Features of laser therapy of venous trophic ulcers of the lower extremities in outpatient surgery

N. Sergeev, A. Sergeev, A. Morozov, M. Belyak
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Abstract

Introduction. Trophic ulcers of venous etiology are a severe complication of chronic venous insufficiency of the lower extremities. At the same time, in most cases, ulcerative defects do not heal for a long time and are prone to recurrence, which leads to a significant deterioration in the quality of life of patients.Aim. To clarify the features of the effect of low-intensity laser radiation to determine the optimal conditions for conservative treatment of venous ulcerative defects.Materials and methods. A randomized prospective clinical trial was performed in which 126 patients with chronic venous insufficiency were monitored. During the conservative treatment of 44 patients of the comparison group, phlebotropic drugs, compression therapy, wound coverings and ointment dressings were used in the conservative treatment of trophic ulcers. In 82 patients of the main group, lowintensity laser radiation was used along with the methods described above.Results. Laser therapy in the complex treatment of venous trophic ulcers helps to reduce the number of microbial bodies vegetating on the surface of ulcerative defects, but does not significantly affect the sensitivity of microflora to antibacterial drugs. Low-intensity laser radiation certainly contributed to a significant and earlier increase in the number of neutrophils, monocytes and macrophages on the surface of trophic ulcers, as well as activation of phagocytic activity of cells.Conclusion. Low-intensity laser radiation improves the results of conservative treatment of venous trophic ulcers, does not adversely affect the sensitivity of the isolated microflora to antibiotics and does not have a “direct” bactericidal effect.
激光治疗下肢静脉营养性溃疡的临床特点
介绍。静脉性营养溃疡是下肢慢性静脉功能不全的严重并发症。同时,在大多数情况下,溃疡性缺损长期不愈合,容易复发,导致患者的生活质量明显下降。目的:明确低强度激光照射的效果特点,确定静脉溃疡性缺损保守治疗的最佳条件。材料和方法。对126例慢性静脉功能不全患者进行了随机前瞻性临床试验。对照组44例保守治疗中,均采用促静脉药物、压迫治疗、创面覆盖物及软膏敷料保守治疗营养性溃疡。主组82例均采用低强度激光照射配合上述方法。激光综合治疗静脉营养性溃疡有助于减少生长在溃疡缺损表面的微生物体数量,但对微生物群对抗菌药物的敏感性无明显影响。低强度激光照射确实有助于营养溃疡表面中性粒细胞、单核细胞和巨噬细胞数量的早期显著增加,以及细胞吞噬活性的激活。低强度激光辐射改善了静脉营养性溃疡保守治疗的结果,不会对分离的微生物群对抗生素的敏感性产生不利影响,也没有“直接”的杀菌作用。
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