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UFO for adults. Ultraviolet radiation

Ultraviolet radiation in medicine is used in the optical range of 180-380 nm (integral spectrum), which is divided into short-wave region (C or AF) - 180-280 nm, medium-wave (B) - 280-315 nm and long-wave (A) - 315- 380 nm (DUV).

Physical and physiological effect ultraviolet radiation

Penetrates biological tissues to a depth of 0.1-1 mm, is absorbed by molecules of nucleic acids, proteins and lipids, has photon energy sufficient to break covalent bonds, electronic excitation, dissociation and ionization of molecules (photoelectric effect), which leads to the formation free radicals, ions, peroxides (photochemical effect), i.e. there is a sequential transformation of energy electromagnetic waves into chemical energy.

The mechanism of action of UV radiation is biophysical, humoral and neuro-reflex:

Change in electronic structure atoms and molecules, ionic conjuncture, electrical properties of cells;
- inactivation, denaturation and coagulation of protein;
- photolysis - breakdown of complex protein structures - release of histamine, acetylcholine, biogenic amines;
- photooxidation - increased oxidative reactions in tissues;
- photosynthesis - reparative synthesis in nucleic acids, elimination of DNA damage;
- photoisomerization - internal rearrangement of atoms in a molecule, substances acquire new chemical and biological properties(provitamin - D2, D3),
- photosensitivity;
- erythema, with CUF it develops within 1.5-2 hours, with DUF - 4-24 hours;
- pigmentation;
- thermoregulation.

Ultraviolet radiation has an effect on functional state various human organs and systems:

Leather;
- central and peripheral nervous system;
- autonomic nervous system;
- cardiovascular system;
- blood system;
- hypothalamus-pituitary-adrenal glands;
- endocrine system;
- all types of metabolism, mineral metabolism;
- respiratory organs, respiratory center.

The healing effect of ultraviolet radiation

The reaction from organs and systems depends on the wavelength, dose and method of exposure to UV radiation.

Local irradiation:

Anti-inflammatory (A, B, C);
- bactericidal (C);
- painkiller (A, B, C);
- epithelializing, regenerating (A, B)

General exposure:

Stimulating immune reactions (A, B, C);
- desensitizing (A, B, C);
- regulation of vitamin balance “D”, “C” and metabolic processes (A, B).

Indications for UV therapy:

Acute, subacute and chronic inflammatory process;
- trauma to soft tissues and bones;
- wound;
- skin diseases;
- burns and frostbite;
- trophic ulcer;
- rickets;
- diseases of the musculoskeletal system, joints, rheumatism;
- infectious diseases- influenza, whooping cough, erysipelas;
- pain syndrome, neuralgia, neuritis;
- bronchial asthma;
- ENT diseases - tonsillitis, otitis media, allergic rhinitis, pharyngitis, laryngitis;
- compensation for solar deficiency, increasing the stamina and endurance of the body.

Indications for ultraviolet irradiation in dentistry

Diseases of the oral mucosa;
- periodontal diseases;
- dental diseases - non-carious diseases, caries, pulpitis, periodontitis;
- inflammatory diseases maxillofacial area;
- TMJ diseases;
- facial pain.

Contraindications to UV therapy:

Malignant neoplasms,
- predisposition to bleeding,
- active tuberculosis,
- functional kidney failure,
- stage III hypertension,
- severe forms atherosclerosis.
- thyrotoxicosis.

Ultraviolet radiation devices:

Integrated sources using DRT (mercury arc tube) lamps of various powers:

ORK-21M (DRT-375) - local and general irradiation
- OKN-11M (DRT-230) - local irradiation
- Mayachnye OKB-ZO (DRT-1000) and OKM-9 (DRT-375) - group and general irradiation
- ON-7 and UGN-1 (DRT-230). OUN-250 and OUN-500 (DRT-400) - local irradiation
- OUP-2 (DRT-120) - otolaryngology, ophthalmology, dentistry.

Selective short-wave (180-280 nm) use bactericidal arc lamps (BA) in the glow electric discharge mode in a mixture of mercury vapor and argon. Lamps of three types: DB-15, DB-30-1, DB-60.

