Objects of research: 1st group (control) - 8 dogs, which apply traditional intensive therapy at craniocereberal trauma without hypothermia. 2 st group - 8 dogs, which apply drug treatment with external craniocerebral hypothermia. 3 st group -8 dogs, which apply drug treatment with perfusion method of hypothermia. At 286 patients with heavy craniocerebral trauma, efficiency hyperventilation on a background of various methods CCH is investigated depending on type of infringement of a cerebral blood flow.
Purpose: to optimize results of protection and reanimation of a brain at a severe craniocereberal trauma by perfection of a method craniocerebral hypothermia and the differentiated choice of a mode of artificial ventilation easy.
Methods: the cerebral blood flow parameters estimated by transcranial Dop-plcrography datas. Also was definite saturation of arterial (SataO2) and venous (SaI. vjO2) blood oxygen, cerebral blood flow (arteriovenous difference O2), a level of lactate in peripheral blood and in liquor, parameters of intensity.
Results and novelty: by complex study was proved that perfusion method of the craniocerebral hypothermia is an effective and adequate method of protection of a brain caused by hypoxia and secondary damages at severe craniocerebral trauma. It is established, that at carrying out perfusion CCH the important factor of protection of a brain from hypoxia and secondary damages to which the death of animals at severe craniocerebral trauma, is preservation on a limit of physiological norm of functioning erythrocytes owing to adaptable decrease in processes the lipid peroxidation, preservation at high enough level of activity of enzymes antioxidant system, reactions peroxide hemolysis erythrocytes and which can serve as criteria of an estimation of the forecast of efficiency of spent treatment, an outcome of disease.
Practical value: it is developed and pathogenetic efficiency of a perfusion method of the CCH is proved at severe craniocerebral trauma. The algorithm of differential use hyperventilation at patients with severe craniocerebral trauma is developed depending on type of cerebral blood supply disturbance and a degree of development intracranial hypertension.
Inclusion of a method perfusion method of the CCH increase efficiency of protection of a brain from hypoxia and secondary damages reduces frequency of lethal outcomes at severe craniocerebral trauma.
Introduction and economic efficiency: results of research are introduced in practice of the Republican science centre of neurosurgery Health Ministry of the Republic of Uzbekistan and department of anesthesiology and resuscitation of 2-clinic of the Tashkent medical academy.
Field of application: resuscitation and neurosurgery.
At present, the cerebral circulation disorder is caused by various factors. According to the Ministry of Health of the Republic of Uzbekistan, 62876 cases of strokes were registered in Uzbekistan in 2019. 15% acquired lethal outcome, 10-15% returned to their previous state, 55 - 70% became disabled. Stroke is translated from the Latin language as a "stroke" which means an acute cerebral circulation disorder. Regardless of the cause of cerebral circulation disorder, the result is always the same - the death of brain neurons. The most common cause is atherosclerosis on the inner walls of blood vessels that supply the brain. They narrow the blood vessels and make them less flexible. In this case, the probability of clogging the blood vessels with blood clots increases, as a result, the blood vessels cannot supply blood to the brain.
Among organic brain lesions, cerebral palsy occupies one of the first places in the structure of nervous diseases. As a result of brain damage, children have severe neurological complications in the form of motor disorders ,as well as a delay in the rate of development of such functions as speech, memory, attention, and thinking. But along with this, the developing brain has high compensatory capabilities and plasticity. Therefore, early diagnosis and adequately selected therapy of cognitive disorders contributes to improving the effectiveness of rehabilitation measures, reducing disability .
The brain organic defect, which forms the basis of cerebral palsy, occurs early, during the incomplete process of formation of the main structures and mechanisms of the brain, which causes a complex combined structure of neurological and mental disorders. The degree of mental disorders varies from mild disorders in the emotional sphere to severe intellectual underdevelopment. The peculiar- ity of mental development in cerebral palsy is not only its slow pace, but also its uneven nature. In recent years, microcurrent reflexo - therapy (MTRT) has been widely used to correct motor and coordination disorders in this group of patients.
