges, which increases by 2-10 cm per day.
In 90% of cases, the legs are affected, although the arms and face may also be affected. In 85% of patients, the onset of the disease is acute, with high fever preceded by several hours of skin symptoms.
TREATMENT: The area of erysipelas involving 5 cm of surrounding tissue is irradiated with UV radiation. The distance of the burner from the skin is 10-12 cm. The duration of irradiation is 10 minutes, with each subsequent irradiation the duration increases by 1 minute. up to 15 min. The course of treatment is 12-15 procedures.
16. Soft tissue bruises
We hurt ourselves mainly as a result of blows or falls. In everyday life, bruises lie in wait for us at every turn. He dropped a heavy object on his leg - he suffered a bruise to the soft tissues of his leg, a black eye under his eye - there was a bruise to the soft tissues of his face, he was pinched by the doors in the subway - the soft tissues of his torso were damaged, he slipped and fell - he also hurt himself. Especially many bruises occur during road accidents (traffic accidents).
TREATMENT: UV irradiation of the bruised area is prescribed to have a bactericidal effect on the microflora of the skin, prevent suppuration of hemorrhages in the subcutaneous tissue and deep-lying tissues, and promote their resorption. Irradiation of the bruise area and surrounding tissues is carried out from a distance of 15-20 cm. The duration of irradiation begins at 10 minutes, increasing daily by 1 minute to 15 minutes. The course of irradiation is 12-15 procedures.
17. Bone fractures
Bone fracture- complete or partial violation of the integrity of the bone under a load exceeding the strength of the injured skeletal area. Fractures can occur both as a result of trauma and as a result of various diseases accompanied by changes in the strength characteristics of bone tissue.
After applying the compression-distraction apparatus G.A. Ilizarov, extraosseous or intraosseous metal osteosynthesis connecting bone fragments, UV irradiation is prescribed to the fracture area. The purpose of irradiation in the early period of a bone fracture is to have a bacteriostatic, analgesic, hemorrhage-absorbing effect.
Irradiation is carried out from a distance of 10-15 cm from the burner. Irradiation dose: from 10-15 minutes, the course of irradiation is 10 procedures.
In the later period of bone fracture (after 2 weeks), in case of delayed formation of callus, ultraviolet irradiation is prescribed to normalize phosphorus-calcium metabolism and stimulate the formation of callus. The entire limb is irradiated on both sides from a distance of 30-50 cm. Dose: continued irradiation for 10-15 minutes. on each side. A course of 10-12 procedures.
18. Acute and chronic vulvitis, colpitis, bartholinitis
Vulvitis- inflammation of the external genital organs and the entrance to the vagina. The causative agents of the inflammatory process are most often staphylococci, streptococci, E. coli, enterococci, less often - gonococcus, diphtheria bacillus (specific vulvitis).
Colpitis (vaginitis) - inflammation of the vaginal mucosa, the causative agent of which can be chlamydia, trichomonas, mycoplasma, streptococcus, staphylococcus, hemophilus influenzae, etc. The disease can also be caused by an association of microorganisms.
Bartholinitis- inflammation of the excretory ducts of the Bartholin glands located at the entrance to the vagina. Most often B. is caused by gonococcus and in this case takes on a protracted nature. When the ducts are blocked, resulting from their inflammation, and pus is retained, severe pain appears in the perineum, significant swelling at the entrance to the vagina (usually one-sided), body temperature rises
TREATMENT: Local ultraviolet irradiation is carried out in a gynecological office using a gynecological speculum, a 15 mm tube is used. radiation dose 2 min. with a daily increase of 1 min. up to 6-8 min. At the same time, the external genitalia are irradiated from a distance of 10 to 10-12 minutes. A course of 6-8 irradiations.
19. Cervical erosions
Cervical erosion- a benign process in the cervix. It occurs in almost every second woman of childbearing age. It can regress on its own, but can lead to an oncological process. Cervical erosion is a defect in the epithelium that covers the vaginal part of the cervix. Cervical erosion may not be clinically apparent. Sometimes there is pain during sexual intercourse and slight bleeding.
TREATMENT: To stimulate the healing of erosion, ultraviolet irradiation is carried out in the gynecological office. Irradiation is performed by a gynecologist. The cervix is exposed using a gynecological speculum, a 15 mm tube is used, the radiation dose is 2 minutes, increasing daily by 1 minute to 6-8 minutes. A course of 5-8 irradiations.
