2 research outputs found
ΠΠ»ΠΈΡΠ½ΠΈΠ΅ ΠΎΠ±ΡΠ΅ΠΉ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΈ ΠΏΡΠΈ Π°Π΄Π΅Π½ΠΎΡΠΎΠΌΠΈΠΈ ΠΈ ΡΠΎΠ½Π·ΠΈΠ»Π»ΠΎΡΠΎΠΌΠΈΠΈ Π½Π° ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΠ΅ ΡΡΠ½ΠΊΡΠΈΠΈ Ρ Π΄Π΅ΡΠ΅ΠΉ
Background. Surgery under general anesthesia can affect the patients neurocognitive outcome. This problem is of particular relevance in pediatric surgical practice.
Goal. The aim of this study is to determine the spectrum of clinical manifestations and the frequency of cognitive dysfunction symptom development in children after adenotomy and/or tonsillotomy performed under general anesthesia.
Methods. This prospective study included 30 children aged 3 7 years (average age 4.9 1.3 years) who underwent adenotomy and/or tonsillotomy under general, combined, balanced anesthesia. In the preoperative period and a day after the operation, neuropsychological testing was performed: The Raven test, mechanical and associative memory test, Mini-Mental State Examination (MMSE) scale adapted for children from 3 years old, and the Bourdon test. A 20% decrease in function compared with the initial level was considered clinically significant.
Results. One day after surgery, 10% of patients had a clinically significant decrease in attention productivity, 10% had a decrease in attention accuracy, 13.3% had a decrease in attention index, and 16.7% had a decrease in overall productivity and the attention index according to the Bourdon test. Also, 13.3% showed a decrease in attention, 30% had a decrease in memory on the MMSE scale, 20% showed a decrease in mechanical memory, and 10% had a decrease in test results on the Raven test.
Conclusion. Conducting even minor surgical interventions with general anesthesia leads to an impairment of various cognitive functions in 10%30% of children aged 3 to 7 years.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. ΠΡΠΏΠΎΠ»Π½Π΅Π½Π½ΡΠ΅ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΠΎΠ±ΡΠ΅ΠΉ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΈ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π° ΠΌΠΎΠ³ΡΡ ΠΎΡΡΠΈΡΠ°ΡΠ΅Π»ΡΠ½ΠΎ Π²Π»ΠΈΡΡΡ Π½Π° Π½Π΅ΠΉΡΠΎΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΠ΅ ΡΡΠ½ΠΊΡΠΈΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°. ΠΡΠΎΠ±ΡΡ Π°ΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ Π΄Π°Π½Π½Π°Ρ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ° ΠΈΠΌΠ΅Π΅Ρ Π² ΠΏΠ΅Π΄ΠΈΠ°ΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅.
Π¦Π΅Π»Ρ. ΠΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ Ρ
Π°ΡΠ°ΠΊΡΠ΅Ρ ΠΈ ΡΠ°ΡΡΠΎΡΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠ² ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ Ρ Π΄Π΅ΡΠ΅ΠΉ ΠΏΠΎΡΠ»Π΅ Π°Π΄Π΅Π½ΠΎ- ΠΈ/ΠΈΠ»ΠΈ ΡΠΎΠ½Π·ΠΈΠ»Π»ΠΎΡΠΎΠΌΠΈΠΈ, ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΡΡ
Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΠΎΠ±ΡΠ΅ΠΉ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΈ.
ΠΠ΅ΡΠΎΠ΄Ρ. Π ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ 30 Π΄Π΅ΡΠ΅ΠΉ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ 37 Π»Π΅Ρ (ΡΡΠ΅Π΄Π½ΠΈΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ 4,9 1,3 Π³ΠΎΠ΄Π°), ΠΊΠΎΡΠΎΡΡΠΌ Π²ΡΠΏΠΎΠ»Π½ΡΠ»ΠΈ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ Π°Π΄Π΅Π½ΠΎΡΠΎΠΌΠΈΠΈ ΠΈ/ΠΈΠ»ΠΈ ΡΠΎΠ½Π·ΠΈΠ»Π»ΠΎΡΠΎΠΌΠΈΠΈ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΠΎΠ±ΡΠ΅ΠΉ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΈ. Π ΠΏΡΠ΅Π΄ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ ΠΈ ΡΠ΅ΡΠ΅Π· ΡΡΡΠΊΠΈ ΠΏΠΎΡΠ»Π΅ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ Π½Π΅ΠΉΡΠΎΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅: ΠΌΠ°ΡΡΠΈΡΡ Π Π°Π²Π΅Π½Π°, ΡΠ΅ΡΡ Π½Π° ΠΌΠ΅Ρ
Π°Π½ΠΈΡΠ΅ΡΠΊΡΡ ΠΈ Π°ΡΡΠΎΡΠΈΠ°ΡΠΈΠ²Π½ΡΡ ΠΏΠ°ΠΌΡΡΡ, Π°Π΄Π°ΠΏΡΠΈΡΠΎΠ²Π°Π½Π½Π°Ρ Π΄Π»Ρ Π΄Π΅ΡΠ΅ΠΉ ΠΎΡ 3 Π»Π΅Ρ ΡΠΊΠ°Π»Π° MMSE ΠΈ ΠΊΠΎΡΡΠ΅ΠΊΡΡΡΠ½ΡΠ΅ ΠΏΡΠΎΠ±Ρ. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΡΠΌ ΡΡΠΈΡΠ°Π»ΠΈ ΡΡΠΎΠ²Π΅Π½Ρ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠΈ Π½Π΅ΠΉΡΠΎΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎ Π΄ΠΎΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ ΡΡΠΎΠ²Π½Ρ Π½Π° 20 % ΠΈ Π±ΠΎΠ»Π΅Π΅.
Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π§Π΅ΡΠ΅Π· ΠΎΠ΄Π½ΠΈ ΡΡΡΠΊΠΈ ΠΏΠΎΡΠ»Π΅ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π° Ρ 10 % ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π±ΡΠ»ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ, Ρ 10 % ΡΠΎΡΠ½ΠΎΡΡΠΈ Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ, 13,3 % ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΠΈ Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ, Ρ 16,7 % ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΎΠ±ΡΠ΅Π³ΠΎ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΠΈ Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΊΠΎΡΡΠ΅ΠΊΡΡΡΠ½ΡΡ
ΠΏΡΠΎΠ±. ΠΠΎ ΡΠΊΠ°Π»Π΅ MMSE ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠΎΠ²Π°Π»ΠΈ ΡΡ
ΡΠ΄ΡΠ΅Π½ΠΈΠ΅ ΠΏΠ°ΠΌΡΡΠΈ Ρ 30 % Π΄Π΅ΡΠ΅ΠΉ, Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ Ρ 13,3 %. Π£ 20 % Π΄Π΅ΡΠ΅ΠΉ Π±ΡΠ»ΠΎ ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΌΠ΅Ρ
Π°Π½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠ°ΠΌΡΡΠΈ. Π£ 10 % ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΌΠ°ΡΡΠΈΡΠ°ΠΌΠΈ Π Π°Π²Π΅Π½Π°.
ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ Π΄Π°ΠΆΠ΅ ΠΌΠ°Π»ΡΡ
Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ² Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΠΎΠ±ΡΠ΅ΠΉ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΈ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ Ρ 1030 % Π΄Π΅ΡΠ΅ΠΉ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ 37 Π»Π΅Ρ