Introduction:
Describing the importance of lymph nodes in the body can distinguish the following important functions: haematopoietic, immunological, exchange and storage tanks. Functional status of the lymph nodes have a decisive influence on the course of the inflammatory response, the spread of infection the formation of new metastatic lesions of purulent-inflammatory process.
According to the theory of segmental structure of the lymphatic system, there is a certain limforazdel abdominal organs. So from the top floor of the abdomen most of the lymph flows away to the lymph nodes of lesser omentum. From the bodies of the middle and lower floors of the abdominal cavity preferential lymph drainage is carried out in mesenteric lymph nodes. Based on these data, it becomes clear need for therapeutic effect on a particular group of lymph nodes, depending on the localization of pathology and surgical intervention in the abdominal cavity.
Known a lot of literature about the successful use of laser surgery. A positive effect of laser on the immune system, microcirculation, recovery, etc. However, until recently, no attempts were made to the impact of the laser to the lymph nodes.
Materials and methods:
Given the above conditions of laser irradiation of lymph nodes of the abdominal cavity for prevention and treatment of inflammatory complications, we propose a method of segmental laser irradiation of the lymph nodes of the abdomen in the postoperative period (patent number 4989).
The essence of this method is that introoperatsionno a small gland or the mesentery brand viagra and large intestine depending on the region of operation through which the catheter is installed in the postoperative period through the optical fiber produced helium-neon irradiation of different groups of lymph nodes. Irradiation produced a helium-neon laser ILGN-104, power 20 mW, a wavelength of 0.63 microns.
Before the widespread use of the method in patients, we carried out experimental and clinical oprabatsiya laser lymphatic therapy.
The experiments were performed on 30 Wistar rats with tsekotomnoy linear scar. All the animals were divided into two groups: control 18 animals, 12 animals and a major.
The rats in the core group used laser irradiation of the right colonic mesenteric lymph nodes in the postoperative period, through a thin PVC catheter.
The research results were evaluated using scanning electron and transmission microscopy of lymph nodes and intestinal wall.
The clinic employed a method in 120 patients (with resection of the stomach, cholecystectomy operations in the small intestine and large intestine) with identical operations of 115 patients in the control group.
Results of experimental studies have shown that the operation leads to swelling and increase the size of mesenteric lymph nodes, decreased clearance of sines with content in them a large number of tissue detritus, microbes and edema fluid.
Study of the cellular composition of lymph nodes revealed the predominance of macrophages and leukocytes with relatively low content of lymphocytes, especially at 3 and 6 days after surgery. These studies have shown that surgical trauma is accompanied by microbial contamination leads to an overload of the regional viagra the disease and its treatment lymph nodes associated with the massive arrival of edema fluid, microbes and products dismetabolizma of an inflammatory focus in the wall of the cecum.
The morphology of the intestinal wall also revealed a pronounced inflammatory infiltration of intercellular spaces in the zone of injury, edema, hyperemia of blood and lymphatic capillaries.
Use of laser irradiation of lymph nodes, a very positive influence on the course of the inflammatory response. So after three sessions of laser therapy significantly reduced lymphatic edema of the stroma of lymph nodes, enlarged marginal gaps and central sinuses. Increases of lymphocytes and plasma cells, compared with a control group in the lumen of the sinuses reduces the content of tissue detritus and microbes. A better picture can be seen in the intestinal wall, where there is significant reduction of morphometric stromal edema, narrowing of the lumen of lymphatic capillaries and venules.
Results of clinical studies have shown that the use of laser irradiation of regional lymph nodes can provide a smoother postoperative course. Thus, in the main group of patients rapidly eliminated leukocytosis and elevated ESR. Quickly returned to normal body temperature is restored laxation. All this contributed to a more active management of early postoperative period, with early feeding and standing patient from the bed. Thanks to laser lymphatic therapy could reduce the number of inflammatory complications from 12,2 to 3,1%.
Discussion.
Summarizing the results of experimental and clinical research we can say that the use of helium-neon laser irradiation to regional lymph nodes of the pathological focus is having a very positive impact. Marked improvement in the morphological picture of the regional lymph nodes. This is manifested reduced edema of the stroma of lymph nodes, with the improvement of the capacity of central and morginalnyh sinuses. Through the use of laser marked decrease in the concentration of microbes in the lumen of the sinuses, increasing the number of lymphocytes and plasma cells. Improve drainage and immunological functions of the regional lymph nodes promotes unloading interstitium of the intestinal wall from excess edematous interstitial fluid, it creates the conditions for the strength of the intestinal suture. Around the wound is reduced inflammatory infiltration, more increases of lymphocytes by improving microcirculation. Regional impact of the laser to the lymph nodes of the pathological process is in our opinion one of the pathogenetic methods of prevention and treatment of inflammatory complications. After all, the lymph nodes first to stand in the way of spreading infection. In some cases, infection with virulent and attenuated protective function of the body's own lymph nodes become gathering places, and microbial growth (suppurative lymphadenitis) All this indicates a need influence at the regional lymph nodes in the fight against this pathology. Clinical studies have confirmed the experimental data on the effectiveness of the method. It is important to note that the method is very easy to implement and can be successfully used in surgical units at any level.
Problem areas
asthma cures
Alveolus
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