18 research outputs found
ΠΡΠ΅Π½ΠΊΠ° ΠΏΡΠΎΡΠ½ΠΎΡΡΠ½ΡΡ Ρ Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊ ΠΏΠΎΠ»ΠΈΠΌΠ΅ΡΠ½ΡΡ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»ΠΎΠ² Π΄Π»Ρ ΠΈΠ·Π³ΠΎΡΠΎΠ²Π»Π΅Π½ΠΈΡ ΡΠ»Π΅ΠΌΠ΅Π½ΡΠΎΠ² ΠΏΠ΅ΡΡΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ»Π΅ΠΊΡΡΠΎΡΡΠ°Π½ΡΠΏΠΎΡΡΠ°
The properties of materials for airless wheel propulsion of vehicles, including electric ones, have been studied. The experimental substantiation of the choice of the type of polymer matrices and compositions of reinforcing fillers for the manufacture of an airless wheel mover of electric vehicles has been carried out. To test the basic epoxy matrix, part of the samples without the addition of reinforcing fibers was cured at room temperature (L-285H), and the rest (L-285G) β when heated to 60 Β°C. In order to improve the strength characteristics of the epoxy matrix L-285G, glass reinforcement was carried out with EC16 1600T-16(400) glass reinforcement. The Smooth-Cast 300 Series was chosen as the matrix for performing samples based on injection-molded polyurethanes. Samples are made of base polyurethane under various conditions: at atmospheric rejection (SC), under vacuum 0.8 kPa (SC-0.8) and during vibration-induced curing (SCV). Comparative tests were carried out, which showed differences in the mechanical properties of the base matrices based on epoxy resins and injection-molded polyurethanes, in particular, the relative elongation of samples from injection-molded polyurethane by more than 2 times. It is established that the most rational use of injection-molded polyurethane is application as damping elements, and the material for manufacturing spokes dampers is composite SCV-S-20. It is advisable to manufacture products from the resulting composite when vibrations are applied to the mold and with preliminary vacuuming at a vacuum of 0.8 kPa of the components of the polyurethane matrix, which reduces the number of internal defects in the form of shells. Since vacuuming of the product during polymerization does not give a significant effect due to the presence of a set of specialized deaeration additives in the base matrix, it is proposed to carry it out under constant control, since exceeding the vacuum in the range from 0.8 to 0.9 kPa entails decomposition of individual matrix components with foam formation.ΠΠ·ΡΡΠ΅Π½Ρ ΡΠ²ΠΎΠΉΡΡΠ²Π° ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»ΠΎΠ² Π΄Π»Ρ Π±Π΅Π·Π²ΠΎΠ·Π΄ΡΡΠ½ΠΎΠ³ΠΎ ΠΊΠΎΠ»Π΅ΡΠ½ΠΎΠ³ΠΎ Π΄Π²ΠΈΠΆΠΈΡΠ΅Π»Ρ ΡΡΠ°Π½ΡΠΏΠΎΡΡΠ½ΡΡ
ΡΡΠ΅Π΄ΡΡΠ², Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ ΡΠ»Π΅ΠΊΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
. ΠΡΠΏΠΎΠ»Π½Π΅Π½ΠΎ ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΠΎΠ΅ ΠΎΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΡΠ±ΠΎΡΠ° ΡΠΈΠΏΠ° ΠΏΠΎΠ»ΠΈΠΌΠ΅ΡΠ½ΡΡ
ΠΌΠ°ΡΡΠΈΡ ΠΈ ΡΠΎΡΡΠ°Π²ΠΎΠ² Π°ΡΠΌΠΈΡΡΡΡΠΈΡ
Π½Π°ΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»Π΅ΠΉ Π΄Π»Ρ ΠΈΠ·Π³ΠΎΡΠΎΠ²Π»Π΅Π½ΠΈΡ Π±Π΅Π·Π²ΠΎΠ·Π΄ΡΡΠ½ΠΎΠ³ΠΎ ΠΊΠΎΠ»Π΅ΡΠ½ΠΎΠ³ΠΎ Π΄Π²ΠΈΠΆΠΈΡΠ΅Π»Ρ ΡΠ»Π΅ΠΊΡΡΠΎΡΡΠ°Π½ΡΠΏΠΎΡΡΠ½ΡΡ
ΡΡΠ΅Π΄ΡΡΠ². ΠΠ»Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΈΡΠΏΡΡΠ°Π½ΠΈΠΉ Π±Π°Π·ΠΎΠ²ΠΎΠΉ ΡΠΏΠΎΠΊΡΠΈΠ΄Π½ΠΎΠΉ ΠΌΠ°ΡΡΠΈΡΡ ΡΠ°ΡΡΡ ΠΎΠ±ΡΠ°Π·ΡΠΎΠ² Π±Π΅Π· Π΄ΠΎΠ±Π°Π²Π»Π΅Π½ΠΈΡ Π°ΡΠΌΠΈΡΡΡΡΠΈΡ
Π²ΠΎΠ»ΠΎΠΊΠΎΠ½ ΠΎΡΠ²Π΅ΡΠΆΠ΄Π°Π»Π°ΡΡ ΠΏΡΠΈ ΠΊΠΎΠΌΠ½Π°ΡΠ½ΠΎΠΉ ΡΠ΅ΠΌΠΏΠ΅ΡΠ°ΡΡΡΠ΅ (L-285H), Π° ΠΎΡΡΠ°Π»ΡΠ½ΡΠ΅ (L-285G) β ΠΏΡΠΈ Π½Π°Π³ΡΠ΅Π²Π΅ Π΄ΠΎ 60 Β°Π‘. Π ΡΠ΅Π»ΡΡ
ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΠΏΡΠΎΡΠ½ΠΎΡΡΠ½ΡΡ
Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊ ΡΠΏΠΎΠΊΡΠΈΠ΄Π½ΠΎΠΉ ΠΌΠ°ΡΡΠΈΡΡ L-285G ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ Π°ΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΡΡΠ΅ΠΊΠ»ΠΎΡΠΎΠ²ΠΈΠ½Π³ΠΎΠΌ ΠΠ‘16 1600Π’-16(400). ΠΠ°ΡΡΠΈΡΠ΅ΠΉ Π΄Π»Ρ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ ΠΎΠ±ΡΠ°Π·ΡΠΎΠ² Π½Π° Π±Π°Π·Π΅ Π»ΠΈΡΡΠ΅Π²ΡΡ
ΠΏΠΎΠ»ΠΈΡΡΠ΅ΡΠ°Π½ΠΎΠ² Π±ΡΠ» Π²ΡΠ±ΡΠ°Π½ Smooth-Cast 300 Series. ΠΠ· Π±Π°Π·ΠΎΠ²ΠΎΠ³ΠΎ ΠΏΠΎΠ»ΠΈΡΡΠ΅ΡΠ°Π½Π° ΠΈΠ·Π³ΠΎΡΠΎΠ²Π»Π΅Π½Ρ ΠΎΠ±ΡΠ°Π·ΡΡ ΠΏΡΠΈ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΡΡΠ»ΠΎΠ²ΠΈΡΡ
: ΠΏΡΠΈ Π°ΡΠΌΠΎΡΡΠ΅ΡΠ½ΠΎΠΌ ΠΎΡΠ²Π΅ΡΠΆΠ΅Π½ΠΈΠΈ (SC), ΠΏΠΎΠ΄ Π²Π°ΠΊΡΡΠΌΠΎΠΌ β81,1 ΠΊΠΠ° (SC-0.8) ΠΈ ΠΏΡΠΈ ΠΎΡΠ²Π΅ΡΠΆΠ΄Π΅Π½ΠΈΠΈ Ρ Π½Π°Π»ΠΎΠΆΠ΅Π½ΠΈΠ΅ΠΌ Π²ΠΈΠ±ΡΠ°ΡΠΈΠΈ (SCV). ΠΡΠΎΠ²Π΅Π΄Π΅Π½Ρ ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ ΠΈΡΠΏΡΡΠ°Π½ΠΈΡ, ΠΊΠΎΡΠΎΡΡΠ΅ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ ΠΎΡΠ»ΠΈΡΠΈΡ ΠΌΠ΅Ρ
Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ²ΠΎΠΉΡΡΠ² Π±Π°Π·ΠΎΠ²ΡΡ
ΠΌΠ°ΡΡΠΈΡ Π½Π° Π±Π°Π·Π΅ ΡΠΏΠΎΠΊΡΠΈΠ΄Π½ΡΡ