Irradiators are produced:

Wall mounted (OBN)
- ceiling (OBP)
- on a tripod (OBSh) and mobile (OBP)
- local (BOD) with lamp DRB-8, BOP-4, OKUF-5M
- for blood irradiation (AUFOK) - MD-73M "Isolda" (with lamp low pressure LB-8).

Selective long-wave (310-320 nm) use fluorescent erythema lamps (LE), 15-30 W, made of uveolian glass with an internal phosphor coating:

Wall-mounted irradiators (OE)
- suspended reflected distribution (OED)
- mobile (OEP).

Beacon-type irradiators (EOKS-2000) with a xenon arc lamp (DKS TB-2000).

An ultraviolet irradiator on a tripod (OUSH1) with a fluorescent lamp (LE153), a large beacon ultraviolet irradiator (OMU), a tabletop ultraviolet irradiator (OUN-2).

Low-pressure gas-discharge lamp LUF-153 in the UUD-1, UDD-2L units for Puva and therapy, in the UV irradiator for the limbs OUK-1, for the head OUG-1 and in the irradiators EOD-10, EGD-5. Units for general and local irradiation are produced abroad: Puva, Psolylux, Psorymox, Valdman.

Technique and methodology of ultraviolet therapy

General exposure

Carry out according to one of the following schemes:

Main (from 1/4 to 3 biodoses, adding 1/4 each)
- slow (from 1/8 to 2 biodoses, adding 1/8 each)
- accelerated (from 1/2 to 4 biodoses, adding 1/2 at a time).

Local irradiation

Irradiation of the affected area, fields, reflexogenic zones, staged or by zone, extrafocal. factional.

Features of irradiation with erythemal doses:

One area of ​​skin can be irradiated no more than 5 times, and the mucous membrane - no more than 6-8 times. Repeated irradiation of the same area of ​​skin is possible only after the erythema has subsided. The subsequent radiation dose is increased by 1/2-1 biodose. When treating with UV rays, light-protective glasses are used for the patient and medical staff.

Dosing

Dosing of UV irradiation is carried out by determining the biodose, biodose - minimum quantity UV radiation sufficient to produce the mildest threshold erythema on the skin within least time, with a fixed distance from the irradiator (20 - 100 cm). The biodose is determined using a BD-2 biodosimeter.

There are different doses of ultraviolet radiation:

Suberythemal (less than 1 biodose)
- erythema small (1-2 biodoses)
- medium (3-4 biodoses)
- large (5-6 biodoses)
- hypererythemal (7-8 biodoses)
- massive (over 8 biodoses).

For air disinfection purposes:

Indirect radiation for 20-60 minutes, in the presence of people,
- direct radiation for 30-40 minutes, in the absence of people.

Many pathologies are treated with the help of ultraviolet waves - skin diseases, problems internal organs and even metabolic disorders. What are the functions of ultraviolet therapy in medicine, what does it treat? this technique, what pros and cons does it have, are there any contraindications to it?

UV therapy: what is this method?

Dosed ultraviolet irradiation with rays of a certain spectrum in medicine and cosmetology is called UV therapy.

Under the influence of natural ultraviolet radiation from the sun, specific changes occur in human tissues. metabolic processes. Tanning with the formation of a dark pigment and dosed solar irradiation due to the action of UV waves give positive effect to your health. But in a city or winter period There is not enough ultraviolet radiation, and it is necessary to use additional UV therapy.

UV therapy: principle of action

When ultraviolet rays penetrate the tissues of the human body, streams of light energy are transformed into energy chemical reactions, while secretion occurs inside the tissues large quantity necessary for the body biologically active substances.

This can be histamine in small doses, serotonin, melatonin, the active metabolite of vitamin D and many others.

All these substances, due to the abundant blood supply to the skin, are actively absorbed into the blood and distributed throughout the body, which causes a response from many organs and systems, activation of metabolism and produces a positive biological effect.

However, with excessive irradiation - both solar and artificial - too many biologically active substances are produced, which leads to negative effects. Therefore, UV therapy is prescribed strictly according to indications and only in doses, literally minute by minute.