20. Antirachitic action (prevention of rickets)
Rickets is impaired mineralization of growing bone, leading to disturbances in skeletal formation in early childhood.
The main cause of vitamin D deficiency rickets is insufficient ultraviolet radiation (anactinosis). Vitamin D deficiency (especially in the winter months) reduces, among other things, the absorption of calcium from the intestines and the exchange of calcium between the blood and the skeletal system, and due to existing hypocalcemia leads to secondary hyperparathyroidism with increased evacuation of calcium from the bones and increased excretion of phosphorus by the kidneys.
In polar conditions, in areas with reduced solar radiation, individually, when signs of rickets appear, a child’s ultraviolet radiation can be used.
Quartz burners DRT 125 do not have an erythema-forming effect. To normalize phosphorus-calcium metabolism and the formation of vitamin D, it is enough to carry out minimal doses of radiation according to a slow schedule.
Tab. No. 1
| Procedure | Distance to burner | Irradiation duration on each side of the body |
| 1 | 60 cm | 1 min |
| 2 | 60 cm | 1.5 min |
| 3 | 60 cm | 2.0 min |
| 4 | 60 cm | 2.5 min |
| 5 | 60 cm | 3.0 min |
| 6 | 60 cm | 3.5 min |
| 7 | 60 cm | 4.0 min |
| 8 | 60 cm | 4.5 min |
| 9 | 60 cm | 5.0 min |
CONTRAINDICATIONS
There are no contraindications for quartzing rooms.
Contraindications for local and general exposures:
- High sensitivity to ultraviolet light
- Oncological diseases of the skin and predisposition to them
- Inflammatory gynecological diseases
- Systemic lupus erythematosus, etc.
Product care rules
The surface of the OUFK-01 irradiator housing and the time relay must be wiped with a dry gauze swab.
Consult your doctor about indications and contraindications for the use of an ultraviolet emitter.
The irradiator is not designed for tanning procedures.
Ultraviolet radiation in medicine is used in the optical range of 180-380 nm (integral spectrum), which is divided into short-wave region (C or AF) - 180-280 nm, medium-wave (B) - 280-315 nm and long-wave (A) - 315- 380 nm (DUV).
Physical and physiological effects of ultraviolet radiation
Penetrates into biological tissues to a depth of 0.1-1 mm, is absorbed by molecules of nucleic acids, proteins and lipids, has photon energy sufficient to break covalent bonds, electronic excitation, dissociation and ionization of molecules (photoelectric effect), which leads to the formation of free radicals, ions, peroxides (photochemical effect), i.e. there is a consistent conversion of the energy of electromagnetic waves into chemical energy.
The mechanism of action of UV radiation is biophysical, humoral and neuro-reflex:
Changes in the electronic structure of atoms and molecules, ionic configuration, electrical properties of cells;
- inactivation, denaturation and coagulation of protein;
- photolysis - breakdown of complex protein structures - release of histamine, acetylcholine, biogenic amines;
- photooxidation - increased oxidative reactions in tissues;
- photosynthesis - reparative synthesis in nucleic acids, elimination of damage in DNA;
- photoisomerization - internal rearrangement of atoms in a molecule, substances acquire new chemical and biological properties (provitamin - D2, D3),
- photosensitivity;
- erythema, with KUF develops 1.5-2 hours, with DUV - 4-24 hours;
- pigmentation;
- thermoregulation.
Ultraviolet radiation affects the functional state of various human organs and systems:
Leather;
- central and peripheral nervous system;
- autonomic nervous system;
- the cardiovascular system;
- blood system;
- hypothalamus-pituitary-adrenal glands;
- endocrine system;
- all types of metabolism, mineral metabolism;
- respiratory organs, respiratory center.
The healing effect of ultraviolet radiation
The reaction from organs and systems depends on the wavelength, dose and method of exposure to UV radiation.
Local irradiation:
Anti-inflammatory (A, B, C);
- bactericidal (C);
- painkiller (A, B, C);
- epithelializing, regenerating (A, B)
General exposure:
Stimulating immune reactions (A, B, C);
- desensitizing (A, B, C);
- regulation of vitamin balance “D”, “C” and metabolic processes (A, B).
Indications for UV therapy:
Acute, subacute and chronic inflammatory process;
- trauma to soft tissues and bones;
- wound;
- skin diseases;
- burns and frostbite;
- trophic ulcer;
- rickets;
- diseases of the musculoskeletal system, joints, rheumatism;
- infectious diseases - influenza, whooping cough, erysipelas;
- pain syndrome, neuralgia, neuritis;
- bronchial asthma;
- ENT diseases - tonsillitis, otitis, allergic rhinitis, pharyngitis, laryngitis;
- compensation for solar deficiency, increasing the stamina and endurance of the body.
