Efficiency of specific therapy in treatment of the pulmonary arterial hypertensia, ассоциированной with congenital heart diseases at children shodmonova D. U. Tashkent Medical Academy, School of public health

EFFICIENCY OF SPECIFIC THERAPY IN TREATMENT OF THE PULMONARY ARTERIAL HYPERTENSIA, АССОЦИИРОВАННОЙ WITH CONGENITAL HEART DISEASES AT CHILDREN

Shodmonova D. U.
Tashkent Medical Academy, School of public health

The pulmonary arterial hypertensia (PAH) unites group of diseases for which progressing increase of pressure in a pulmonary artery and pulmonary vascular resistance is characteristic. The natural current of the overwhelming majority of congenital heart diseases (ВПС) is accompanied by development the LOG. Frequently, несмотря, on the executed "radical" correction of defect, signs резидуальной the LOG remain.

The work purpose: the analysis of results of work on rendering of specialised medical aid to children about the LOG, ассоциированной with ВПС. Main objectives at conducting patients about the LOG - semiology reduction, improvement of quality of a life.
Materials and methods. Under supervision according to the republican register the LOG 29 patients at the age of 2 are registered - 17 years (middle age 12,57±4,7 years), prevail girls - 69 %. Мониторинговые researches on revealing the LOG are spent since 2011.
Inspection includes: an electrocardiogram, ЭхоКГ, пульсоксиметрию, катетеризацию hearts with the test on вазореактивность. For the characteristic of weight the LOG is used functional classification of the New York association of heart and data of the test with 6 minute walking (6) children is more senior 7 years.
Results of research: According to statistical reports at children's age, as well as at patients of advanced ages, various forms of a pulmonary hypertensia are presented. At the same time, the percentage parity of these forms at children and adults essentially differs. According to the register following forms the LOG at children are presented: идиопатическая - 6,9 %, ассоциированная with ВПС - 93,1 %. In some cases the LOG after surgical correction remains or again progresses. The LOG, ассоциированная with ВПС after surgical correction is marked at 38 % of patients. Now the priority of specific therapy is put in a basis of modern system of rendering кардиохирургической the help to patients about the LOG. With 2013года to children with ВПС with «haemodynamic dumps», and also after carrying out of procedure Фонтена, Glenn in the postoperative period in branch of children's anesthesiology - resuscitations the preparation from group простаноидов - илопрост in the inhalation form is used. In children's кардиохирургическом branch as specific therapy apply ингибиторы фосфодиэстеразы type 5. At an out-patient stage specific therapy is spent as in the form of monotherapy блокаторами receptors эндотелина (бозентан) at 62,1 % of patients, ингибиторами фосфодиэстеразы type 5 (ревацио) - 24,1 %, and to combinations (a combination ревацио with бозентаном) - 6,8 %. For a fiscal year at the expense of the state republican sources of financing preparations provide 75,8 % of patients. At an estimation of efficiency of treatment in 6 months improvement of the functional status, a gain in a distance in the test 6 is marked has on the average made 35 m, frequency of hospitalisation of children about the LOG decreases. By data doppler-EhOkG authentic decrease систолического pressure in a pulmonary artery on the average with 85,18±16,18 to 78,18±19,4 mm рт the item was marked

The conclusion: thus, the existing continuity at treatment stages in appointment of modern medicamentous therapy to children about the LOG, influences pathogenetic mechanisms of disease, renders beneficial effect on a current of disease and the forecast of patients.