The main therapeutic effects of UV therapy

The main therapeutic and prophylactic effects of UV therapy:

  • anti-inflammatory;
  • anesthetic;
  • immunostimulating;
  • restorative;
  • antiallergic.

In addition, ultraviolet waves, when exposed to the skin, activate calcium metabolism and accelerate the absorption of vitamin D. This leads to a smooth and physiological decrease blood pressure, strengthening the processes of formation of lymphocytes in the blood and tissues.

In addition, the effect of ultraviolet rays on the body also has psychological effect, improving mood, helps to activate the immune system.

Local and general Ural Federal District

The use of UV therapy can be general, systemic, with effects on the entire human body, or local, with local irradiation of problem or painful areas.

Systemic ultraviolet radiation is used in dermatology for significant damage to the skin or mucous membranes, as well as for the prevention or treatment of rickets in children. In addition, general ultraviolet radiation increases the body's resistance and is used to prevent infection. Systemic ultraviolet radiation is used to stimulate metabolism and hematopoiesis, especially in chronic diseases.

Local irradiation with UV rays is practiced for seasonal colds, laryngitis and bronchitis, tonsillitis and sinusitis. Therapy is no less effective for bronchial asthma, osteochondrosis of the spine, burns and purulent wounds, for bedsores. Usually, special devices are used for local irradiation.

Ultraviolet irradiation is no less actively used for hypertension and rheumatism, peptic ulcer, lung diseases, skeletal problems and neurological disorders.

A separate procedure is ultraviolet irradiation of blood, passing it through a special apparatus and returning it back to circulatory system. The procedure stimulates immune protection, improves tissue trophism, enhances the functions of hemoglobin and red blood cells, normalizes blood acidity.

Due to the ultraviolet radiation of the blood, the effect of medications is activated. It is used in gynecology, dermatology or sports medicine.

When should UV therapy not be used?

There are no procedures without contraindications; there are also contraindications for UV therapy. It is strictly forbidden to use UV therapy for oncological diseases pulmonary tuberculosis, bleeding, smallpox, hyperthyroidism, systemic autoimmune diseases.

Therefore, when prescribing ultraviolet therapy, consultation with a physiotherapist is necessary.

In addition, no matter how good artificial UV irradiation is, it will never be equivalent sunlight. Therefore, all UV irradiation procedures must be taken in strictly dosed doses.

Phototherapy is widely used in medicine for the prevention and treatment of many diseases. The most commonly used is exposure to ultraviolet rays, or UVR.

What is UFO

Ultraviolet irradiation is a method of physiotherapy that is based on the impact electromagnetic spectrum, located between visible and x-rays. The wavelength of this radiation is different, and the effect produced on the human body will depend on it.

Long-wave radiation causes erythema, that is, redness of the skin and increased metabolic processes in it. Medium wave treatment stimulates the production of vitamin D and strengthens the immune system. And short ultraviolet rays have a bactericidal effect.
In UV physiotherapy, 2 types of devices generating UV rays are used:

  • integral - produces the entire spectrum from long to short;
  • selective - a source of one type of radiation.

General UV irradiation is used for preventive purposes. It is often prescribed to those who have recently suffered from an illness and are in a weakened state.

Local ultraviolet radiation is used to enhance blood circulation and lymphatic drainage, as well as stimulate the immune response in the affected area. Radiation helps prevent purulent complications in the presence of wounds and prevention of rheumatism with frequent sore throats.

Another use of ultraviolet light is the disinfection of premises. Germicidal lamps are installed in children's and medical institutions, sometimes in production and in public places.

How is physiotherapy performed?

Artificial general ultraviolet radiation can be carried out both individually and in groups. Group exposures occur more often in special rooms. An irradiator is installed in the center of the room, around which up to 25 people are placed at a distance of 3 m. The procedure takes only 3-4 minutes.
This technique is often used in pediatric practice to prevent vitamin D deficiency and rickets.

During local physiotherapy, ultraviolet light is directed locally to the treatment area using special attachments. These may be reflexogenic zones, mucous membranes or fields located near the site of injury. The course consists of 6-12 procedures, prescribed 2 or 3 times a week.

