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«Наука через призму времени»
Апрель, 2023 / Международный научный журнал
«Наука через призму времени» №4 (73) 2023
Автор: Nabieva Shohista Mustafaevna, assistant
Рубрика: Медицинские науки
Название статьи: Diagnostic scale for assessing the functional state of the cardiovascular system in newborns with perinatal damage to the central nervous system
Дата публикации: 12.04.2023
DIAGNOSTIC SCALE FOR ASSESSING THE FUNCTIONAL STATE OF
THE
CARDIOVASCULAR SYSTEM IN NEWBORNS WITH PERINATAL DAMAGE
TO THE CENTRAL NERVOUS SYSTEM
Nabieva Shokhista Mustafaevna
Assistant
of the Department of Pediatrics No. 1 and Neonatology
Samarkand State Medical University, Samarkand,
Uzbekistan
Abstract. In recent years, diseases of
the cardiovascular system in children have been detected more and more often,
among which functional pathology of the heart is of great importance, there are
not enough studies on the postnatal adaptation of the cardiovascular system and
newborn children affected by perinatal hypoxia, no work has been found on
corrective measures in this category of patients. Our goal was to develop a
differentiated approach to the early diagnosis of changes in the functional
state of the cardiovascular system in newborns with perinatal lesions of the
central nervous system, therefore, a diagnostic scale for instrumental
assessment of the functional state of the cardiovascular system was developed
and proposed, which is determined by the value of the diagnostic coefficient
and will enable early diagnosis of cardiovascular disorders systems in newborns
with perinatal damage to the central nervous system.
Keywords: diagnostic coefficient, diagnostic
scale, functional state of the cardiovascular system, instrumental assessment.
The
relevance of research. Reducing
mortality and morbidity in the neonatal period remains one of the important
tasks of modern medicine. Perinatal lesions of the central nervous system of
newborns occupy a leading place in the structure of perinatal morbidity and
account for about 50% of children's disability. At the same time, various
disorders of the condition in the perinatal period of a newborn can cause the
development of cardiovascular disorders, the development of heart failure [1,2].
In recent years, diseases of the cardiovascular system
in children have been detected more and more often, among which functional
pathology of the heart is of great importance [8]. In newborns with perinatal
hypoxia, developing hypoxic-ischemic changes in many organs and systems of the
body are further manifested mainly by perinatal lesions of the central nervous
system, and some children - in the form of myocardial changes, the severity of
which depends on the severity of hypoxia, hemodynamic disorders, as well as
their pathological interactions on each other. The complex of changes that
occur in this case has an adverse effect on both the central nervous system,
disrupting the regulatory influence of subcortical structures of the brain on
the functional state of internal organs, and directly on the cardiovascular
system, which in turn undoubtedly has an adverse effect on the neurological
status, thereby creating a "closed" circle [3,4].
Considering the urgency of this problem, as a result of the conducted studies,
which determined the relationship of anamnestic, clinical, laboratory and
instrumental indicators, according to the purpose and objectives of the study,
there was a need to compile a diagnostic scale for assessing the functional
state of the cardiovascular system in perinatal lesions of the central nervous
system in newborns [5, 6, 7].
Purpose of research:
for a comprehensive
study of the data obtained, compile and use a table of coefficients (Table 1),
which was the basis for the development of a diagnostic scale for instrumental
assessment of the functional state of the cardiovascular system in newborns
with perinatal lesions of the central nervous system.
Research materials: We evaluated the effectiveness of the diagnostic scale
of instrumental assessment of the functional state of the cardiovascular system
in newborns with perinatal damage to the central nervous system by examining 30
newborns with perinatal damage to the central nervous system in the Regional
Children's Multidisciplinary Center in the Department of Neonatology.
Results and discussion: For the purpose of a comprehensive study of the data
obtained, we compiled a table of coefficients (Table 1), which was the basis
for the development of a diagnostic scale for the instrumental assessment of
the functional state of the cardiovascular system in newborns with perinatal central
nervous system lesion.