Cardiovascular pathology and acute cerebrovascular accident (ACV) are in first and second place, respectively, as the causes of mortality in the structure of general mortality of the population. In this regard, interest in the issues of cerebral blood flow disorders does not weaken all over the world, more and more new aspects of this problem are being considered. CVA is a widespread pathology in the world and according to the WHO “... about 17.5 million people die every year from cerebrovascular diseases in the world, which is 30% of mortality from all diseases ...”. The most severe form of vascular pathology of the brain is a stroke. In European countries, mortality from stroke varies from 63.5 to 273.4 people per 100,000 population per year. About 85-88% of cerebral strokes are ischemic in nature. Ischemic stroke in developed countries ranks first as a cause of permanent disability. Movement disorders of varying severity are the most common and severe consequences of strokes.
Purpose of research. To assess the impact of the severity of motor disorders in children with cerebral palsy on nutritional status.
Materials and methods of research. The study included 102 children with cerebral palsy aged 2 to 17 years, 60 boys (58.8%) and 42 girls (41.2%). The average age of the children was 7.23 ± 4.9 years. Patients were ranked by age group in accordance with the age classification of the GMFCS scale. All children underwent a comprehensive clinical and neurological examination, nutritional status assessment, and anthropometry (measurement of shoulder circumference and plicometry). During anthropometry, the control group included 30 healthy children with an average age of 7.7±4.2 years.
Results. It was found that with an increase in the severity of motor disorders, the number of children with protein-energy deficiency increases from 50% at level I to 100% at level V on the GMFCS scale (the significance of differences in Pearson's Chi-square was confirmed statistically: 9.32, p = 0.002069). At the same time, a severe degree of protein-energy insufficiency was observed mainly in double hemiplegia (amounting to 40.9%). Prognostically, cerebral palsy was the most favorable type of spastic hemiparesis and spastic diplegia, with a predominance of protein-energy insufficiency of a mild degree, amounting to 45.8% and 60%, respectively. In 71.6% of cases (n=73), children with cerebral palsy were diagnosed with oral-motor dysfunction of varying severity, problems with food consumption and, as a result, a noticeable lag in anabolic processes. Statistically significant differences were found in the frequency of feeding difficulties in children with levels I and V of motor abilities (Pearson's Chi-square: 20.12, p = 0.000005).
Chronic brain ischemia (CHEM) develops due to insufficient blood circulation of the brain, is one of the most common cerebrovascular diseases, accompanied by cognitive disorders, with a decrease in concentration and cognitive activity, and emotional disorders.
The article describes a clinical case of a patient with chronic brain ischemia.
Clinically, neurotrophic disorders manifest themselves most often in acute brain diseases (strokes, injuries, meningoencephalitis, etc.), accompanied by the involvement of the hypothalamus - pituitary gland, brain stem, sympathetic and vagus nerves [3]. At the same time, the greatest functional and morphological disorders are observed in the gastrointestinal tract (ulcers, erosion, hemorrhages), lungs (edema, pneumonia) and pancreas (transient hyperglycemia) [1, p. 529] and liver (4, p. 170] Despite the fact that the main theater of action is expressed in a local catastrophe of the brain and neurological disorders, most researchers and practitioners do not pay due attention to the essential role of the "main laboratory" of the body - the morphofunctional state of the liver [7, p. 876].
I ntroduction. At an international seminar devoted to CCP (Maryland, USA, 2004), researchers concluded that CCP is a clinical descriptive term, not an etiologic diagnosis, and includes a group of developmental disorders and body postures that limit activity that are caused by non progressive defeat of the developing brain of the fetus or child. Attention was drawn to the fact that motor disorders in cerebral palsy are often accompanied by sensory defects, changes in cognitive and communicative functions, perceptual disorders, behavior, and convulsive attacks [1,9]
Hemorrhagic stroke among acute cerebral circulatory disorders is characterized by severe neurological complications and the need to choose between surgical intervention or therapeutic therapy. According to the World Health Organization (WHO)". Globally, stroke deaths will reach 7.8 million by 2030 unless an aggressive global response to the epidemic is put in place" 1. Subarachnoid haemorrhage, which accounts for half of the non-traumatic intracerebral haemorrhage, affects the most active and able-bodied population. The most important medical and social objectives are to monitor the course of the disease from the first hours after the onset of stroke, to prescribe adequate treatment in a timely manner, and to reduce mortality and disability rates [5,9].