For acute respiratory infections, ultraviolet irradiation of the nasopharyngeal mucosa is prescribed; special tubes are used for this. A session for an adult is 1 minute, for a child 30 seconds. They also irradiate the chest along the fields, placing a special oilcloth with windows on it. This is necessary so that a new zone is processed each session.

Pustular skin lesions are treated only after sanitation of the eruptive elements, abscesses and boils - after excision. The emitter should be at a distance of 10 cm from the skin.
Regardless of which technique is chosen, the physiotherapist determines the minimum effective biodose for each patient before treatment. Most often, the course begins with 1/4-1/2 biodose.

Contraindications to the procedure

For some diseases and conditions, ultraviolet radiation is not prescribed. The procedure is contraindicated for:

  1. The presence of malignant neoplasms.
  2. Fever and hyperthermia.
  3. Excessive production of thyroid hormones.
  4. Immune diseases.
  5. Recently suffered a heart attack myocardium.
  6. Acute cerebrovascular accident.
  7. Insufficiency of liver and kidney function.
  8. Blood clotting disorders.
  9. Photodermatoses.
  10. Exacerbations chronic hepatitis and pancreatitis.
  11. Cachexia.

There are no contraindications for quartzing, but you must leave the room while the lamp is operating, and after disinfection is complete, ventilate the room well.

Both small children and adults suffer from diseases of the ENT organs. Cope with negative impact Physiotherapy using ultraviolet irradiation will help with the inflammatory process in the tissues of the ear, nose and throat. Proper Use procedures will help cure acute and chronic processes, improve general condition and help achieve maximum effect in treatment.

What is UV therapy? This is a technique that allows you to treat foci of the inflammatory process using ultraviolet radiation. The manipulation is completely painless; it increases blood flow in injured areas and ensures an active supply of leukocytes to relieve inflammation.

This technique has been found wide application in the treatment of ENT pathologies, since it allows you to regulate the length of the waves and the depth of their action. With short and shallow penetration it can have a bactericidal and antiviral effect. Average depth (from 280 nm) helps to activate the work of vitamins and improve the activity of immune processes in the body. Long-wave irradiation can form pigments and stimulate the immune system.

In the treatment of ENT pathologies, the method has the following effects:

  • Relieves inflammatory processes.
  • Works as a pain reliever.
  • Improves or activates regeneration processes on cellular level, thereby accelerating the healing process.
  • Bactericidal. Destroys microorganisms on the surface of wound areas or in inflammatory areas.
  • Improves and restores metabolic processes.

This physiotherapy procedure is often prescribed to small children for preventive or therapeutic purposes with a lack of vitamin D. Due to its deficiency, rickets can develop, and when exposed to ultraviolet radiation, the vitamin is actively synthesized, preventing the disease from developing.

Indications for use

UV therapy should not be used without apparent reason or without a prescription. Only when it occurs pathological processes in ENT organs, after examination and staging accurate diagnosis, the doctor can make an appointment.

The use of ultraviolet rays is recommended for:

  • Acute and chronic tonsillitis.
  • Treatment and prevention of bronchitis.
  • Sinusitis and sinusitis.
  • Enlarged adenoids in children.
  • Rhinitis.
  • Therapy for ear diseases.
  • Pharyngitis.

In some cases, doctors prescribe UVB therapy to stimulate or restore active work immune system, and also as prophylactic against respiratory viral infections.

Before starting the procedure, you should accurately establish the diagnosis, as there are a number of contraindications that can cause complications.

Contraindications for use

To restore the cell, its regeneration and protective functions In case of injuries or infections, it is recommended to use UV physiotherapy. But despite the effectiveness this method treatment, there are contraindications to its use:

  • Any stage of oncology development.
  • Autoimmune processes that are accompanied by sensitivity to ultraviolet radiation, for example, lupus.
  • Acute purulent inflammatory processes.
  • Excessive fragility of blood vessels and frequent bleeding.
  • Stomach ulcer, tuberculosis and arterial hypertension.

While pregnant or breastfeeding You can undergo physiotherapy only with the permission of your attending physician. The appointment is performed in case of inflammation of the nasal or oral mucosa.