Table 1 Coefficients
of risk factors for the development of congenital heart disease in newborns.
|
№ |
Factor |
Characteristic of the
indicator |
|
|
indicators |
Coefficient (point) |
||
|
Neurosonography |
|||
|
1.
|
Third ventricle
(mm) |
≤5,9 |
1 |
|
2.
|
Fourth ventricle
(mm) |
≤6,1 |
1 |
|
3.
|
Subarachnoid space (mm) |
≤4,9 |
1 |
|
Echocardiography |
|||
|
4.
|
Final
systolic size (cm) |
≤3,14 |
1 |
|
5.
|
Final
diastolic volume (ml) |
≤6,58 |
1 |
|
6.
|
Impact
volume (ml) |
≤5,09 |
1 |
|
7.
|
Minute blood volume, l/min |
≤0,77 |
1 |
For the objectivity of further analysis, we have taken
only reliably significant indicators reflecting the state of the cardiovascular
and central nervous systems, the results of which we received earlier and each
of which was rated 1 point. In 30 newborns with perinatal lesions of the
central nervous system, divided into 3 subgroups (1, 2, and 3 subgroups) of 10
people, the diagnostic coefficient was equal to: Diagnostic coefficient<1,0 point,
1,0< Diagnostic
coefficient<4,0 и Diagnostic coefficient≥5,0 points according to the subgroup of
children.
Based on the
obtained values of the coefficient of risk factors for the development of
congenital heart disease in newborns and for the convenience of practical use
of the result obtained, a diagnostic scale of instrumental assessment of the
functional state of the cardiovascular system in newborns with perinatal central nervous system lesion was compiled. After
examination of a newborn with a perinatal central nervous system lesion, in
order to determine the state of the cardiovascular system, along with clinical
and laboratory examination, the patient's risk factor coefficients were
determined on the basis of neurosonographic and
echocardiographic examination (Table. 1) and the diagnostic coefficient was
calculated, which was determined by summing the scores of the coefficients of
risk factors (Table 2).
Table
2 Diagnostic scale of instrumental assessment of the functional state of the
cardiovascular system in newborns with perinatal central nervous system lesion.
|
Diagnostic coefficient |
Functional
state of
the cardiovascular system |
|
DC<1,0
point |
There are no changes |
|
1,0<DC<4,0 point |
Moderate changes |
|
DC≥5,0 point |
Pronounced changes |
As can be seen from the table, the functional state of
the cardiovascular system is assessed according to the presented diagnostic
scale, with DC<1.0 points there are no clinical signs of the functional
state of the cardiovascular system, with 1.0 <DC<4.0 points moderate and
with DC≥5.0 points pronounced functional changes of the cardiovascular
system in children with perinatal central nervous system damage are detected.
The results of the study confirmed the possibility of
using a diagnostic scale for instrumental assessment of the functional state of
the cardiovascular system in newborns with perinatal central nervous system
lesion.
Conclusions. Thus, the results obtained in these groups of
children provided additional diagnostic criteria - a diagnostic scale for
instrumental assessment of the functional state of the cardiovascular system in
newborns with perinatal lesions of the central nervous system, the use of which
will allow timely treatment and reduce the incidence of complications of the
disease. The study of literature data, analysis and discussion of their own
research served as the basis for making relevant conclusions and practical
recommendations.
Literature:
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- Afonina I. A., Naumenko E. I. Electrocardiography in children with extrasystoles //Materials. – 2019. – Vol. 100. – P. 130
- Barashnev Yu.I. Perinatal neurology. M.: Triad-X, 2005; pp. 87-122
- Bokeria E.L. The nature of changes in morphometric parameters of the heart in various types of fetal cardiac rhythm and conduction disorders at 22-29 weeks of gestation / E.L. Bokeria, E.D. Bespalova, O.G. Suratova // Diagnostic issues in pediatrics. - 2011. - No. 6. - pp. 33-39.
- Zinchuk V. V., Gatsura S. V., Glutkina N. V. Correction of oxygen transport function of blood in pathology of the cardiovascular system. – 2016.
- Strizhakov A. N., Lipatov I. S., Tezikov Yu. V. Placental insufficiency. – 2014.)
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