СОВРЕМЕННЫЕ ПРИНЦИПЫ КОМПЛЕКСНОЙ РЕАБИЛИТАЦИИ ДЕТЕЙ С ПОСЛЕДСТВИЯМИ ИНСУЛЬТА

The article is dedicated to an urgent issue of modern pediatrics and neurology — complex treatment of stroke consequences in children. The article details etiological aspects, pathophysiological mechanisms and clinical peculiarities of stroke consequences in children, the primary among which are asthenic syndrome (73–86% of the patients), movement disorders (33–58%), cognitive disorders (60%), paroxysmal conditions (30%), sensory disorders (14%), emotional-volitional and behavioral disorders (17–38%), vegetative dysfunction syndrome (60–74%), pain syndrome (53–74%) and syncopal conditions (12%). The article details the main spheres of complex rehabilitation of children with stroke consequences, including use of innovative medical rehabilitation technologies — kinesitherapy, dynamic proprioceptive correction, mechanotherapy using robotic systems, physiotherapy and drug correction. The article demonstrates that diagnosis and treatment of stroke consequences in children is a difficult problem, which requires a differential complex approach in order to improve effectiveness of both drug therapy and rehabilitation and quality of life of the patients.Статья посвящена актуальной проблеме современной педиатрии и неврологии — комплексному лечению последствий инсульта у детей. Подробно освещены этиологические аспекты, патофизиологические механизмы и клинические особенности последствий инсульта в детском возрасте, основными из которых являются астенический синдром (у 73–86% пациентов), двигательные расстройства (у 33–58%), когнитивные нарушения (у 60%), пароксизмальные состояния (у 30%), сенсорные расстройства (у 14%), эмоционально-волевые и поведенческие нарушения (у 17–38%), синдром вегетативной дисфункции (у 60–74%), болевой синдром (у 53–74%), синкопальные состояния (у 12%). Рассмотрены современные направления комплексной реабилитации детей после перенесенного инсульта, в том числе с применением инновационных технологий восстановительного лечения — кинезиотерапии, метода динамической проприоцептивной коррекции, механотерапии с использованием роботизированных систем, физиолечения, медикаментозной коррекции. Показано, что диагностика и лечение последствий инсульта в детском возрасте является сложной проблемой, требующей дифференцированного комплексного подхода с целью повышения эффективности как медикаментозной терапии, так и реабилитациии и улучшения качества жизни пациентов

Organisational technologies for ambulatory outpatient healthcare quality improvement in cardiovascular disease patients

The article presents an innovative clinico-organisational model of medical care in cardiovascular disease (CVD), functioning in a large industrial city. The model is based on the “closed circle” principle, including a unified ambulatory-outpatient system of cardiologic care and a multi-level hospital system of CVD healthcare: therapeutic cardiologic and high-technology surgical service, post-infarction and post-intervention rehabilitation, including sanatorium level. The base of the model is ambulatory service, uniting all city policlinic cardiologists at specialised municipal healthcare centres — cardiology dispansers, and functionally linked to other healthcare — specialised hospitals and sanatoriums. The “closed circle” system: policlinic — hospital — sanatorium — policlinic, facilitates consistency of patients’ treatment; accessibility and quality of healthcare; wide implementation of promising, cost-effective and high technology-based methods of diagnostics and treatment at ambulatory level; and effective use of expensive inpatient cardiosurgery resources. The new model is focused on CVD prevention, quality of life and demographics improvement, and working capacity maintenance in the population

CURRENT PRINCIPLES OF COMPLEX REHABILITATION OF CHILDREN WITH STROKE CONSEQUENCES

The article is dedicated to an urgent issue of modern pediatrics and neurology — complex treatment of stroke consequences in children. The article details etiological aspects, pathophysiological mechanisms and clinical peculiarities of stroke consequences in children, the primary among which are asthenic syndrome (73–86% of the patients), movement disorders (33–58%), cognitive disorders (60%), paroxysmal conditions (30%), sensory disorders (14%), emotional-volitional and behavioral disorders (17–38%), vegetative dysfunction syndrome (60–74%), pain syndrome (53–74%) and syncopal conditions (12%). The article details the main spheres of complex rehabilitation of children with stroke consequences, including use of innovative medical rehabilitation technologies — kinesitherapy, dynamic proprioceptive correction, mechanotherapy using robotic systems, physiotherapy and drug correction. The article demonstrates that diagnosis and treatment of stroke consequences in children is a difficult problem, which requires a differential complex approach in order to improve effectiveness of both drug therapy and rehabilitation and quality of life of the patients