Therapy using ultraviolet irradiation in correct dosages and at the right approach – indispensable assistant, effective remedy in the fight against ENT pathologies.

ENT diseases and ultraviolet treatment

If there are ENT pathologies, the doctor may prescribe radiation in the following cases:

  • ARVI. For the purpose of prevention or treatment of respiratory viral infections, daily dosed irradiation of the posterior wall of the nasopharynx and nasal mucosa is carried out. For adults, one minute is enough, for children half a minute.
  • For bronchitis, pneumonia and asthma. To carry out irradiation and eliminate foci of inflammation, it is necessary to “treat” 5 fields chest. When irradiating zones 1 and 2, the patient lies on his stomach, the manipulation is carried out over half of the posterior surface of the sternum (either side) or where the inflammatory process is located. When treating the lateral surfaces of the chest, the patient takes a “lying on his side” position with his arm thrown behind his head; this is considered the third and fourth area for irradiation. The fifth zone is located on the anterior side of the sternum with right side, V in this case the patient should lie on his back. It is necessary to irradiate each zone separately. In one day, you can perform only one procedure on one of the selected areas. The physiotherapy procedure takes about 5 minutes, each area should be treated 2-3 times.

  • Acute rhinitis, pharyngitis and laryngotracheitis. When you have a runny nose initial stage perform irradiation bottom surface stop for 4 days for 10 minutes. Also, using a special tube, UV irradiation of the mucous surfaces of the nose and pharynx is carried out starting from 30 seconds to a couple of minutes for 5 days. For pharyngitis and laryngotracheitis, ultraviolet radiation is used on the anterior surface of the chest, trachea and posterior surface of the neck. The rays have a good effect on back wall pharynx (using a tube). The manipulation takes no more than 10 minutes, therapy is carried out for one week.
  • Chronic tonsillitis. For inflammation of the tonsils, use a special tube with a cut ring. It is necessary to open your mouth wide and press your tongue to the bottom as much as possible; the cut side of the tube is directed directly to the affected tonsils. The impact should be alternated on each side for 2–3 minutes. The course of therapy is from a week to 10 days.

The possibilities of physiotherapy are enormous and, with the right approach, have the most positive effect on the body and affected areas, destroying pathogenic microorganisms, improving metabolic processes, accelerating healing and cell regeneration.

Features of the event


To ensure that the treatment is correct and does not harm the general condition of the patient, you should contact medical institution, where you will be provided with proper care using special equipment. However, there are also portable devices that can be used independently at home.

Step-by-step implementation of the physiotherapy technique:

  • To irradiate one of the selected zones, it is necessary to select the correct tube. There are several types of them, depending on the area that needs to be treated.
  • Before use, the device must be turned on and warmed up.
  • Start the session with 30 seconds and gradually increase the time limits to prescribed by the doctor period.
  • After completing the manipulation, the lamp must be turned off.
  • The patient should rest for half an hour.

The duration of the manipulation, the length of ultrasound penetration, the course of therapy - all this is prescribed and selected by the attending physician immediately after making an accurate diagnosis. Self-medication is very dangerous, especially at home.

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Dosimetry and dosing of ultraviolet radiation

Currently, domestic compact portable devices (UV radiometers) are produced for practice, making it possible to measure the energy characteristics of any sources of UV radiation with high accuracy.

IN practical work therapeutic and prophylactic and sanatorium-resort institutions can be used:
1. UV radiometer "Ermeter", designed to measure the effective erythemal illumination of human skin and determine the dose of radiation from any artificial, as well as natural source of UV radiation, regardless of the latitude of the area and the state of the Earth's ozone layer.
2. UV radiometer (“UV-A”, “UV-B”, “UV-C”), designed to measure the intensity and dose of UV radiation in spectral ranges A, B and C.
3. UV radiometer “Bactmeter”, designed to measure bactericidal UV illumination from bactericidal lamps.

All of the above radiometers consist of an electronic unit with a digital output and a photoreceiving head, the spectral sensitivity of which is different types radiometers are adjusted to tabulated sensitivity in accordance with WHO recommendations.

