1 Научный центр здоровья детей, Москва, Российская Федерация 2 Городская клиническая больница № 3, Томск, Российская Федерация Проведен критический анализ публикаций, посвященных возможностям медикаментозного лечения синдрома обструктивного апноэ сна у детей. На основании изученного обзора исследований сделан вывод, что интраназальные глюкокортикостероиды и антагонисты лейкотриеновых рецепторов могут быть эффективны у детей с легкой и средней степенью тяжести такого нарушения. Тем не менее в настоящее время опубликованных данных для рекомендации указанных препаратов в качестве альтернативы хирургическому лечению у детей с остановкой легочной вентиляции во время сна пока недостаточно. Необходимы дальнейшие исследования по определению оптимальной длительности консервативного лечения синдрома обструктивного апноэ сна у детей, выяснению стойкости полученного эффекта, а также уточнению показаний и противопоказаний для различных групп препаратов. Ключевые слова: синдром обструктивного апноэ сна, дети, аденоиды, интраназальные глюкокортикостероиды, антагонисты лейкотриеновых рецепторов.(Для цитирования: Латышева Е. Н., Русецкий Ю. Ю., Малявина У. С., Храмов П. А. Возможности медикаментозного лечения синдрома обструктивного апноэ сна у детей. Педиатрическая фармакология.We have conducted a critical analysis of publications regarding the possibilities of medicamental treatment of obstructive sleep apnoea syndrome in children. Based on the examined studies we made a conclusion that intranasal glucocorticosteroids and leukotriene receptor antagonists can be effective in children with light and moderate lesions of this nature. At the same time, for the time being there isn't enough published data to justify the recommendation of mentioned preparations as an alternative to surgery in children suffering from pulmonary ventilation stoppages. Further studies are required in order to determine the optimal terms of conservative treatment of obstructive sleep apnea in children, to determine the durability of the effect and ascertain the indications and contraindications for different groups of preparations. Контактная информация:Латышева Елена Николаевна, кандидат медицинских наук, старший научный сотрудник оториноларингологического отделения НЦЗД Адрес: 119991, Москва, Ломоносовский проспект, д. 2,
Клинические наблюдения Relevance. The hypoplastic left-heart syndrome at congenital heart disease has frequency of 261 cases out of 10,000 newborns. Children with hypoplastic left-heart syndrome can have comorbid congenital anomalies and acquired diseases that require treatment and are associated with high mortality risk. Description of a clinical case. Female patient, 6 years 4 months, with the hypoplastic left-heart syndrome was admitted to our hospital with the diagnosis «Sensorineural hearing loss, speech delay» for performing of cochlear implantation. The council of physicians was convoked before the surgery to coordinate patient management. Members of surgical, anesthesiology, laboratory and instrumental examination departments were involved into preoperative assessment and planning due to the high level of surgical and anesthetic risk. The patient was dismissed from hospital on the 10 th day after cochlear implantation. The patient has undergone the course of auditory-verbal therapy a month after. The child was dismissed wit state improvement. Conclusion. The example of successfully performed surgery in the patient with hypoplastic left-heart syndrome and such severe comorbid pathology as sensorineural hearing loss is presented. Complete physical examination of the child in preoperative period and adequate preparation for the surgery were the key factors for patient successful management and further rehabilitation.
Society of Neuropathologists and Psychiatrists at Kazan State University. Meeting on May 28, 1930, dedicated to the memory of Prof. A. V. Favorsky I. Rusetsky. To the study of hyperkinesis. From the available classifications of hyperkinesis, the speaker accepts the following: 1) trembling hyperkinesis, 2) myoclonic, 3) systematized rhythmic bradyhyperkinesis, and 4) choreiform hyperkinesis. The speaker conducted a study of these forms of hyperkinesis in 35 patients by using graphic methods for registering contraction of hyperkinetic muscles.
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