ΡΠΌΠΎΠ» ΠΈ Π»ΠΈΡΡΠ΅Π²ΡΡ
ΠΏΠΎΠ»ΠΈΡΡΠ΅ΡΠ°Π½ΠΎΠ², Π² ΡΠ°ΡΡΠ½ΠΎΡΡΠΈ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΡΠ΄Π»ΠΈΠ½Π΅Π½ΠΈΠ΅ ΠΎΠ±ΡΠ°Π·ΡΠΎΠ² ΠΈΠ· Π»ΠΈΡΡΠ΅Π²ΠΎΠ³ΠΎ ΠΏΠΎΠ»ΠΈΡΡΠ΅ΡΠ°Π½Π° Π±ΠΎΠ»Π΅Π΅ ΡΠ΅ΠΌ Π² 2 ΡΠ°Π·Π°. Π£ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ Π΄Π΅ΠΌΠΏΡΠΈΡΡΡΡΠΈΡ
ΡΠ»Π΅ΠΌΠ΅Π½ΡΠΎΠ² Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π»ΠΈΡΡΠ΅Π²ΠΎΠ³ΠΎ ΠΏΠΎΠ»ΠΈΡΡΠ΅ΡΠ°Π½Π°, Π° ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Π° ΠΈΠ·Π³ΠΎΡΠΎΠ²Π»Π΅Π½ΠΈΡ ΡΠΏΠΈΡ-Π΄Π΅ΠΌΠΏΡΠ΅ΡΠΎΠ² β ΠΊΠΎΠΌΠΏΠΎΠ·ΠΈΡΠ° SCV-S-20. ΠΠ·Π³ΠΎΡΠΎΠ²Π»Π΅Π½ΠΈΠ΅ ΠΈΠ·Π΄Π΅Π»ΠΈΠΉ ΠΈΠ· ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΊΠΎΠΌΠΏΠΎΠ·ΠΈΡΠ° ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΠΎ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΡΡ ΠΏΡΠΈ Π½Π°Π»ΠΎΠΆΠ΅Π½ΠΈΠΈ Π½Π° ΡΠΎΡΠΌΡ Π²ΠΈΠ±ΡΠ°ΡΠΈΠΉ ΠΈ Ρ ΠΏΡΠ΅Π΄Π²Π°ΡΠΈΡΠ΅Π»ΡΠ½ΡΠΌ Π²Π°ΠΊΡΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΏΡΠΈ Π²Π°ΠΊΡΡΠΌΠ΅ 81,1 ΠΊΠΠ° ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠΎΠ² ΠΏΠΎΠ»ΠΈΡΡΠ΅ΡΠ°Π½ΠΎΠ²ΠΎΠΉ ΠΌΠ°ΡΡΠΈΡΡ, ΡΡΠΎ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΡΠ½ΠΈΠ·ΠΈΡΡ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ Π²Π½ΡΡΡΠ΅Π½Π½ΠΈΡ
Π΄Π΅ΡΠ΅ΠΊΡΠΎΠ² Π² Π²ΠΈΠ΄Π΅ ΡΠ°ΠΊΠΎΠ²ΠΈΠ½. ΠΠ°ΠΊΡΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΈΠ·Π΄Π΅Π»ΠΈΡ ΠΏΡΠΈ ΠΏΠΎΠ»ΠΈΠΌΠ΅ΡΠΈΠ·Π°ΡΠΈΠΈ Π½Π΅ Π΄Π°Π΅Ρ Π·Π½Π°ΡΠΈΠΌΠΎΠ³ΠΎ ΡΡΡΠ΅ΠΊΡΠ° Π²Π²ΠΈΠ΄Ρ Π½Π°Π»ΠΈΡΠΈΡ Π² Π±Π°Π·ΠΎΠ²ΠΎΠΉ ΠΌΠ°ΡΡΠΈΡΠ΅ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ° ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π΄Π΅Π°ΡΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΠΏΡΠΈΡΠ°Π΄ΠΎΠΊ, ΠΏΠΎΡΡΠΎΠΌΡ ΠΏΡΠ΅Π΄Π»ΠΎΠΆΠ΅Π½ΠΎ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΡΡ Π΅Π³ΠΎ ΠΏΡΠΈ ΠΏΠΎΡΡΠΎΡΠ½Π½ΠΎΠΌ ΠΊΠΎΠ½ΡΡΠΎΠ»Π΅, ΡΠ°ΠΊ ΠΊΠ°ΠΊ ΠΏΡΠ΅Π²ΡΡΠ΅Π½ΠΈΠ΅ Π²Π°ΠΊΡΡΠΌΠ° Π² ΠΏΡΠ΅Π΄Π΅Π»Π°Ρ
ΠΎΡ 81,1 Π΄ΠΎ 91,2 ΠΊΠΠ° Π²Π»Π΅ΡΠ΅Ρ ΡΠ°Π·Π»ΠΎΠΆΠ΅Π½ΠΈΠ΅ ΠΎΡΠ΄Π΅Π»ΡΠ½ΡΡ
ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠΎΠ² ΠΌΠ°ΡΡΠΈΡΡ Ρ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΏΠ΅Π½Ρ
Π§ΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ Π±Π°ΡΠΎΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠ² ΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ Π°Π²ΡΠΎΠ½ΠΎΠΌΠ½ΠΎΠΉ Π½Π΅ΡΠ²Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΡΠΌΠΈ ΡΠΎΠ·Π½Π°Π½ΠΈΡ
Purpose of the study: to examine sensibility of baroreceptors and the autonomic nervous in the passiveΒ orthostatic test in patients with chronic impairment of consciousness due to severe brain damage and determineΒ their role in the rehabilitation process.Materials and methods. The study included 30 patients with long-term impairment of consciousness due toΒ severe brain damage (group 1), 10 of them being in the vegetative state (VS) and 20 being in the minimally consciousΒ state (MCS). Craniocerebral trauma was the main cause of severe damage in that group (53% of patients).Β The comparison group included 24 patients with focal neurological symptoms caused predominantly β 79.2%Β of cases β by cerebrovascular disorders (group 2). The control group (group 3) consisted of 22 healthy volunteersΒ of a comparable age. All measurements were done with the help of a Task Force Monitor 1030i (CNSystem, Austria)Β in the course of passive orthostatic test at 0Β°β30Β°β60Β°β0Β°. Changes in the power of low-frequency (LFS) and highfrequencyΒ spectrum (HFS) of heart rate variability and baroreceptors sensibility (BRS) were analyzed. StatisticalΒ analysis was carried out using Statistica-10 software. Significance of inter-group differences on unrelated samplesΒ was determined by the MannβWhitney U-test. Differences between groups were considered significant at PΒ 0.05.Results. Maximal background values of BRS were found in the control group. In group 1 and 2 patients,Β considerable decrease of that index was noted, which was proportional to the brain damage severity. SimilarΒ dynamics was observed for the indices of autonomic nervous system sensibility (LFS and HFS). The main trendΒ of orthostatic changes of BRS, LFS, and HFS was characterized by progressive decrease of the indices with increaseΒ of the patientsβ angle of tilting and their return to the baseline level after the patients were put back intoΒ the horizontal position. 