BOLALARDA OPERATSIYADAN KEYINGI KOGNITIV BUZILISHLAR: JARROHLIK ARALASHUVI DAVOMIYLIGINING TA’SIRI
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operatsiyadan keyingi kognitiv disfunksiya, bolalar, umumiy anesteziya, kognitiv buzilishlar, neyropsixologik testlash, perioperatsion boshqaruv, neyroproteksiya##article.abstract##
Maqolada umumiy anesteziya ostida rejalashtirilgan jarrohlik amaliyotining davomiyligiga bog‘liq holda bolalarda kognitiv buzilishlarni qiyosiy o‘rganish natijalari keltirilgan. Tadqiqotga 7–14 yoshdagi 120 nafar bola jalb qilinib, ular operatsiya davomiyligiga ko‘ra uch guruhga bo‘lingan: 1 soatgacha (I guruh), 1 soatdan 2 soatgacha (II guruh), 2 soatdan ortiq (III guruh). Kognitiv holat operatsiyadan oldin va operatsiyadan keyingi 7-kuni neyropsixologik testlar (xotira, diqqat, psixomotor reaksiyalar tezligi, ijro etuvchi funksiyalar) yordamida baholandi. Operatsiya davomiyligi bilan kognitiv faoliyat ko‘rsatkichlari o‘rtasida statistik jihatdan ahamiyatli teskari korrelyatsiya aniqlandi (r = 0,58–0,69; p < 0,001). Operatsiyadan keyingi kognitiv disfunksiya (OKKD) uchrashish chastotasi mos ravishda I, II va III guruhlarda 12,5 %, 30,0 % va 52,5 % ni tashkil etdi (χ² = 15,87; p < 0,001). Logistik regressiya tahlili natijalariga ko‘ra, operatsiya davomiyligining 2 soatdan ortiq bo‘lishi OKKD rivojlanishining mustaqil prediktori ekanligi aniqlandi (OR = 3,84; 95 % IS 1,76–8,42). Olingan natijalar bolalarda perioperatsion boshqaruv protokollarini neyroprotektiv strategiyalarni hisobga olgan holda takomillashtirish zarurligini ko‘rsatadi.
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