JIGAR SIRROZI BILAN BEMORLARDA JIGAR ENSEFALOPATIYASINING OG‘IRLIK DARAJASINI ANIQLASH
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Jigar sirrozi, jigar ensefalopatiyasi, kritik xilpillash chastotasi, portotizim shuntlash##article.abstract##
Maqsad. Jigar sirrozi bilan bemorlarda jigar ensefalopatiyasining og‘irlik darajasini aniqlash. Material va usullar. Tadqiqotga jigar sirrozi bo‘yicha operatsiya qilingan 490 ta bemor olingan. Portotizim shuntlash operatsiyalari etaplarida jigar ensefalopatiyasining og‘irlik darajasini baholash kriteriysi sifatida HEPAtonormTM-Analyzer apparatida olingan kritik hilpillash chastotasi natijalari xizmat qildi. Bemorlar rejali ravishda operatsiya qilindi: selektiv shuntlash (distal splenorenal anastomoz) – 306 (62,4%); markaziy – 184 (37,6%): proksimal splenorenal anastomoz splenektomiya bilan – 13 (2,7%); latero-lateral splenorenal anastomoz – 62 (12,7%); splenosuprarenal anastomoz – 84 (17,1%); N-simon splenorenal anastomoz – 25 (5,1%). Natijalar. Portotizim shuntlash 100% holda kritik xilpillash chastotasi natijalarini ( 39,5±0,9 dan 37,8±1,2 Hz, gacha R<0,001) yomonlashtirdi, agar operatsiyagacha jigar ensefalopatiyasi bo‘lmagan bo‘lsa yoki latent formada 76,3% bemorlarda bu ko‘rsatgich operatsiyadan keyingi erta davrda 46,7% gacha tushdi, vaholanki, ko‘pchilik bemorlarda jigar ensefalopatiyasining yaqqol klinik ko‘rinishlari bilan edi. Operatsiya oldi tayyorgarligi fonida kritik hilpillash chastotasi darajasi yaxshilanishi selektiv portosistem shutlash operatsiyasidan keyin (39,5±1,1 Hz) gacha kuzatildi, markaziy tipdagi dekompressiyada kritik xilpillash chastotasi ko‘rsatgichlari kamroq intensivlikda yaxshilanib, kasalxonadan chiqarish vaqtiga kelib 38,3±1,2 Hz (R<0,001) ni tashkil qildi. Xulosalar. Portotizim shuntlash operatsiyalarini rejalashtirishda kritik xilpillash chastotasi darajasi prinsipial axamiyatga ega bo‘lib, agar bu ko‘rsatgichlar past darajada bo‘lganda operatsiyadan keyingi davrda jigar ensefalopatiyasi rivojlanish ehtimolining yuqoriligidan dalolat beradi.
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