4 patients of group 1 (14%) displayed signs of orthostatic disorders upon tilting to 30Β°:Β in 3 cases, orthostatic hypotension was observed, and in one case the postural orthostatic tachycardia syndromeΒ (POTS) was diagnosed. Those patients differed by lower BRS and higher sympathetic system activityΒ (LFS) vs. the same indices of other patients in that group.Conclusion. Patients with chronic impairment of consciousness during the post-comatose period after aΒ severe brain damage display a significant decrease of baroreceptors sensibility and autonomic nervous systemΒ disorders manifesting in significantly lower activity of the sympathetic and parasympathetic systems. TheΒ prominence of such disorders is associated with brain damage severity. Their risk of developing orthostaticΒ hypotension during tilting towards a vertical position is higher in patients who have lower baroreceptors sensibility,Β and this should be taken into account beginning the process of their verticalization.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΈΠ·ΡΡΠΈΡΡ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ Π±Π°ΡΠΎΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠ² ΠΈ Π°Π²ΡΠΎΠ½ΠΎΠΌΠ½ΠΎΠΉ Π½Π΅ΡΠ²Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡΒ ΠΏΡΠΈ ΠΏΠ°ΡΡΠΈΠ²Π½ΠΎΠΉ ΠΎΡΡΠΎΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠΎΠ±Π΅ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΡΠΌΠΈ ΡΠΎΠ·Π½Π°Π½ΠΈΡ Π²ΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅ ΡΡΠΆΠ΅Π»ΡΡ
ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠΉ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° ΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΠΈΡ
ΡΠΎΠ»Ρ Π² ΡΠ΅Π°Π±ΠΈΠ»ΠΈΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΡΠΎΡΠ΅ΡΡΠ΅.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠΈΠ»ΠΈ 30 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠΌΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΡΠΌΠΈ ΡΠΎΠ·Π½Π°Π½ΠΈΡ, Π²ΡΠ·Π²Π°Π½Π½ΡΠΌΠΈ ΡΡΠΆΠ΅Π»ΡΠΌΠΈ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡΠΌΠΈ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° (Π³ΡΡΠΏΠΏΠ° 1), 10 ΠΈΠ· ΠΊΠΎΡΠΎΡΡΡ
Π±ΡΠ»ΠΈ Π² Π²Π΅Π³Π΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠΌ ΡΠΎΡΡΠΎΡΠ½ΠΈΠΈ (ΠΠ‘) ΠΈ 20 β Ρ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ ΠΌΠ°Π»ΠΎΠ³ΠΎ ΡΠΎΠ·Π½Π°Π½ΠΈΡ (Π‘ΠΠ‘). ΠΡΠ½ΠΎΠ²Π½ΠΎΠΉ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ ΡΡΠΆΠ΅Π»ΡΡ
Β ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠΉ Π±ΡΠ»Π° ΡΠ΅ΡΠ΅ΠΏΠ½ΠΎ-ΠΌΠΎΠ·Π³ΠΎΠ²Π°Ρ ΡΡΠ°Π²ΠΌΠ° (53% ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΡΠΎΠΉ Π³ΡΡΠΏΠΏΡ). Π Π³ΡΡΠΏΠΏΡ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Π²ΠΎΡΠ»ΠΈΒ 24 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Ρ ΠΎΡΠ°Π³ΠΎΠ²ΠΎΠΉ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΡΠΈΠΊΠΎΠΉ, ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΉ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ ΠΊΠΎΡΠΎΡΠΎΠΉ Π² 79,2% ΡΠ»ΡΡΠ°Π΅Π²Β Π±ΡΠ»ΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ ΠΌΠΎΠ·Π³ΠΎΠ²ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΠΎΠ±ΡΠ°ΡΠ΅Π½ΠΈΡ (Π³ΡΡΠΏΠΏΠ° 2). ΠΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΡΡ Π³ΡΡΠΏΠΏΡ (Π³ΡΡΠΏΠΏΠ° 3) ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ 22Β Π·Π΄ΠΎΡΠΎΠ²ΡΡ
Π΄ΠΎΠ±ΡΠΎΠ²ΠΎΠ»ΡΡΠ° ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΠΎΠ³ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ°. ΠΡΠ΅ ΠΈΠ·ΠΌΠ΅ΡΠ΅Π½ΠΈΡ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΌΠΎΠ½ΠΈΡΠΎΡΠ° TaskΒ Force Monitor 1030i (CNSystem, ΠΠ²ΡΡΡΠΈΡ) Π² ΠΏΡΠΎΡΠ΅ΡΡΠ΅ ΠΏΠ°ΡΡΠΈΠ²Π½ΠΎΠΉ ΠΎΡΡΠΎΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠΎΠ±Ρ 0Β°β30Β°β60Β°β0Β°.Β ΠΡΠΎΠ²Π΅Π»ΠΈ Π°Π½Π°Π»ΠΈΠ· ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΠΌΠΎΡΠ½ΠΎΡΡΠΈ Π½ΠΈΠ·ΠΊΠΎΡΠ°ΡΡΠΎΡΠ½ΠΎΠ³ΠΎ (ΠΠ§Π‘) ΠΈ Π²ΡΡΠΎΠΊΠΎΡΠ°ΡΡΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠΏΠ΅ΠΊΡΡΠΎΠ² (ΠΠ§Π‘) Π²Π°ΡΠΈΠ°Π±Π΅Π»ΡΠ½ΠΎΡΡΠΈ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎΠ³ΠΎ ΡΠΈΡΠΌΠ° ΠΈ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Π±Π°ΡΠΎΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠ² (Π§ΠΠ ). Π‘ΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΏΡΠΎΠ²Π΅Π»ΠΈ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΏΠ°ΠΊΠ΅ΡΠ° ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌ Β«Statistica-10Β». ΠΠ½Π°ΡΠΈΠΌΠΎΡΡΡ ΠΌΠ΅ΠΆΠ³ΡΡΠΏΠΏΠΎΠ²ΡΡ
ΡΠ°Π·Π»ΠΈΡΠΈΠΉ Π½Π΅ΡΠ²ΡΠ·Π°Π½Π½ΡΡ
