PHOTOTHERAPY

From Big Medical Encyclopedia

PHOTOTHERAPY (synonym phototherapy) — use with the medical and preventive purpose of a radiant energy of an optical spectral range, i.e. infrared, visible and ultra-violet radiations. At S. use insolation in the range of lengths of waves about 200 — 3000 nanometers (see. Heliation ) and light from artificial sources, with wavelength from 760 nanometers — infrared radiation (see), with the wavelength of 400 — 760 nanometers — visible radiation, with wavelength is shorter than 400 nanometers — ultraviolet radiation (see).

Fiziol. action of a radiant energy of an optical part of a range depends on the wavelength and energy of the absorbed quanta of radiation (see. Light ). Energy of the infrared radiation (IK-radiation) is absorbed by fabrics on depth from 3 mm to 4 cm, energy of Uv-radiation does not get more deeply than 0,5 — 1 mm. The energy of quanta of Uv-radiation absorbed by fabrics causes transition of atoms and molecules to excited state, to Krom their ability to enter chemical reactions increases many times over (see. Molecule, excited states of molecules ). In skin there is a formation of substances to new physical and chemical properties, change of proteinaceous molecules of cells, strengthening of enzymatic activity. Energy of IK-radiation and visible light at absorption by fabrics passes generally into thermal, strengthening blood circulation and fabric exchange, increasing phagocytal activity of leukocytes, stimulating sweating.

In the mechanism of effect of light on an organism plays a role not only a humoral, but also neuroreflex factor. Nek-ry dyes (e.g., eosine, methylene blue, acridic dyes, etc.) and waste products of an organism (bile, haematoporphyrin, etc.) are capable to increase sensitivity of an organism to light. Fotosensibilization (see), i.e. sensitization to effect first of all of visible light, can lead to development of heavy reactions with education on the body parts which underwent radiation, hypostases and even necroses.

Indications

Phototherapy by visible light and IK-radiation is shown at subacute and chronic diseases of upper respiratory tracts, skin and hypodermic cellulose, internals (kidneys, etc.), a musculoskeletal system and peripheral nerves, and also at burns, freezing injuries, contractures, spastic paralyzes of extremities, easy and medium-weight forms of an obliterating endarteritis.

Indications to UF-radiation — cm. Ultraviolet radiation.

Contraindications

Phototherapy is contraindicated at purulent processes, bleedings, malignant tumors, an active pulmonary tuberculosis, the expressed atherosclerosis, an idiopathic hypertensia of IIB-III of a stage, a circulatory unefficiency of the II—III stage, at diseases of the kidneys which are followed by a renal failure, bronchial asthma with frequent and heavy attacks, the expressed disturbances of functions of closed glands, especially at a thyrotoxicosis, sharply expressed functional disturbances from a nervous system and the expressed organic diseases of c. N of page (a myelosyringosis, multiple sclerosis, etc.), diseases of blood, a lupus erythematosus, malaria, hypersensitivity by a sunlight (a hematoporphyria, etc.).

Dosing

Dosing at S. shall be carried out very strictly. At the general and especially local influences it is necessary to consider the spectral list and a radiation intensity, and also individual sensitivity of the patient (see. Dosing ).

Phototherapy of children

Phototherapy of children is carried out especially carefully, taking into account their cart-rayetnykh of anatomo-physiological features. Due to the hypersensitivity of a children's organism to radiation the number and duration of procedures is reduced in comparison with number and duration of procedures at adults. At general irradiations of children UF-light, in addition to age features, individual properties of an organism and svetoklimatichesky conditions, it needs to consider terms of reception by the child of vitamin D, and also time of carrying out preventive inoculations.

Sources of light radiation

for the purpose of impact on an organism light of a certain wavelength use artificial light sources, to-rye divide on caloric and luminescing.

At caloric (thermal) light sources the quantity and structure of emitted energy depends on extent of heating of the radiating body. Carry to such sources: an infrared radiator on a support; a lamp sollyuks — stationary and figurative — with power from 200 to 1000 W; a lamp of Menin with the 40 — 60 W electric filament lamp which is built in in the parabolic reflector fixed on the wooden handle; an electrolight bathtub (see. Infrared radiation in physical therapy ).

At luminescent light sources radiation is caused generally by a luminescence of so-called phosphors under the influence of weak Uv-radiation. For the treatment-and-prophylactic purposes use quartz-mercury irradiators, UF-irradiators on a support, mobile UF-irradiators for group radiations, UF-ob-luchateli for a nasopharynx, the selection sources At the F-radiation (arc germicidal and cold erythematous lamps) in mobile, wall and ceiling irradiators, etc. (see. Ultraviolet radiation in physical therapy ).

During the use of sources of light radiation in to lay down. - the prof. institutions needs to follow the corresponding rules according to the accident prevention during the holding physiotherapeutic procedures concerning personnel and patients (see. Physiotherapeutic office , Fotary ).



Bibliography: Biological effect of ultraviolet radiation, under the editorship of G. M. Frank, etc., M., 1975; Problems of practical photobiology, under the editorship of D. N. Lazarev and K. A. Samoylova, Pu-shchino, 1977; The Guide to physical therapy and physioprevention of children's diseases, under the editorship of A. N. Obrosov and T. V. Karachev-tseva, page 81, M., 1976; Ultraviolet radiation, under the editorship of G. M. Frank, etc., Saturday. 3,5, M., 1960, 1971. See also bibliogr. to St. Heliation, Dosing, Infrared radiation, Light.


T. M. Kamenetskaya.

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