Indications for ultraviolet irradiation in dentistry
Diseases of the oral mucosa;
- periodontal diseases;
- dental diseases - non-carious diseases, caries, pulpitis, periodontitis;
- inflammatory diseases of the maxillofacial area;
- TMJ diseases;
- facial pain.
Contraindications to UV therapy:
Malignant neoplasms,
- predisposition to bleeding,
- active tuberculosis,
- functional kidney failure,
- stage III hypertension,
- severe forms of atherosclerosis.
- thyrotoxicosis.
Ultraviolet radiation devices:
Integrated sources using DRT (mercury arc tube) lamps of various powers:
ORK-21M (DRT-375) - local and general irradiation
- OKN-11M (DRT-230) - local irradiation
- Mayachnye OKB-ZO (DRT-1000) and OKM-9 (DRT-375) - group and general irradiation
- ON-7 and UGN-1 (DRT-230). OUN-250 and OUN-500 (DRT-400) - local irradiation
- OUP-2 (DRT-120) - otolaryngology, ophthalmology, dentistry.
Selective short-wave (180-280 nm) use bactericidal arc lamps (BA) in the glow electric discharge mode in a mixture of mercury vapor and argon. Lamps of three types: DB-15, DB-30-1, DB-60.
Irradiators are produced:
Wall mounted (OBN)
- ceiling (OBP)
- on a tripod (OBSh) and mobile (OBP)
- local (BOD) with lamp DRB-8, BOP-4, OKUF-5M
- for blood irradiation (AUFOK) - MD-73M "Isolde" (with low pressure lamp LB-8).
Selective long-wave (310-320 nm) use fluorescent erythema lamps (LE), 15-30 W, made of uveolian glass with an internal phosphor coating:
Wall-mounted irradiators (OE)
- suspended reflected distribution (OED)
- mobile (OEP).
Beacon-type irradiators (EOKS-2000) with a xenon arc lamp (DKS TB-2000).
An ultraviolet irradiator on a tripod (OUSH1) with a fluorescent lamp (LE153), a large beacon ultraviolet irradiator (OMU), a tabletop ultraviolet irradiator (OUN-2).
Low pressure gas discharge lamp LUF-153 in the UUD-1, UDD-2L units for Puva and therapy, in the UV irradiator for the limbs OUK-1, for the head OUG-1 and in the irradiators EOD-10, EGD-5. Units for general and local irradiation are produced abroad: Puva, Psolylux, Psorymox, Valdman.
Technique and methodology of UV therapy
General exposure
Carry out according to one of the following schemes:
Basic (from 1/4 to 3 biodoses, adding 1/4 each)
- slow (from 1/8 to 2 biodoses, adding 1/8 each)
- accelerated (from 1/2 to 4 biodoses, adding 1/2 each).
Local irradiation
Irradiation of the affected area, fields, reflexogenic zones, staged or by zone, extrafocal. factional.
Features of irradiation with erythemal doses:
One area of the skin can be irradiated no more than 5 times, and the mucous membrane - no more than 6-8 times. Repeated irradiation of the same area of skin is possible only after the erythema has subsided. The subsequent radiation dose is increased by 1/2-1 biodose. When treating with UV rays, light-protective glasses are used for the patient and medical staff.
Dosing
Dosing of UV irradiation is carried out by determining the biodose, the biodose is the minimum amount of UV radiation sufficient to obtain the weakest threshold erythema on the skin in the shortest time, with a fixed distance from the irradiator (20 - 100 cm). The biodose is determined using a BD-2 biodosimeter.
There are different doses of ultraviolet radiation:
Suberythemal (less than 1 biodose)
- erythema small (1-2 biodoses)
- medium (3-4 biodoses)
- large (5-6 biodoses)
- hypererythemal (7-8 biodoses)
- massive (over 8 biodoses).
For air disinfection purposes:
Indirect radiation for 20-60 minutes, in the presence of people,
- direct radiation for 30-40 minutes, in the absence of people.