Π²ΡΠ±ΠΎΡΠΎΠΊ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΠΈ ΡΠ°ΡΡΠ΅ΡΠΎΠΌ ΠΊΡΠΈΡΠ΅ΡΠΈΡ ΠΠ°Π½Π½Π° Π£ΠΈΡΠ½ΠΈ (MannβWhitneyΒ U-test). ΠΠΎΡΡΠΎΠ²Π΅ΡΠ½ΡΠΌΠΈ ΡΡΠΈΡΠ°Π»ΠΈ ΡΠ°Π·Π»ΠΈΡΠΈΡ ΠΏΡΠΈ Π΄ΠΎΡΡΠΈΠΆΠ΅Π½ΠΈΠΈ ΡΡΠΎΠ²Π½Ρ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΠΈ pΒ 0,05.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠ°ΠΊΡΠΈΠΌΠ°Π»ΡΠ½ΡΠ΅ ΡΠΎΠ½ΠΎΠ²ΡΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΡ Π§ΠΠ Π²ΡΡΠ²ΠΈΠ»ΠΈ Π² ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅. Π£ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² 1Β ΠΈ 2 Π³ΡΡΠΏΠΏ ΠΎΡΠΌΠ΅ΡΠ°Π»ΠΈ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΡΠΎΠ³ΠΎ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ, ΠΏΡΠΎΠΏΠΎΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ΅ ΡΡΠΆΠ΅ΡΡΠΈ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠΉΒ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°. ΠΠ½Π°Π»ΠΎΠ³ΠΈΡΠ½ΡΡ Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΡ ΠΈΠΌΠ΅Π»ΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Π°Π²ΡΠΎΠ½ΠΎΠΌΠ½ΠΎΠΉ Π½Π΅ΡΠ²Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ (ΠΠ§Π‘ ΠΈ ΠΠ§Π‘). ΠΡΠ½ΠΎΠ²Π½ΠΎΠΉ ΡΡΠ΅Π½Π΄ ΠΎΡΡΠΎΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ Π§ΠΠ , ΠΠ§Π‘, ΠΠ§Π‘ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΠΎΠ²Π°Π»ΡΡ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΠ²Π½ΡΠΌ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΡΡΠΈΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΠΏΡΠΈ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°ΡΡΠ΅ΠΌΡΡ ΡΠ³Π»Π΅ Π½Π°ΠΊΠ»ΠΎΠ½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΈ Ρ Π²ΠΎΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΠ΅ΠΌ ΠΈΡ
Π΄ΠΎ ΠΈΡΡ
ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΡΡΠΎΠ²Π½Ρ ΠΏΠΎΡΠ»Π΅ Π²ΠΎΠ·Π²ΡΠ°ΡΠ° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π² Π³ΠΎΡΠΈΠ·ΠΎΠ½ΡΠ°Π»ΡΠ½ΠΎΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠ΅. Π£ 4 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²Β Π³ΡΡΠΏΠΏΡ 1 (14%) ΠΏΡΠΈ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΠΈ Π½Π°ΠΊΠ»ΠΎΠ½Π° Π½Π° 30Β° ΠΏΠΎΡΠ²ΠΈΠ»ΠΈΡΡ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΈ ΠΎΡΡΠΎΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ: Π² 3Β ΡΠ»ΡΡΠ°ΡΡ
Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΈ ΠΎΡΡΠΎΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΡΡ Π³ΠΈΠΏΠΎΡΠ΅Π½Π·ΠΈΡ ΠΈ Π² ΠΎΠ΄Π½ΠΎΠΌ β ΡΠΈΠ½Π΄ΡΠΎΠΌ ΠΏΠΎΡΡΡΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΎΡΡΠΎΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉΒ ΡΠ°Ρ
ΠΈΠΊΠ°ΡΠ΄ΠΈΠΈ (Π‘ΠΠΠ’). ΠΡΠ»ΠΈΡΠΈΠ΅ΠΌ ΡΡΠΈΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π±ΡΠ»ΠΈ Π±ΠΎΠ»Π΅Π΅ Π½ΠΈΠ·ΠΊΠ°Ρ Π§ΠΠ ΠΈ Π±ΠΎΠ»Π΅Π΅ Π²ΡΡΠΎΠΊΠΈΠ΅ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠΈΠΌΠΏΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ (ΠΠ§Π‘) ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌΠΈ Π΄ΡΡΠ³ΠΈΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π΄Π°Π½Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π£ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΡΠΌΠΈ ΡΠΎΠ·Π½Π°Π½ΠΈΡ Π² ΠΏΠΎΡΡΠΊΠΎΠΌΠ°ΡΠΎΠ·Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅Β ΠΏΠΎΡΠ»Π΅ ΡΡΠΆΠ΅Π»ΡΡ
ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠΉ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° Π½Π°Π±Π»ΡΠ΄Π°ΡΡΡΡ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Π±Π°ΡΠΎΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠ² ΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ Π°Π²ΡΠΎΠ½ΠΎΠΌΠ½ΠΎΠΉ Π½Π΅ΡΠ²Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ, Π²ΡΡΠ°ΠΆΠ°ΡΡΠΈΠ΅ΡΡ Π² Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΌ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠΈ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠΈΠΌΠΏΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈ ΠΏΠ°ΡΠ°ΡΠΈΠΌΠΏΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌ. Π‘ΡΠ΅ΠΏΠ΅Π½Ρ ΡΡΠΈΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π° Ρ ΡΡΠΆΠ΅ΡΡΡΡ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠΉ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°. Π ΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΎΡΡΠΎΡΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π³ΠΈΠΏΠΎΡΠ΅Π½Π·ΠΈΠΈ ΠΏΡΠΈΒ Π²Π΅ΡΡΠΈΠΊΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ Π²ΡΡΠ΅ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π±ΠΎΠ»Π΅Π΅ Π½ΠΈΠ·ΠΊΠΎΠΉ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡΡ Π±Π°ΡΠΎΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠ², ΡΡΠΎ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΡΡΠΈΡΡΠ²Π°ΡΡ Π² Π½Π°ΡΠ°Π»Π΅ ΠΏΡΠΎΡΠ΅ΡΡΠ° ΠΈΡ
Π²Π΅ΡΡΠΈΠΊΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ
ΠΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΡΠ»Π΅ΠΊΡΡΠΎΠΌΠΈΠΎΠ³ΡΠ°ΡΠΈΠΈ Π² ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ Π²ΠΎΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ ΠΏΡΠΈ ΠΈΠ΄ΠΈΠΎΠΏΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΠΈ Π»ΠΈΡΠ΅Π²ΠΎΠ³ΠΎ Π½Π΅ΡΠ²Π°
