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METHOD OF PHOTODYNAMIC THERAPY OF ACUTE STONE-FREE CHOLECYSTITIS IN ELDERLY AND SENILE PATIENTS WITH HIGH OPERATION AND ANAESTHESIOLOGY RISK
专利权人:
Federalnoe gosudarstvennoe byudzhetnoe uchrezhdenie "Gosudarstvennyj nauchnyj tsentr lazernoj meditsiny imeni O.K. Skobelkina Federalnogo mediko-biologicheskogo agentstva"
发明人:
Baranov Aleksej Viktorovich (RU),Баранов Алексей Викторович (RU),Derbenev Valentin Arkadevich (RU),Дербенев Валентин Аркадьевич (RU),Mustafaev Rovshan Dzhalalovich (RU),Мустафаев Ровшан Джалалович (RU
申请号:
RU2019126121
公开号:
RU0002720105C1
申请日:
2019.08.19
申请国别(地区):
RU
年份:
2020
代理人:
摘要:
FIELD: medicine.SUBSTANCE: invention relates to medicine, namely to surgery. Gallbladder is punctured under the ultrasound control by the trocar. Inflammatory exudate and bile are removed. Surgical endoscope is inserted into the gallbladder, the gallbladder cavity and the cystic duct mouth are inspected. That is followed by high-power laser coagulation of the gallbladder duct mouth under visual control to shut off the gallbladder. That is followed by a photodynamic therapy (PDT) of the gallbladder, for which an elastic silicone balloon with an optical light guide with a cylindrical diffuser is inserted into the gallbladder cavity through the trocar. Balloon is filled with distilled water in amount of 50–80 ml under ultrasonic control so that the balloon receives the contours of the gallbladder, and the laser is exposed to the gallbladder mucosa. In a particular case, laser coagulation of the mouth of the cystic duct for the gallbladder disconnection is performed by means of a laser apparatus with wave length from 881 ± 0.3 nm to 1060 ± 0.3 nm after tissue infiltration of the cystic duct mouth area with 0.25 % novocaine or 0.9 % sodium chloride solution. In a particular case, laser coagulation of the mouth of the cystic duct is performed by contact with a laser light guide with diameter of 0.6–0.8 mm at radiation power at the end of the light guide of 8–10 W to form a uniform coagulation scull. In a particular case, 40–60 minutes before PDT, the patient is intravenously injected with a chlorine-based photosensitizer solution in amount of 0.8 mg/kg of body weight in 100 ml of 0.9 % sodium chloride. In a particular case, the illumination of the gallbladder mucosa is performed by irradiating a laser apparatus with wavelength of 635 ± 0.3 nm to 670 ± 0.3 nm with laser radiation power density on the surface of gallbladder mucosa 0.05–0.3 Wt/cm2 and light energy dose of 80–100 J/cm2. In a particular case, the manipulations are terminated by inserting 5 mm diameter drain tu
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