ULCER BEAM (a synonym an ulcer x-ray) — the defect of skin or mucous membrane and subjects of fabrics which arose owing to impact of ionizing radiation.
The etiology and a pathogeny of beam ulcers are connected with action of ionizing radiation (see) on biological objects. I. l. can arise in the conditions of therapeutic radiation at the beam loadings exceeding tolerance of skin and mucous membranes (see. Beam damages; Burns, beam burns). The total doses leading to emergence I. l., are various that is connected with fractionation of a dose in time and the volume of radiation (see. Radiation therapy). Modern methods of protection of personnel practically exclude danger of developing of professional beam ulcers.
To emergence I. l. usually the itch, a hyperemia, burning sensation in the field of earlier irradiated site of skin precede. As a rule, beam ulcers develop against the background of inertly current radioepidermitis (see) and a radioepithelitis (see). Their torpid current, gradual, but steady progressing is characteristic. The symptomatology depends on localization of an ulcer, its sizes, proximity to it of nervous, vascular and other anatomic educations. I. l. on extremities are followed by hypostasis and pains. Beam ulcers of a mucous membrane of an oral cavity are dangerous by accession of an infection, development of phlegmons and sepsis. Ulcer beam cystitis (see) it is shown by a frequent urodynia. I. l. a mucous membrane of a rectum are followed by pains, emergence of blood and slime in a chair, disturbance of bowel emptying. They can be complicated by perforation in an abdominal cavity or formation of fistulas.
In differential diagnosis is important morfol. a research of fabric from edges of an ulcer for an exception of a recurrent tumor, apropos a cut radiation therapy was carried out.
Treatment is begun, as a rule, with the conservative actions consisting of a complex of the general and local influences. Purpose of vitamins and regulation of a homeostasis, in particular its immune and endocrine links concern to the first. Locally apply 10 — 50% of ointment with Dimexidum, carry out treatment in the conditions of gnotobiologichesky isolation (see. The managed abakterial-ny environment). In some cases at a beam ulcer of skin its full excision within healthy fabrics with possible plastics a free rag is shown (see. Skin plastics).
The forecast at svoyevrekhmenny treatment, as a rule, favorable.
Prevention of emergence I. l. at therapeutic radiation consists in rational planning of volumes and a radiation time, protection of skin and mucous membranes, the accounting of tolerance of the irradiated covers, and also creation of conditions for differential impact on a tumor and healthy fabrics during radiation (see). Medicinal prevention vklyu-
hopes greasing of skin and mucous membranes during radiation and after it before complete elimination of beam reactions. Vitaminous ointments and oils (sea-buckthorn, peach or a dogrose), disinfecting solutions, etc. are used. Bibliography: Bardychev M. S. and
C y A. F. Local beam damages, M., 1985; Kozlova A. V., Possible effects of damages of bodies and fabrics at radiation therapy of malignant tumors, Medical radio-gramophones., t. 22, No. 12, page 71, 1977; Pavlov A. S. and Kostromina K. N. Rak of a neck of uterus, page 136, M., 1983; Strelin G. S. Regeneration processes in development and elimination of beam damage, M., 1978; Alexandrov S. N. Late radiation pathology of mammals, B., 1982.
L. P. Simbirtseva.