Л.А. Кобылко, Н.В. Галиновская, Н.В. Николаева, Ю.В. Табанькова, Е.В. Цитко, М.Ф. Пальцева
Учреждение образования «Гомельский государственный медицинский университет», Гомель, Беларусь, Учреждение здравоохранения «Гомельская университетская клиника-областной госпиталь инвалидов Великой Отечественной войны», Гомель, Беларусь, Филиал открытого акционерного общества «Гомсельмаш» Санаторий «Машиностроитель», Гомель, Беларусь
Цель. Формирование дифференцированной программы медицинской реабилитации у пациентов после реваскуляризации миокарда в сочетании с неврологическими проявлениями повреждения межпозвонковых дисков.
Материалы и методы. Проведено когортное исследование 55 (48 мужчин и 7 женщин) пациентов после реваскуляризации миокарда в сочетании с неврологическими проявлениями повреждения межпозвонковых дисков (средний возраст 60 [64;66] лет). Пациентам выполнено клиническое обследование, функциональные пробы и лабораторное обследование. Все пациенты были разделены на группы случайным образом. В основной группе применен метод медицинской реабилитации, основанный на разделении пациентов по сочетанию выраженности кардиогенного и вертеброгенного болевого синдрома.
Результаты. Использование метода дифференцированной медицинской реабилитации на основании градации болевого синдрома выявило более значимое функциональное улучшение (ограничение жизнедеятельности в категории трудоспособность 35% и 98%, р = 0,004), субъективно (по данным ВАШ, кардиогенный болевой синдром 1,9 и 0,65 балла, p < 0,01; вертеброгенный болевой синдром 3,5 и 1 балл, p < 0,001). Выявлена стабилизация систолического артериального давления после реабилитации в более низком диапазоне 130 [120; 140] и 120 [110; 120] мм.рт.ст., р < 0,01.
Заключение. Применение метода дифференцированной медицинской реабилитации с учетом сочетания болевого синдрома кардиогенного и вертеброгенного генеза выявило более значимое улучшение состояния пациентов.
ключевые слова: реваскуляризация миокарда, боль в нижней части спины, методы медицинской реабилитации
для цитирования: Л.А. Кобылко, Н.В. Галиновская, Н.В. Николаева, Ю.В. Табанькова, Е.В. Цитко, М.Ф. Пальцева.Выбор методов медицинской реабилитации пациентов после реваскуляризации миокарда в сочетании с болями в нижней части спины. Неотложная кардиология и кардиоваскулярные риски, 2024, Т. 8, № 2, С. 2252–2261
Selection of medical rehabilitation methods for patients after myocardial revascularization combined with low back pain
L. Kabylka, N. Halinouskaya, Y. Tabanjkova, N. Nikalaeva, E. Tsitko, M. Paltsava
Objective. To develop a differentiated program of medical rehabilitation for patients after myocardial revascularization associated with neurological manifestations of intervertebral disc damage.
Materials and methods. A cohort study of 55 (48 males and 7 females) patients after myocardial revascularization combined with neurological manifestations of intervertebral disc damage (mean age 60 [64; 66] years) was performed. Patients underwent clinical examination, functional tests, and laboratory examination. All patients were divided into groups randomly. In the main group, a method of medical rehabilitation based on the division of patients according to the combination of cardiogenic and vertebrogenic pain syndrome severity was applied.
Results. The use of the method of differentiated medical rehabilitation based on the gradation of pain syndrome revealed more significant functional improvement (limitation of life activity in the category of ability to work 35% and 98%, p = 0.004), subjectively (according to VAS, cardiogenic pain syndrome 1.9 and 0.65 points, p < 0.01; vertebrogenic pain syndrome 3.5 and 1 point, p < 0.001). Stabilization of systolic blood pressure after rehabilitation was found in the lower range of 130 [120; 140] and 120 [110; 120] mm. Hg., p < 0.01.
Conclusion. Application of the method of differentiated medical rehabilitation taking into account the combination of pain syndrome of cardiogenic and vertebrogenic genesis revealed a more significant improvement of the patients’ condition.
keywords: myocardial revascularisation, low back pain, medical rehabilitation methods
for references: L. Kabylka, N. Halinouskaya, Y. Tabanjkova, N. Nikalaeva, E. Tsitko, M. Paltsava. Selection of medical rehabilitation methods for patients after myocardial revascularization combined with low back pain. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2024, vol. 8, no. 2, pp. 2252–2261.
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