Using UV radiometers, it is possible to determine the threshold dose of UV radiation required for subsequent therapeutic effects. For example, the average threshold erythema-forming dose (with maximum sensitivity at 297 nm), according to some foreign standards (German Standard Din 5031, part 10) will be 250-500 J/m2.

However, in physiotherapy, to assess UV radiation, it is important to focus not only on physical quantities that reflect energy irradiation or radiation intensity, but also take into account the nature of the radiation it causes. biological effect. In this regard, the Dalfeld-Gorbachev method for assessing individual photosensitivity of the skin to UV rays has become widespread in practice (Fig. 327). With this method, the minimum duration of irradiation time required to obtain a threshold erythema reaction of the skin is determined. One biological dose (biodose) is taken as a unit of measurement.

The biodose is most often determined from a distance of 90 or 50 cm from the lamp to the surface of the skin of the abdomen outward from midline; the biodose from irradiators of the “ON” or “BOP-4” type (for irradiation of the nasopharynx) is determined on inner surface forearms.

To assess the photosensitivity of the skin, a standard biodosimeter (“BD-2”) is used, which is a metal plate 100x60 mm with 6 rectangular windows (“holes” 25x7 mm each), closed by a shutter moving on top. The biodosimeter is sewn into oilcloth and has ribbons for fixing it on the patient’s body.

Determination of biodose

1. The patient’s position on the couch is lying on his back. The patient puts on light-protective glasses.
2. A biodosimeter with closed windows is attached to the skin of the abdomen outward from the midline (right or left). Areas of the body not subject to UV irradiation are covered with a sheet.
3. The irradiator lamp is placed above the biodosimeter, measuring along a plumb line with a centimeter tape what is needed for subsequent medical procedures distance (30 or 50 cm) from the radiation source to the surface of the biodosimeter.
4. Turn on the irradiator and sequentially (opening the shutter every 30 s) irradiate 1-6 windows of the biodosimeter.
5. Upon completion of irradiation of all windows, close them with a shutter and turn off the irradiator.

The results of determining individual photosensitivity of the skin are assessed after 24 hours (in daylight), while the erythema stripe of minimal (in terms of color degree) intensity, but with clear edges, will correspond to the time of 1 biodose.

For example, when the biodosimeter was irradiated for 3 minutes (i.e., 30 s for each window), the irradiation time of the first window was 3 minutes, the second - 2 minutes, etc., and the sixth - 30 s. After a day, only 5 of 6 stripes appeared on the skin of the abdomen with decreasing (top to bottom) color intensity, with the last (5th) strip having unclear (“blurred”) edges. In this case, the threshold erythema reaction of the skin should be taken as the 4th strip (with clear edges) and the corresponding biodose time, i.e. 1.5 minutes.

Depending on the task of the physiotherapist and the type of irradiator, UV irradiation is carried out from various working distances: 30, 50, 75, 100 cm. Based on a known biodose, if necessary, an arithmetic recalculation of the biodose can be made to any required distance using the formula:

X = A*(B2/C2) (min),

Where: X is the required biodose per minute; A - time in minutes and C - distance in cm of a known biodose; B is the distance in cm from which irradiation is supposed to be carried out.

Example. A known biodose (from a distance of 50 cm) is equal to 1 minute. It is necessary to determine the biodose time from a distance of 100 cm. Using the formula we find:

X = 4 min.

Consequently, the time of one biodose from a distance of 100 cm will be equal to 4 minutes.

IN outpatient practice, as well as for UV irradiation that does not require delay (for example, with erysipelas etc.), it is allowed to use the so-called “average biodose” for a specific irradiator. It is preliminarily determined (for each irradiator separately) in 10-12 practically healthy individuals, while the arithmetic average value of the time of the found biodoses will correspond to the time of the “average biodose” for a given irradiator. It is recommended to determine the “average biodose” every 3 months.

To determine the biodose of UV radiation in pediatric practice, the same method (Dalfeld-Gorbachev) is used. Given the high sensitivity child's body to UV rays, it is recommended to sequentially open the biodosimeter windows every 15 s (this should be done especially when determining the biodose in children in the first months and years of life). In children school age It is permissible to open the “holes” of the biodosimeter every 30 s.

