ISHEMIK INSULTDA TIZIMLI TROMBOLITIK TERAPIYADAN KEYIN ISHEMIK-REPERFUZIYA JAROHATLANISH
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ishemik insult; tizimli vena ichiga trombolitik terapiya; reperfuziya sindromi, nevrologik defitsit##article.abstract##
Ishemik insult bilan og'rigan va vena ichiga tizimli trombolizis terapiya (TLT) o`tkazilgan 67 bemorda istiqbolli tadqiqot o'tkazildi. Reperfuziyadan keyingi davrning borishiga qarab, bemorlar ikki guruhga bo'lindi: birinchi guruh ishemik-reperfuziya jarohatlanish (IRJ) rivojlanmagan 48 bemordan, ikkinchi guruh esa IRJ klinik ko'rinishlariga ega 19 bemordan iborat edi.
IRJ bo'lmagan bemorlarda o`tkazilgan TLTdan keyingi dastlabki 24 soat ichida nevrologik holatda sezilarli yaxshilanish kuzatildi: GCS bo'yicha ong darajasi 10,3±1,2 dan 13,8±1,2 ballgacha ko'tarildi va 7-kunga kelib 14,1±0,9 ballgacha yetdi (p<0,005), NIHSS esa 24 soatdan keyin 14,2±1,8 dan 6,3±1,5 ballgacha va 7-kunga kelib 5,2±2,1 ballgacha pasaydi (p<0,005). Aksincha, ishemik insult bilan og'rigan bemorlarda erta klinik yomonlashuv kuzatildi, bu gipertermiya, nevrologik defitsitning yomonlashishi, ongning buzilishi, tutqanoqlar, gemodinamik va nafas olish qiyinlishuvi bilan birga keldi. GCS 24 soatdan keyin 10,6±2,4 balldan 9,3±3,5 ballgacha pasaydi va 7-kuni 10,1±4,5 ballgacha yetdi, NIHSS esa 24 soatdan keyin 14,9±3,5 balldan 18,3±4,1 ballgacha ko'tarildi va 7-kuni yuqori (16,1±4,5 ball) bo'lib qoldi. Tizimli TLTdan keyin IRJ rivojlanishi erta nevrologik yomonlashuv va klinik parametrlarning noqulay dinamikasi bilan bog'liq bo'lib, ishemiya-reperfuziya miya shikastlanishining rivojlanishini aks ettiradi.
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