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Dosimetry and dosing of ultraviolet radiation
Currently, domestic compact portable devices (UV radiometers) are being produced for practice, which allow measuring the energy characteristics of any UV radiation sources with high accuracy.In the practical work of medical and preventive and sanatorium-resort institutions, the following can be used:
1. UV radiometer "Ermetr", designed to measure the effective erythemal illumination of human skin and determine the radiation dose from any artificial, as well as natural source of UV radiation, regardless of the latitude of the terrain and the state of the Earth's ozone layer.
2. UV radiometer ("UV-A", "UV-B", "UV-C"), designed to measure the intensity and dose of UV radiation in the spectral ranges A, B and C.
3. UV radiometer "Baktmetr", designed to measure the bactericidal UV illumination from bactericidal lamps.
All of the above radiometers consist of an electronic unit with a digital output and a photodetector head, the spectral sensitivity of which in different types of radiometers is corrected for tabulated sensitivity in accordance with WHO recommendations.
Using UV radiometers, it is also possible to determine the threshold dose of UV radiation required for subsequent therapeutic effects. For example, the average threshold erythema-forming dose (with a maximum sensitivity at 297 nm), according to some foreign standards (German Standard Din 5031, part 10) will be 250-500 J/m2.
However, in physiotherapy, to assess UV radiation, it is important to focus not only on physical quantities that reflect energy exposure or radiation intensity, but also take into account the nature of the biological effect caused by it. In this regard, the method (Dalfeld-Gorbachev) of assessing the individual photosensitivity of the skin to UV rays has become widespread in practice (Fig. 327). This method determines the minimum duration of exposure time required to obtain a threshold erythema skin reaction. One biological dose (biodose) is taken as a unit of measurement.
Biodose is most often determined from a distance of 90 or 50 cm from the lamp to the surface of the skin of the abdomen outward from the midline; biodose from irradiators such as "OH" or "BOP-4" (for irradiation of the nasopharynx) is determined on the inner surface of the forearm.
To assess the photosensitivity of the skin, a standard biodosimeter (“BD-2”) is used, which is a metal plate 100x60 mm with 6 rectangular windows (“holes” 25x7 mm each), closed by a flap moving from above. The biodosimeter is sewn into oilcloth and has ribbons for fixing it on the patient’s body.
Determination of biodose
1. The patient’s position on the couch is lying on his back. The patient puts on light-protective glasses.2. A biodosimeter with closed windows is attached to the skin of the abdomen outward from the midline (right or left). Areas of the body not subject to UV irradiation are covered with a sheet.
3. The irradiator lamp is placed above the biodosimeter, measuring along a plumb line with a centimeter tape the distance required for subsequent treatment procedures (30 or 50 cm) from the radiation source to the surface of the biodosimeter.
4. Turn on the irradiator and sequentially (opening the shutter every 30 s) irradiate 1-6 windows of the biodosimeter.
5. Upon completion of irradiation of all windows, close them with a shutter and turn off the irradiator.
The results of determining individual photosensitivity of the skin are assessed after 24 hours (in daylight), while the erythema stripe of minimal (in terms of color degree) intensity, but with clear edges, will correspond to the time of 1 biodose.
For example, when the biodosimeter was irradiated for 3 minutes (i.e., 30 s for each window), the irradiation time of the first window was 3 minutes, the second - 2 minutes, etc., and the sixth - 30 s. After a day, only 5 of 6 stripes appeared on the skin of the abdomen with decreasing (top to bottom) color intensity, with the last (5th) strip having unclear (“blurred”) edges. In this case, the threshold erythema reaction of the skin should be taken as the 4th strip (with clear edges) and the corresponding biodose time, i.e. 1.5 minutes.
Depending on the task of the physiotherapist and the type of irradiator, UV irradiation is carried out from various working distances: 30, 50, 75, 100 cm. Based on a known biodose, if necessary, you can arithmetic recalculate the biodose to any required distance using the formula:
X = A*(B2/C2) (min),
Where: X is the required biodose per minute; A - time in minutes and C - distance in cm of a known biodose; B is the distance in cm from which irradiation is supposed to be carried out.
Example. A known biodose (from a distance of 50 cm) is equal to 1 minute. It is necessary to determine the biodose time from a distance of 100 cm. Using the formula we find:
X = 4 min.
Consequently, the time of one biodose from a distance of 100 cm will be equal to 4 minutes.
In outpatient practice, as well as for UV irradiation that does not require delay (for example, for erysipelas, etc.), it is allowed to use the so-called “average biodose” for a specific irradiator. It is preliminarily determined (for each irradiator separately) in 10-12 practically healthy individuals, while the arithmetic average value of the time of the found biodoses will correspond to the time of the “average biodose” for a given irradiator. It is recommended to determine the “average biodose” every 3 months.