The results of determining skin photosensitivity in children should be preliminarily assessed 3-6 hours after irradiation (in a hospital setting) and finally after 24 hours (in inpatients and outpatients). When carrying out UV irradiation, it is also necessary to take into account the general condition of the child, the period of the disease, the nature of its course, the state of the body's protective and adaptive mechanisms, and the light-climatic conditions of the child's life.

Ultraviolet radiation technique

General ultraviolet exposure

At general exposure During one procedure, the front and back surfaces of the patient’s naked body are alternately exposed. Irradiation can be individual or group. The patient's position is lying or standing.

For group irradiations, it is recommended to center the irradiator lamp on the chest, back, and for individual irradiations, on the upper third of the thigh (when using the ORK-21M irradiator) or on the navel area (when using the EOD-10 irradiator). Depending on the type of irradiator, the distance from the UV radiation source to the irradiated surface is 50-100 cm.

Before general individual irradiation, the photosensitivity of the patient's skin is determined. For group irradiations, it is permissible to use the average biodose for a given irradiator. For general UV exposure, patients should wear light-protective glasses. Irradiation is carried out according to schemes, starting with suberythemal doses (1/8, 1/4, 1/2 biodose). There are 3 generally accepted (approximate) schemes for general UV irradiation (Table 7). The choice of circuit is determined general condition patient and (or) the nature of the disease. General UV irradiation is carried out daily or every other day; if necessary, the course is repeated after 2-3 months.

Table 7. Sample diagrams general UV exposure

Local ultraviolet irradiation

With local irradiation, limited areas of the skin surface are exposed: 400-600 cm2 (in adults) and 50-400 cm2 (in children). In children, the area of ​​the irradiated surface depends on the age of the child: up to 1 year of life - 50-80 cm2; from 1 year to 3 years - 80-100 cm2; from 3 to 5 years - 100-160 cm2; from 5 to 7 years - 150-200 cm2; for children over 7 years old - 200-400 cm2. For local irradiation, erythemal (1-8 biodoses) and less often suberythemal (up to 1 biodose) dosages of UV irradiation are used. In children, the first dose of radiation should not exceed 2 biodoses.

Repeated irradiation of the same area of ​​skin is usually carried out every other day (less often - after 2 days), various areas skin surface (taking into account their area) can be irradiated in one day. Repeated irradiations of the same field are carried out in increasing (by 1-2 biodoses) dosage.

Due to changes in the optical properties of the skin, erythema doses are prescribed repeatedly to the same area, but on average no more than 4-5 times. The number of local irradiations using suberythemal UV exposure can be increased to 7-14. If indicated, a second course of erythemotherapy can be carried out no earlier than after 7-8 weeks, i.e. after restoration of sensitivity of irradiated skin areas to UV rays.

There are several methods of local irradiation: a) irradiation of the site (focus) of the lesion (wound, trophic ulcer, etc.); b) extrafocal irradiation (repercussion technique) - exposure to an area of ​​the skin surface symmetrical to the site of the lesion (for example, if there is a plaster cast on the affected leg - irradiation of the healthy leg); c) irradiation with fields (chest, along the nerve, etc.);

D) segmental irradiation of reflexogenic zones (collar zone, panty zone, Zakharyin-Ged zones, etc.); e) stage-nose irradiation (by zone-belt); c) fractionated irradiation, in which, in order to limit UV exposure over an area, a “perforated localizer” made of medical oilcloth measuring 30x30 cm is used.

150-200 square holes with a side of 1 cm and at a distance of 1-2 cm from each other are cut out in it. Irradiation is carried out in erythemal doses through holes in an oilcloth placed on the patient’s body. During one procedure, two fields are irradiated (chest, back). For fractionated irradiation of children, a perforated localizer is also used: for newborns - with 12 holes with an area of ​​0.5-1 cm2; for infants - from 40 and for older children - with 70-125 holes of the specified area size.

Bogolyubov V.M., Vasilyeva M.F., Vorobyov M.G.