Ларинготрахеит у детей

According to the World Health Organization, in recent years there has been an increase in the incidence of acute respiratory viral infection. In this regard, the attention of pediatricians and otolaryngologists is attracted by acute stenosing -laryngotracheitis (ASLT). According to the data of many years of research, the number of patients with ASLT ranges from 0.1 to 0.4% of all children hospitalized with a diagnosis of acute respiratory viral infection. The development of stenosing laryngotracheitis in acute respiratory viral infection (AR.VI) dramatically aggravates the condition of sick children, and sometimes the life of a child depends on its attachment to the underlying disease.
Since the first days of independence , large-scale reforms have been consistently implemented in our country in order to improve the quality of medical care for the population . Thus, effective medical care for children ensured timely detection, early diagnosis and treatment of patients with ASLT, which made it possible to reduce the duration of their treatment in the hospital by 3-4 days.
Despite numerous scientific studies devoted to the study of the patterns of the infectious process in stenosing laryngotracheitis, the role of dysbiocenosis of the mucous membranes of the upper respiratory tract, the process of endogenous intoxication (El), which develops as a result of illness in children and its relationship with the course of the disease, as well as the state of the system of local and general immunity dictate the need to improve the methods of their correction in the light of modern requirements. At the same time, the causes of recurrence of acute stenosing laryngotracheitis have not been fully determined; an important task is to develop prognostic criteria for assessing the outcomes of OSLT.
Given the dissertation research to a certain extent serves to solve the problems provided for in the resolutions of the President of the Republic of Uzbekistan No. PP-2133 dated February 19, 2014 “On the State Program" The Year of a Healthy Child ’’and No. PP-2221 dated August 1, 2014 “On the State Program for Further Strengthening reproductive health of the population, protection of the health of mothers, children and adolescents in Uzbekistan for the period 2014-2018”, as well as in other legal documents adopted in this area.
Scientific research aimed at improving the methods of complex diagnostics, treatment and prevention of stenosing laryngotracheitis in children was carried out in many leading medical centers, such as the Schneider Children's Medical Center (Israel), Giessen University Hospital (Germany), St. Mary's Children's Clinic (Germany), Center of Innovative Medicine Interbalkan (Greece), Generale Clinic (Switzerland), Royal Clinic (Great Britain), Queens Medical Center (Great Britain), IDIBAPS Clinic (Spain), St. Luke's Hospital (Japan), Federal Scientific and Clinical Center of Otorhinolaryngology FMBA of Russia (Russia) , as well as the Tashkent Pediatric Medical Institute and the Republican Specialized Scientific and Practical Medical Center for Pediatrics (Uzbekistan).
As a result of the studies, criteria for assessing the risk of occurrence and recurrent course of OSLT were developed, the mechanisms that determine the sensitivity of the respiratory tract were identified (Freiburg Clinic, Germany); established endocrine dysfunction in children with primary and recurrent acute stenosing laryngotracheitis (Children's Hospital, Ireland); the influence of the composition of the microflora of the main loci of the body, connective tissue dysplasia, regulatory systems on the function of external respiration, the formation of threshold sensitivity and reactivity of the respiratory tract in children with recurrent stenosing laryngotracheitis (RSLT) was proved (Melbourne University, Australia).
At present, the goal of many studies in the world is to further determine at the immunomolecular level the role of specific and non-specific factors of immune protection in the pathogenesis of acute stenosing laryngotracheitis; assessment of the state of non-specific protection during OSLT; study of significant changes in the cellular link of immunity, changes in T-suppressors and partially B-lymphocytes; as well as the prevention of relapses and the improvement of methods for diagnosing and treating the disease.

As the analysis of special literature showed, a number of researchers studied the role of the allergic component and the autonomic nervous system in the pathogenesis of the development of primary and recurrent OSLT. According to the results obtained, more than 90% of sick children in the pathogenesis of primary and recurrent acute stenosing laryngotracheitis is dominated by allergic component with the identification of common and allergen-specific IgE . In addition, it has been proven that the development of OSLT in parainfluenza infection is associated with a significant increase in IgE titer and specific IgA in nasopharyngeal secretions in children with ARVI. The mechanisms of OSLT recurrence based on a significant change in the immunological reactivity of the body, which are associated with its allergization by both infectious and non-infectious agents, including adverse environmental, seasonal, meteorological and even social conditions, have been studied. It has been proven that OSLT proceeds with vegetative disorders, which, in turn, have a significant impact on the course and outcome of the underlying disease. An improved treatment of OSLT at the height of the disease is proposed, based on the use of drags, taking into account the type of initial vegetative tone of the body.
Despite numerous works devoted to the study of acute stenosing laryngotracheitis, its diagnosis and methods of treatment, the trend towards an increase in the recurrence of the disease persists, which dictates the need to study the general patterns of the infectious process in stenosing laryngotracheitis, assess the significance of the microbiocenosis of the mucous membranes of the upper respiratory tract, disorders of the immune and interferon statuses and development of ways to correct them, predict the disease on the basis of a prognostic map, as well as improve the effectiveness of treatment and preventive measures.