MEXANIK TROMBEKTOMIYADAN KEYINGI INDIVIDUALLASHTIRILGAN ERTA REABILITATSIYA: FUNKSIONAL NATIJALARGA TA’SIRI
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ishemik insult, mexanik trombektomiya, erta reabilitatsiya, individuallashtirilgan reabilitatsiya, funksional natijalar, neyroplastiklik, NIHSS, ASPECTS, modifikatsiyalangan Rankin shkalasi, Barthel indeksi, FIM##article.abstract##
Ishemik insult butun dunyoda o‘lim, nogironlik va uzoq muddatli funksional mustaqillik yo‘qolishining yetakchi sabablaridan biri bo‘lib qolmoqda. Endovaskulyar davolash usullarining, ayniqsa yirik miya tomirlari okluziyasida mexanik trombektomiyaning keng joriy etilishiga qaramay, muvaffaqiyatli reperfuziyadan keyingi klinik natijalar hamon bir xil emas. Bu esa o‘tkir va erta tiklanish davrida nevrologik funksiyalarni yaxshilashga qodir qo‘shimcha omillarni aniqlash zaruratini belgilaydi. Mazkur tadqiqotning maqsadi mexanik trombektomiyadan keyingi dastlabki 24–48 soat ichida boshlangan individuallashtirilgan erta reabilitatsiyaning o‘tkir ishemik insult bilan og‘rigan bemorlardagi funksional natijalarga ta’sirini baholashdan iborat bo‘ldi. Tadqiqot prospektiv kohort tahlili shaklida o‘tkazildi va oldingi qon aylanish havzasi tomirlari okluziyasi sababli mexanik trombektomiya bajarilgan 132 nafar bemorni qamrab oldi. Bemorlar reabilitatsiya boshlanish vaqtiga qarab ikki guruhga ajratildi: erta reabilitatsiya guruhi va kechiktirilgan reabilitatsiya guruhi. Samaradorlik NIHSS, ASPECTS, mRS, Barthel indeksi hamda FIM shkalalari yordamida baholandi. Tadqiqot natijalari shuni ko‘rsatdiki, individuallashtirilgan erta reabilitatsiya 90-kunda qulay funksional natijalarning ko‘proq uchrashi, kundalik hayot faoliyati ko‘rsatkichlarining yaxshilanishi va umumiy funksional mustaqillikning yuqoriligi bilan bog‘liq bo‘ldi. Ayniqsa ASPECTS ≥7 va NIHSS ≤14 bo‘lgan bemorlarda ijobiy ta’sir yanada yaqqol kuzatildi. Olingan natijalar mexanik trombektomiyadan keyingi erta, strukturali va individual yondashuvga asoslangan reabilitatsiya xavfsiz hamda klinik jihatdan samarali ekanini, nogironlikni kamaytirishi, immobilizatsiya bilan bog‘liq asoratlarni qisqartirishi va ishemik insultni davolash natijalarini yaxshilashini ko‘rsatadi.
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