In the article we present the results of the retrospective clinico-electrophysiological analysis of 182 patients suffering from the idiopathicΒ neuropathy of the facial nerve (Bell`s palsy). The comparison of the most common electromyographical (ENMG) predictors of outcomes wasΒ made. It was demonstrated that the most sensitive method in the acutest period (less then 5 days) is the level of excitability of the nerve, inΒ the acute period (less then 14 days) β estimation of M-answer amplitude loss, and from the 21st day β the presence of denervation in muscles.Β The most specific electromyographical approach to estimate the therapy efficiency is an analysis of the M-answer amplitude and latency.Β In conclusion, neurologists have the possibility to predict the outcome and to control the therapy efficiency in any period of the disease.Β The correlation dynamics ΓNMG sensitivity settings β NLN on different dates can be used to determine the volume of ΓNMG β the NLNΒ study depending on the timing for the treatment of patients.ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-ΡΠ»Π΅ΠΊΡΡΠΎΠΌΠΈΠΎΠ³ΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ (ΠΠΠΠ) Π°Π½Π°Π»ΠΈΠ·Π° 182 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΈΠ΄ΠΈΠΎΠΏΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΠ΅ΠΉ Π»ΠΈΡΠ΅Π²ΠΎΠ³ΠΎ Π½Π΅ΡΠ²Π° (ΠΠΠ). ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΠ΅ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΠΎ ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΡΡ
ΠΠΠΠ-ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΎΠ² Π΄Π»Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡΒ Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΠΎΠ³ΠΎ ΠΈ Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΎΠ² Π²ΠΎΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ. ΠΡΡΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΡΠΌ ΠΠΠΠ-ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΎΠΌΒ Π² ΠΎΡΡΡΠ΅ΠΉΡΠ΅ΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ (Π΄ΠΎ 5 Π΄Π½Π΅ΠΉ) ΠΠΠ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΏΠΎΡΠΎΠ³Π° Π²ΡΠ·ΡΠ²Π°Π½ΠΈΡ ΠΌΠΎΡΠΎΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ²Π΅ΡΠ° ΠΈ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΌΠΈΠ³Π°ΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎΒ ΡΠ΅ΡΠ»Π΅ΠΊΡΠ°; Π² ΠΎΡΡΡΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ (ΠΎΡ 10 Π΄ΠΎ 14 Π΄Π½Π΅ΠΉ) β ΠΈΠ·ΠΌΠ΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΡΠΎΡΠ΅Π½ΡΠ½ΠΎΠ³ΠΎ ΡΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ ΠΏΠ°Π΄Π΅Π½ΠΈΡ Π°ΠΌΠΏΠ»ΠΈΡΡΠ΄Ρ Π-ΠΎΡΠ²Π΅ΡΠ° ΠΏΠΎΡΠ°ΠΆΠ΅Π½Π½ΠΎΠΉ ΡΡΠΎΡΠΎΠ½Ρ ΠΏΠΎ ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ ΠΊ Π·Π΄ΠΎΡΠΎΠ²ΠΎΠΉ; Π½Π°ΡΠΈΠ½Π°Ρ Ρ 21 Π΄Π½Ρ β Π½Π°Π»ΠΈΡΠΈΠ΅ Π½Π΅Π²ΡΠΎΠ³Π΅Π½Π½ΡΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ Π² ΠΌΡΡΡΠ°Ρ
. ΠΠ° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΡ
Β Π΄Π°Π½Π½ΡΡ
ΠΏΡΠ΅Π΄Π»Π°Π³Π°Π΅ΡΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΡΠΉ ΠΎΠ±ΡΠ΅ΠΌ ΠΠΠΠ-ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΈ ΠΈΠ΄ΠΈΠΎΠΏΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΠΠ Π½Π° ΡΠ°Π·Π½ΡΡ
ΡΡΠΎΠΊΠ°Ρ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ
ΠΠ ΠΠΠΠΠΠ« ΠΠΠΠΠΠΠΠ― ΠΠΠΠΠ¦ΠΠΠ‘ΠΠΠ ΠΠΠΠΠ©Π Π Π ΠΠΠΠΠ₯ ΠΠΠΠΠΠ§ΠΠ‘ΠΠΠ ΠΠΠ ΠΠΠΠ¦ΠΠ
In order to strengthen the state support of national medical science and to improve the effectiveness of the use of scientific andΒ technological potential of federal clinics currently a legal framework is created for medical care delivery within clinical testing of methods ofΒ prevention, diagnostics, treatment and rehabilitation. The article considers the problems of medical care organization within clinical testing.Β It is shown that the priority areas of rulemaking in this sphere are the creation of viable mechanisms for assessment the effectiveness ofΒ new technologies as well as the security of medical care provided to patients who are selected and hospitalized to institutions and researchΒ centers according to the themes of scientific researches.Π ΡΠ΅Π»ΡΡ
ΡΡΠΈΠ»Π΅Π½ΠΈΡ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠΊΠΈ ΠΎΡΠ΅ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ Π½Π°ΡΠΊΠΈ ΠΈ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ Π½Π°ΡΡΠ½ΠΎ-ΡΠ΅Ρ
Π½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π»Π° ΡΠ΅Π΄Π΅ΡΠ°Π»ΡΠ½ΡΡ