To determine the biodose of UV radiation in pediatric practice, the same method (Dalfeld-Gorbachev) is used. Considering the high sensitivity of the child’s body to UV rays, it is recommended to sequentially open the biodosimeter windows every 15 s (this should be done especially when determining the biodose in children in the first months and years of life). For school-age children, it is permissible to open the “holes” of the biodosimeter every 30 seconds.
The results of determining skin photosensitivity in children should be preliminarily assessed 3-6 hours after irradiation (in a hospital setting) and finally after 24 hours (in inpatients and outpatients). When carrying out UV irradiation, it is also necessary to take into account the general condition of the child, the period of the disease, the nature of its course, the state of the body's protective and adaptive mechanisms, and the light-climatic conditions of the child's life.
Ultraviolet radiation technique
General ultraviolet exposure
With general irradiation, during one procedure, the front and back surfaces of the patient’s naked body are exposed alternately. Irradiation can be individual or group. The patient's position is lying or standing.For group irradiations, it is recommended to center the irradiator lamp on the chest, back, and for individual irradiations, on the upper third of the thigh (when using the ORK-21M irradiator) or on the navel area (when using the EOD-10 irradiator). Depending on the type of irradiator, the distance from the UV radiation source to the irradiated surface is 50-100 cm.
Before general individual irradiation, the photosensitivity of the patient's skin is determined. For group irradiations, it is permissible to use the average biodose for a given irradiator. For general UV exposure, patients should wear light-protective glasses. Irradiation is carried out according to schemes, starting with suberythemal doses (1/8, 1/4, 1/2 biodose). There are 3 generally accepted (approximate) schemes for general UV irradiation (Table 7). The choice of regimen is determined by the general condition of the patient and (or) the nature of the disease. General UV irradiation is carried out daily or every other day; if necessary, the course is repeated after 2-3 months.
Table 7. Approximate schemes of general UV irradiations
Local ultraviolet irradiation
With local irradiation, limited areas of the skin surface are exposed: 400-600 cm2 (in adults) and 50-400 cm2 (in children). In children, the area of the irradiated surface depends on the age of the child: up to 1 year of life - 50-80 cm2; from 1 year to 3 years - 80-100 cm2; from 3 to 5 years - 100-160 cm2; from 5 to 7 years - 150-200 cm2; for children over 7 years old - 200-400 cm2. For local irradiation, erythemal (1-8 biodoses) and less often suberythemal (up to 1 biodose) dosages of UV irradiation are used. In children, the first dose of radiation should not exceed 2 biodoses.Repeated irradiation of the same area of skin is usually carried out every other day (less often - after 2 days); different areas of the skin surface (taking into account their area) can be irradiated on the same day. Repeated irradiations of the same field are carried out in increasing (by 1-2 biodoses) dosage.
Due to changes in the optical properties of the skin, erythema doses are prescribed repeatedly to the same area, but on average no more than 4-5 times. The number of local irradiations using suberythemal UV exposure can be increased to 7-14. If indicated, a second course of erythemotherapy can be carried out no earlier than after 7-8 weeks, i.e. after restoration of sensitivity of irradiated skin areas to UV rays.
There are several methods of local irradiation: a) irradiation of the site (focus) of the lesion (wound, trophic ulcer, etc.); b) extrafocal irradiation (repercussion technique) - exposure to an area of the skin surface symmetrical to the site of the lesion (for example, if there is a plaster cast on the affected leg - irradiation of the healthy leg); c) irradiation with fields (chest, along the nerve, etc.);
D) segmental irradiation of reflexogenic zones (collar zone, panty zone, Zakharyin-Ged zones, etc.); e) stage-nose irradiation (by zone-belt); c) fractionated irradiation, in which, in order to limit UV exposure over the area, a “perforated localizer” made of medical oilcloth with a size of 30x30 cm is used.
It cut 150-200 square holes with a side of 1 cm and at a distance of 1-2 cm from each other. Irradiation is carried out with erythemal doses through holes in the oilcloth placed on the patient's body. During one procedure, two fields are irradiated (chest, back). With fractionated irradiation of children, a perforated localizer is also used: for newborns - with 12 holes with an area of 0.5-1 cm2; for infants - from 40 and for older children - from 70-125 holes of the indicated area size.
Bogolyubov V.M., Vasilyeva M.F., Vorobyov M.G.
