慢性肾盂肾炎孕妇综合应用物理治疗及预形成的物理因素

М. І. Pavliuchenko, V. H. Siusiuka, N. V. Haidai, M. Serhiienko, O. Deinichenko
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引用次数: 0

摘要

本研究的目的是评价慢性肾盂肾炎孕妇物理治疗和预成型物理因素对中心血流动力学指标的影响。材料和方法。本文研究了134例处于缓解期的慢性肾盂肾炎(CP)孕妇的动态,这些孕妇接受了复杂的疗养院康复计划。主要研究组包括79名患有慢性肾盂肾炎的孕妇。在这支妇女队伍中,疗养院康复综合设施还包括间歇性常压低氧治疗(INH)。对照组包括55名患有CP的孕妇,其中疗养院康复中心不包括INH课程。对照组由37名身体健康的怀孕生理过程妇女代表。使用计算机诊断复合体REOKOM (Kharkiv)检查所有孕妇的中心血流动力学(CH)指标。妊娠期20-30周和31-30周的CP妇女的特点是中央血流动力学的病理负荷。同时,在疗养院康复中心(主组)申请INH课程,可以增加CH孕妇的代偿能力。因此,在主组妊娠22-30周期间,舒张压和心率指标可能低于对照组(P < 0.001)。与研究时间无关,本组血管外周阻力值与对照组接近(P > 0.05)。通过对CH的研究以及不同妊娠期和研究组之间的比较,发现反映心血管动力学强度的指标与血管阻力指标呈反比关系,是维持血压在生理水平的最终机制之一。或其在慢性肾盂肾炎和子痫前期的病理性增加。考虑到各研究组心脏指标与外周血管总阻力的比值稳定,且直接依赖于血压水平,为评估卒中CP指标或心脏指标孕妇的CH状态,建议实际应用。其特征是心脏血流动力学的强度,而不依赖于孕妇的人体测量数据。慢性肾盂肾炎孕妇在复杂的疗养院康复方案中应用物理治疗和预先形成的物理因素,即间歇性常压低氧治疗,增加了心血管系统的代偿能力,在心脏指数升高的背景下,总外周阻力值显著降低,证实了这一点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Complex applying physical therapy and preformed physical factors in pregnant women with chronic pyelonephritis
The aim of the work is to evaluate the impact of physical therapy and preformed physical factors in pregnant women with chronic pyelonephritis on central hemodynamic indicators. Materials and methods. The dynamics of 134 pregnant women with chronic pyelonephritis (CP) in the remission stage, who underwent a complex sanatorium rehabilitation program, were examined. The main study group consisted of 79 pregnant women with chronic pyelonephritis. In this contingent of women, the sanatorium rehabilitation complex additionally included a course of intermittent normobaric hypoxytherapy (INH). The comparison group consisted of 55 pregnant women with CP, for whom the sanatorium rehabilitation complex did not include an INH course. The control group is represented by 37 somatically healthy women with a physiological course of pregnancy. All pregnant women were examined for central hemodynamic (CH) indicators using the computer diagnostic complex REOKOM (Kharkiv). Results. Pregnancy periods of 20–30 and 31–30 weeks in women with CP are characterized by a pathological load on central hemodynamics. At the same time, the application for the INH course in the sanatorium rehabilitation complex (the main group) allows for an increase in the compensatory capabilities of the pregnant woman with CH. Thus, in the period of pregnancy of 22–30 weeks in the main group, indicators of diastolic blood pressure and heart rate were probably lower than the control values (P < 0.001), which in this group is determined by values of peripheral resistance of blood vessels close to those of the control group (P > 0.05), regardless of the timing of the study. The study of CH and the comparison of different periods of gestation and between research groups indicate an inverse relationship between indicators that reflect the intensity of cardiohemodynamics and indicators of vascular resistance, as one of the final mechanisms of maintaining blood pressure at a physiological level, or its pathological increase in chronic pyelonephritis and preeclampsia Taking into account that the ratio of cardiac index indicators and total peripheral vascular resistance in all study groups was stable and directly dependent on the level of blood pressure, it is advisable to recommend for practical application in order to assess the state of CH of pregnant women with CP indicators of stroke or cardiac indices, which characterize the intensity cardiohemodynamics and do not depend on the anthropometric data of the pregnant woman. Conclusions. The application of physical therapy and preformed physical factors, namely, intermittent normobaric hypoxytherapy in pregnant women with chronic pyelonephritis in a complex program of sanatorium rehabilitation increases the compensatory capabilities of the cardiovascular system, which is confirmed by a significant decrease in the values of the total peripheral resistance against the background of an increase in the cardiac index.  
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