ΠΊΠ»ΠΈΠ½ΠΈΠΊ Π² Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΡΠΎΠ·Π΄Π°Π½Π° ΠΏΡΠ°Π²ΠΎΠ²Π°Ρ Π±Π°Π·Π° Π΄Π»Ρ ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉΒ ΠΏΠΎΠΌΠΎΡΠΈ Π² ΡΠ°ΠΌΠΊΠ°Ρ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π°ΠΏΡΠΎΠ±Π°ΡΠΈΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ, Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ, Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ ΡΠ΅Π°Π±ΠΈΠ»ΠΈΡΠ°ΡΠΈΠΈ. Π ΡΡΠ°ΡΡΠ΅ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°ΡΡΡΡ ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Π² ΡΠ°ΠΌΠΊΠ°Ρ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π°ΠΏΡΠΎΠ±Π°ΡΠΈΠΈ. ΠΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ ΠΏΡΠΈΠΎΡΠΈΡΠ΅ΡΠ½ΡΠΌΠΈ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΡΠΌΠΈΒ Π½ΠΎΡΠΌΠΎΡΠ²ΠΎΡΡΠ΅ΡΡΠ²Π° Π² ΡΡΠΎΠΉ ΡΡΠ΅ΡΠ΅ ΡΠ²Π»ΡΡΡΡΡ ΡΠΎΠ·Π΄Π°Π½ΠΈΠ΅ Π΄Π΅ΠΉΡΡΠ²Π΅Π½Π½ΡΡ
ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠΎΠ² ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΈΠ²Π½ΠΎΡΡΠΈ Π½ΠΎΠ²ΡΡ
ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ, Π° ΡΠ°ΠΊΠΆΠ΅Β Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ, ΠΎΠΊΠ°Π·ΡΠ²Π°Π΅ΠΌΠΎΠΉ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ, ΠΎΡΠΎΠ±ΡΠ°Π½Π½ΡΠΌ ΠΈ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΌ Π² ΠΈΠ½ΡΡΠΈΡΡΡΡ ΠΈ Π½Π°ΡΡΠ½ΡΠ΅ ΡΠ΅Π½ΡΡΡΒ ΠΏΠΎ ΡΠ΅ΠΌΠ°ΡΠΈΠΊΠ΅ Π½Π°ΡΡΠ½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ
ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π²ΠΈΠ±ΡΠΎΠ΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΏΡΠΈ ΡΠΎΠ·Π΄Π°Π½ΠΈΠΈ ΡΠ»Π΅ΠΌΠ΅Π½ΡΠΎΠ² ΠΏΠ΅ΡΡΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ»Π΅ΠΊΡΡΠΎΡΡΠ°Π½ΡΠΏΠΎΡΡΠ°
The study of vibration loading of the main elements of personal electric vehicles and the search for ways to reduce vibration characteristics was conducted. The issues of measuring vibration arising on a bicycle, which is driven by human muscle power and an electric drive, are considered. Measurements of vibration acceleration and frequency spectra in a certain area of motion were carried out using the βOctave-101VMβ spectrum analyzer in three stages. At the first stage, the electric bike was driven by a pedal drive, at the second β by an electric drive, at the third β the pedals and the electric drive worked in parallel. As a result of the tests carried out, it was found that the greatest vibration occurred in the βMotorβ mode during the use of an electric bicycle, the least vibration occurred when driving with the electric motor turned off. It was found that the electric drive increases the vibration level (at the same time, the electric bike does not exceed the maximum permissible values of vibration levels on all axes). In order to reduce the vibration arising from the electric motor on a personal electric vehicle, a 3D computer model has been developed and an airless wheel mover has been manufactured using this model on a 3D printer (a wheel for an electric scooter with internal damping has been manufactured). Bench tests have shown that the developed wheel, in comparison with a pneumatic tire, has a smaller (up to 45 %) contact spot. The results obtained can be used in the development of competitive products, in particular personal electric vehicles.ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΈΠ±ΡΠΎΠ½Π°Π³ΡΡΠΆΠ΅Π½Π½ΠΎΡΡΠΈ ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
ΡΠ»Π΅ΠΌΠ΅Π½ΡΠΎΠ² ΠΏΠ΅ΡΡΠΎΠ½Π°Π»ΡΠ½ΡΡ
ΡΠ»Π΅ΠΊΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΠ°Π½ΡΠΏΠΎΡΡΠ½ΡΡ
ΡΡΠ΅Π΄ΡΡΠ² ΠΈ ΠΏΠΎΠΈΡΠΊ ΠΏΡΡΠ΅ΠΉ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ Π²ΠΈΠ±ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊ. Π Π°ΡΡΠΌΠΎΡΡΠ΅Π½Ρ Π²ΠΎΠΏΡΠΎΡΡ ΠΈΠ·ΠΌΠ΅ΡΠ΅Π½ΠΈΡ Π²ΠΈΠ±ΡΠ°ΡΠΈΠΈ, Π²ΠΎΠ·Π½ΠΈΠΊΠ°ΡΡΠ΅ΠΉ Π½Π° Π²Π΅Π»ΠΎΡΠΈΠΏΠ΅Π΄Π΅, ΠΊΠΎΡΠΎΡΡΠΉ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡΡΡ Π² Π΄Π²ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΌΡΡΠΊΡΠ»ΡΠ½ΠΎΠΉ ΡΠΈΠ»ΠΎΠΉ ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ° ΠΈ ΡΠ»Π΅ΠΊΡΡΠΎΠΏΡΠΈΠ²ΠΎΠ΄ΠΎΠΌ. ΠΠ·ΠΌΠ΅ΡΠ΅Π½ΠΈΡ Π²ΠΈΠ±ΡΠΎΡΡΠΊΠΎΡΠ΅Π½ΠΈΡ ΠΈ ΡΠ°ΡΡΠΎΡΠ½ΡΡ
ΡΠΏΠ΅ΠΊΡΡΠΎΠ² Π½Π° ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΠΎΠΌ ΡΡΠ°ΡΡΠΊΠ΅ Π΄Π²ΠΈΠΆΠ΅Π½ΠΈΡ ΠΎΡΡΡΠ΅ΡΡΠ²Π»ΡΠ»ΠΈΡΡ Ρ ΠΏΠΎΠΌΠΎΡΡΡ Π°Π½Π°Π»ΠΈΠ·Π°ΡΠΎΡΠ° ΡΠΏΠ΅ΠΊΡΡΠ° Β«ΠΠΊΡΠ°Π²Π°-101ΠΠΒ» Π² ΡΡΠΈ ΡΡΠ°ΠΏΠ°. ΠΠ° ΠΏΠ΅ΡΠ²ΠΎΠΌ ΡΡΠ°ΠΏΠ΅ ΡΠ»Π΅ΠΊΡΡΠΎΠ²Π΅Π»ΠΎΡΠΈΠΏΠ΅Π΄ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΠ»ΡΡ Π² Π΄Π²ΠΈΠΆΠ΅Π½ΠΈΠ΅ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΏΠ΅Π΄Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΈΠ²ΠΎΠ΄Π°, Π½Π° Π²ΡΠΎΡΠΎΠΌ β ΡΠ»Π΅ΠΊΡΡΠΎΠΏΡΠΈΠ²ΠΎΠ΄ΠΎΠΌ, Π½Π° ΡΡΠ΅ΡΡΠ΅ΠΌ β ΠΏΠ΅Π΄Π°Π»ΠΈ ΠΈ ΡΠ»Π΅ΠΊΡΡΠΎΠΏΡΠΈΠ²ΠΎΠ΄ ΡΠ°Π±ΠΎΡΠ°Π»ΠΈ ΠΏΠ°ΡΠ°Π»Π»Π΅Π»ΡΠ½ΠΎ. Π ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΡΡ
