Cerebral ischemia (CI) is damage to the brain tissue that occurs as a result of prolonged insufficient oxygen supply. CI occupies one of the most important places in terms of incidence and significance in the morbidity structure, making up 60-80% of all diseases of early childhood and occupying the 1st place in the structure of children’s disability. She is assigned the main role in the formation of the breakdown of the adaptive capacity of the newborn. Pathologically, this pathology is manifested in persistent hypoxia of brain tissue due to spasm of small blood vessels, a decrease in blood flow to the brain, and metabolic disorders in nerve cells [6, 12].

One of the pathogenetically substantiated non-drug methods of treating patients with this pathology is general magnetic therapy and hyperbaric oxygenation (HBO). Under our supervision there were 150 children of the first month of life with cerebral ischemia of moderate severity, hypertensive-hydrocephalic syndrome, who were hospitalized at MMU DGKB № 1 them. N.N. Ivanova G. O. Samara in 2009-2010 : (I can’t translate all study sorry)

So: Just part for 3 d group: Hbot+ magnetic therapy

Children III, the main group received a standard for this pathology drug therapy, a course of general magnetic therapy, and after it ended, they conducted a course of hyperbaric oxygenation (HBO). HBO was performed in the physiotherapy department of the MUH DGKB № 1 them. N.N. Ivanova in accordance with the requirements of ONTP 24-86 MVD, SNiP 11-69-78, GOST 12.2.052-81, OMU 42-21-26-88, GOST R 51316-99. Used pressure chamber BLKS – 3-01. The equipment is certified by the relevant authorities and approved by the Ministry of Health and Social Development of the Russian Federation and the Gosgortechnadzor of Russia to conduct HBO sessions.

Before the first session of HBO therapy, the parents of the children were introduced to the essence of the upcoming treatment in the pressure chamber, the requirements for the child’s clothes. When placed in the pressure chamber, patients were dressed in cotton underwear, and a cotton cap was put on their heads. For vacation sessions of hyperbaric oxygenation to children in the first months of life, we have developed a device in the form of a special L-shaped mattress. It is made of technical foam rubber, impregnated with flame retardant. The mattress is located in the pressure chamber, closing the input panel, but thus not preventing the child from moving [8].

Hyperbaric oxygenation was performed for children in an atmosphere of pure oxygen, carrying out a preliminary leaching regime, the pressure was raised to 0.2-0.4 ati, ( it’s means 1,2-1,4 ata total pressure) at a rate of 0.1 ati (1,1 ata) for 2 minutes, saturation for 15-20 minutes, decompression at 0.1 (1,1ata) at 1 minute . The duration of compression and decompression was 4 minutes each. The total duration of the session is 30 minutes. The course of treatment was 8-10 procedures carried out daily [3].

In children who received complex treatment in combination with HBO and general magnetic therapy, the most positive dynamics of NSDG parameters were observed. In 65.4% of patients in this group, a decrease in lateral ventricular indices was noted, in 72.1% a decrease in bone-brain diastasis, in 74.3% a decrease in the size of the interhemispheric fissure (p <0.05) compared with group 1 . In 23% of the observed children, the presence of periventricular leukomalacia was noted. She underwent a reverse development during treatment in patients in all three groups. However, we observed a significant decrease in the number of patients with such an ultrasound picture of the brain tissue only in children who received physiotherapy treatment.

Patients of group II compared in 22.5%, III, main group, in 47% (p <0.05). One third of children with cerebral ischemia under our supervision observed the presence of a pseudocyst or a symptom of « Swiss cheese. » Against the background of the therapy, statistically significant changes in the form of complete resorption of these formations or reduction of their size were noted only in the II and III groups – in 32.2% and 33.1%, respectively.

After treatment, all patients showed a positive trend in EEG indices. However, significant changes were noted only in children of groups II and III. So, the restoration of the picture of the zonal pattern of the electroencephalogram according to the age norm was observed in 29.4% of patients of group II and 36.5% of group III (p <0.05). Significant negative samples for hypercapnia and photostimulation were observed only in children of group III compared with data in children of groups I and II (p <0.05).

Thus, the proposed methods of non-pharmacological treatment of cerebral ischemia in children in the neonatal period can significantly improve the effectiveness of standard therapy for this pathology.

Пименов Ю.С., д.м.н., профессор, зав. кафедрой внутренних болезней НОУ ВПО «Самарский медицинский институт «РЕАВИЗ», г. Самара;

Богданова Л.П., д.м.н., профессор кафедры реабилитации и сестринского дела НОУ ВПО «Самарский медицинский институт «РЕАВИЗ», г. Самара.

Laisser un commentaire