Low-intensive Laser Therapy for Management of Cerebral Dysfunction in Patients with Obstructive Jaundice of Non-tumor Origin

Abstract

BACKGROUND The liver’s function is impaired above all others in the mechanical jaundice, which leads to the progression of endogenous intoxication and the damage of different organs and systems, including the brain. The development of hepatic encephalopathy undoubtedly aggravates the course of the disease, which requires its timely management.AIM OF STuDy: to evaluate the effcacy of the low-intensity laser therapy when managing the cerebral dysfunction in mechanical jaundice of non-tumor origin.MATERIAL AND METHODS A comprehensive study of 60 patients with obstructive jaundice of non-tumor origin was performed. The patients were divided into 2 groups: I (comparison) — the standard therapy (n=30); II (studied) group — inclusion of low-intensity laser irradiation of blood (n=30). On check dates (day 1 and 7), the severity of cerebral dysfunction was assessed in all patients using the psychometric tests (“Point in Circle, “Labyrinth”). The microcirculation was assessed with LACC 02 device (Russia). The coagulation/lysis system of blood was studied with TEG 5000 thrombelastograph (USA).RESULTS In patients with obstructive jaundice, disorders of the functional state of the liver were noted, which resulted in the growth of total bilirubin, alanine and aspartic aminotransferases, and toxic products. All this was accompanied by cerebral dysfunction, which was shown by results of the psychometric study and extended performance of tests, in particular (“Point in Circle”, “Labyrinth”). Signifcant changes and disorders of the hemostatic system were revealed in patients. The complex treatment of obstructive jaundice, which included laser therapy, allowed a relatively rapid recovery of the functional state of the brain to be observed, as evidenced by the shortening of the test time for the tests being studied. The positive effect of this kind of therapy was accompanied by a decrease in the severity of the syndrome of endogenous intoxication, improved microcirculation and hemostasis.CONCLUSION The presence of pancreatic obstructive jaundice lead to the development of florid syndrome of endogenous intoxication, which was reflected in the growth of ALT, AST, amylase, and total bilirubin. During the entire period of the study, a decrease in studied blood parameters was observed in patients who had underwent low-intensity laser therapy sessions. Conducting a psychometric study in the initial periods revealed some violations, such as extended performance of tests (“Point in Circle”, “Labyrinth”).