ΠΈΡΠΏΡΡΠ°Π½ΠΈΠΉ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ Π½Π°ΠΈΠ±ΠΎΠ»ΡΡΠ°Ρ Π²ΠΈΠ±ΡΠ°ΡΠΈΡ ΠΏΡΠΎΠΈΡΡ
ΠΎΠ΄ΠΈΠ»Π° Π² ΡΠ΅ΠΆΠΈΠΌΠ΅ Β«ΠΠΎΡΠΎΡΒ» Π² ΠΏΡΠΎΡΠ΅ΡΡΠ΅ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΡΠ»Π΅ΠΊΡΡΠΎΠ²Π΅Π»ΠΎΡΠΈΠΏΠ΅Π΄Π°, Π½Π°ΠΈΠΌΠ΅Π½ΡΡΠ°Ρ Π²ΠΈΠ±ΡΠ°ΡΠΈΡ β ΠΏΡΠΈ Π΅Π·Π΄Π΅ Ρ Π²ΡΠΊΠ»ΡΡΠ΅Π½Π½ΡΠΌ ΡΠ»Π΅ΠΊΡΡΠΎΠ΄Π²ΠΈΠ³Π°ΡΠ΅Π»Π΅ΠΌ. ΠΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΎ, ΡΡΠΎ ΡΠ»Π΅ΠΊΡΡΠΎΠΏΡΠΈΠ²ΠΎΠ΄ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π΅Ρ ΡΡΠΎΠ²Π΅Π½Ρ Π²ΠΈΠ±ΡΠ°ΡΠΈΠΈ (ΠΏΡΠΈ ΡΡΠΎΠΌ Ρ ΡΠ»Π΅ΠΊΡΡΠΎΠ²Π΅Π»ΠΎΡΠΈΠΏΠ΅Π΄Π° ΠΏΠΎ Π²ΡΠ΅ΠΌ ΠΎΡΡΠΌ Π½Π΅ ΠΏΡΠΎΠΈΡΡ
ΠΎΠ΄ΠΈΡ ΠΏΡΠ΅Π²ΡΡΠ΅Π½ΠΈΡ ΠΏΡΠ΅Π΄Π΅Π»ΡΠ½ΠΎ Π΄ΠΎΠΏΡΡΡΠΈΠΌΡΡ
Π·Π½Π°ΡΠ΅Π½ΠΈΠΉ ΡΡΠΎΠ²Π½Π΅ΠΉ Π²ΠΈΠ±ΡΠ°ΡΠΈΠΉ). Π‘ ΡΠ΅Π»ΡΡ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΡ Π²ΠΎΠ·Π½ΠΈΠΊΠ°ΡΡΠ΅ΠΉ ΠΎΡ ΡΠ»Π΅ΠΊΡΡΠΎΠ΄Π²ΠΈΠ³Π°ΡΠ΅Π»Ρ Π²ΠΈΠ±ΡΠ°ΡΠΈΠΈ Π½Π° ΠΏΠ΅ΡΡΠΎΠ½Π°Π»ΡΠ½ΠΎΠΌ ΡΠ»Π΅ΠΊΡΡΠΎΡΡΠ°Π½ΡΠΏΠΎΡΡΠ΅ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π° ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½Π°Ρ 3D-ΠΌΠΎΠ΄Π΅Π»Ρ ΠΈ ΠΈΠ·Π³ΠΎΡΠΎΠ²Π»Π΅Π½ ΠΏΠΎ Π΄Π°Π½Π½ΠΎΠΉ ΠΌΠΎΠ΄Π΅Π»ΠΈ Π½Π° 3D-ΠΏΡΠΈΠ½ΡΠ΅ΡΠ΅ Π±Π΅Π·Π²ΠΎΠ·Π΄ΡΡΠ½ΡΠΉ ΠΊΠΎΠ»Π΅ΡΠ½ΡΠΉ Π΄Π²ΠΈΠΆΠΈΡΠ΅Π»Ρ (ΠΊΠΎΠ»Π΅ΡΠΎ Π΄Π»Ρ ΡΠ»Π΅ΠΊΡΡΠΎΡΠ°ΠΌΠΎΠΊΠ°ΡΠ° Ρ Π²Π½ΡΡΡΠ΅Π½Π½ΠΈΠΌ Π΄Π΅ΠΌΠΏΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ). Π‘ΡΠ΅Π½Π΄ΠΎΠ²ΡΠ΅ ΠΈΡΠΏΡΡΠ°Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ, ΡΡΠΎ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π½ΠΎΠ΅ ΠΊΠΎΠ»Π΅ΡΠΎ Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ ΠΏΠ½Π΅Π²ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΈΠ½ΠΎΠΉ ΠΈΠΌΠ΅Π΅Ρ ΠΌΠ΅Π½ΡΡΠ΅Π΅ (Π΄ΠΎ 45 %) ΠΏΡΡΠ½ΠΎ ΠΊΠΎΠ½ΡΠ°ΠΊΡΠ°. ΠΠΎΠ»ΡΡΠ΅Π½Π½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΌΠΎΠΆΠ½ΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡ ΠΏΡΠΈ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠ΅ ΠΊΠΎΠ½ΠΊΡΡΠ΅Π½ΡΠΎΡΠΏΠΎΡΠΎΠ±Π½ΠΎΠΉ ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠΈ, Π² ΡΠ°ΡΡΠ½ΠΎΡΡΠΈ ΠΏΠ΅ΡΡΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ»Π΅ΠΊΡΡΠΎΡΡΠ°Π½ΡΠΏΠΎΡΡΠ°
ΠΡΡΡΡΠ΅ ΠΈ Ρ ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π΄ΠΈΠ·ΠΈΠΌΠΌΡΠ½Π½ΡΠ΅ ΠΏΠΎΠ»ΠΈΠ½Π΅Π²ΡΠΎΠΏΠ°ΡΠΈΠΈ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ ΠΏΠ°Π½Π΄Π΅ΠΌΠΈΠΈ COVID-19: ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΠ°ΡΡΠΈΠ½Ρ, Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (ΠΎΠ±Π·ΠΎΡ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ)
Dysimmune polyneuropathies are the etiologically heterogeneous group of diseases with autoimmune damage to the peripheral nervous system. The rarity of these diseases doesnβt exclude the possibility of their development or exacerbation in patients infected with SARSβCoVβ2, which will require timely differential diagnosis and urgent specific therapy. The article summarizes current information on the mechanisms of development, clinical features, diagnosis and management of acute and chronic dysimmune polyneuropathies in the context of the COVIDβ19 pandemic.ΠΠΈΠ·ΠΈΠΌΠΌΡΠ½Π½ΡΠ΅ ΠΏΠΎΠ»ΠΈΠ½Π΅Π²ΡΠΎΠΏΠ°ΡΠΈΠΈ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΡΡ ΡΠΎΠ±ΠΎΠΉ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈ Π³Π΅ΡΠ΅ΡΠΎΠ³Π΅Π½Π½ΡΡ Π³ΡΡΠΏΠΏΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ Ρ Π°ΡΡΠΎΠΈΠΌΠΌΡΠ½Π½ΡΠΌ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π½Π΅ΡΠ²Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ. Π Π΅Π΄ΠΊΠΎΡΡΡ Π΄Π°Π½Π½ΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ Π½Π΅ ΠΈΡΠΊΠ»ΡΡΠ°Π΅Ρ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΈΡ
ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΈΠ»ΠΈ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΡ Ρ ΠΈΠ½ΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
SARSβCoVβ2 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΡΡΠΎ, Π² ΡΠ²ΠΎΡ ΠΎΡΠ΅ΡΠ΅Π΄Ρ, ΠΏΠΎΡΡΠ΅Π±ΡΠ΅Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΡΠ²ΠΎΠ΅Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ Π½Π΅ΠΎΡΠ»ΠΎΠΆΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΠΉ ΠΈ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. Π ΡΡΠ°ΡΡΠ΅ ΠΎΠ±ΠΎΠ±ΡΠ΅Π½Ρ Π°ΠΊΡΡΠ°Π»ΡΠ½ΡΠ΅ Π½Π° Π΄Π°Π½Π½ΡΠΉ ΠΌΠΎΠΌΠ΅Π½Ρ ΡΠ²Π΅Π΄Π΅Π½ΠΈΡ, ΠΊΠ°ΡΠ°ΡΡΠΈΠ΅ΡΡ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠΎΠ² ΡΠ°Π·Π²ΠΈΡΠΈΡ, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠ΅ΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΠ°ΡΡΠΈΠ½Ρ, Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ ΡΠ°ΠΊΡΠΈΠΊΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΎΡΡΡΡΡ
ΠΈ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
Π΄ΠΈΠ·ΠΈΠΌΠΌΡΠ½Π½ΡΡ
ΠΏΠΎΠ»ΠΈΠ½Π΅Π²ΡΠΎΠΏΠ°ΡΠΈΠΉ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΠΏΠ°Π½Π΄Π΅ΠΌΠΈΠΈ COVIDβ19
Effects of an Innovative Head-Up Tilt Protocol on Blood Pressure and Arterial Stiffness Changes
The objective of our study was to identify blood pressure (BP) and pulse wave velocity (PWV) changes during orthostatic loading, using a new the head-up tilt test (HUTT), which incorporates the usage of a standardized hydrostatic column height. Methods: 40 healthy subjects 20β32 years performed HUTT, which was standardized to a height of the hydrostatic column at 133 cm. Exposure time was 10 min in each of 3 positions: horizontal supine 1, HUTT, and horizontal supine 2. The individual tilt up angle made it possible to set the standard value of the hydrostatic column. Hemodynamic parameters were recorded beat to beat using βTask Force Monitor 3040 iβ, pulse-wave velocity (PWV) was measured with a sphygmographβsphygmomanometer VaSera VS1500N. Results: Orthostatic loading caused a significant increase in heart rate (HR) and a decrease in stroke volume (SV) (p < 0.05) but no significant reductions in cardiac output, changes in total vascular resistance (TVR), or BP. An analysis of personalized data on systolic blood pressure (SBP) changes in tilt up position as compared to horizontal position (ΞSBP) revealed non-significant changes in this index in 48% of subjects (orthostatic normotension group), in 32% there was a significant decrease in it (orthostatic hypotension group) and in 20% there was a significant increase in it (orthostatic hypertension group). These orthostatic changes were not accompanied by any clinical symptoms and/or syncope. During HUTT, all subjects had in the PWV a significant increase of approximately 27% (p < 0.001). Conclusion: The new test protocol involving HUTT standardized to a height of hydrostatic column at 133 cm causes typical hemodynamics responses during orthostatic loading. Individual analysis of the subjects revealed subclinical orthostatic disorders (OSD) in up to 52% of the test persons. During HUTT, all test subjects showed a significant increase in PWV. The new innovative HUTT protocol can be applied in multi-center studies in healthy subjects to detect preclinical forms of orthostatic disorders under standard gravity load conditions
Orthostatic Hemodynamic Changes in Brain Damage
Aim: to study orthostatic hemodynamic changes in patients with chronic disorders of consciousness after critical brain damage.Materials and methods. We studied 30 patients (10 women and 20 men) with chronic disorders of consciousness after severe brain damage aged 45Β±7 years, 10 of which were in the vegetative state (VS) and 20 had the minimally conscious state (MCS). The main causes of brain damage were traumatic brain injury (53% of patients) and cerebrovascular accidents (CVA) (23.3%). The rest of the patients had posthypoxic encephalopathy or were after brain tumor removal surgery. Passive orthostatic test (POT) 0Β° to 60Β° to 0Β° was performed using an electrically driven tilt table (Vario Line). Hemodynamic monitoring during the verticalization was done using a non-invasive oscillometric recording of blood pressure on the brachial artery, stroke volume (SV) and cardiac minute output (CMO) were measured by impedance cardiography with the multifunctional Β«Task Force Monitor 3010iΒ» (CNSystem, Austria). Data were statistically analyzed using the Statistica 10 software package.Results. Orthostatic hemodynamic stability was found in 26 out of 30 patients with chronic disorders of consciousness after critical brain damage. It was manifested by stable systolic blood pressure (SBP) in tilted orthostatic and horizontal position (120.7Β±2.2 and 121.1Β±3.6 mmHg, respectively, P>0.05). Orthostatic hypotension was observed in 3 patients and postural tachycardia syndrome (PTS) in one patient. We compared orthostatic hemodynamic changes in the studied cohort versus published data on orthostatic hemodynamic changes uncluding POT revealed in patients with severe brain damage examined before and after brain death.Conclusion. Orthostatic stability of blood circulation can be maintained for a short period of time in patients surviving after critical diffuse brain damage associated with chronic disorders of consciousness. Critical brain damage resulting in brain death associates with a significant reduction of all hemodynamic parameters and severe orthostatic hypotension with restoration of initial blood pressure values when the patient is returned to the horizontal position