Posterior perikardiotomiyaning ishlayotgan yurakdagi koronar arteriyalarni shuntlash (OPCAB) amaliyotidan keyingi supraventrikulyar aritmiya xavfiga ta’siri
Annotatsiya
Maqsad. Koronar arteriyalarni ishlab turgan yurakda shuntlash amaliyotini o‘tkazadigan bemorlarda jarrohlik amaliyotidan keyingi supraventrikulyar aritmiya xavfiga ta’siri bilan kasallanishni kamaytirishda Posterior perikardiotomiya amaliyotini samaradorligini baholash.
Materiallar va usullar. Bu ilmiy tadqiqot Respublika ixtisoslashtirilgan kardiologiya ilmiy-amaliy tibbiyot markazida amalga oshirildi. Tadqiqotda yurak ishemik kasalligi bilan og‘rigan va jarrohlik amaliyotiga ko‘rsatma bo‘lgan 220 ta bemor ishtirok etdi. Bemorlarning o‘rtacha yoshi 58,6±7,2 yosh, tadqiqotda qatnashgan bemorlarning 31tasi ayol va qolgan189 tasi erkak. Randomizatsiya usulida bemorlar 2 guruhga bo‘lindi. Birinchi guruhdagi 110 ta bemorlarga posterior perikardiotomiya amaliyoti bajarildi, ikkinchi guruhdagi 110 ta bemorlarga bu amaliyot bajarilmadi. Barcha bemorlar operatsiyadan 5 kun va 24 soat oldin Xolter EKG monitoringi (XM EKG) o’tkazildi.
Natijalar. Monitoring natijalariga ko‘ra, 48 ta bemorda koronar arteriyalarni ishlab turgan yurakda shuntlash amaliyotidan keyingi BF rivojlandi, bu umumiy bemorlarning 21,8% ni tashkil etdi. Klinik va anamnestik ko‘rsatkichlarni tahlil qilish quyidagilarni aniqladi. Guruhlar yoshi va jinsi bo‘yicha sezilarli darajada farq qilmadi (1-jadval). Gipertenziya JAKBF bo’lgan guruhda tez-tez qayd etilgan va JAKBF bo‘lmagan guruhda 44,3% ga nisbatan 95,1% ni tashkil etgan (X2 = 29,9; r<0,001). Shuningdek, asosiy guruhdagi bemorlar JAKBF bo‘lmagan guruhga qaraganda semizlik kasalligi bilan ko‘proq og‘rigan (X2 = 7,1; r = 0,008). Qandli diabet (QD) ham JAKBF bilan og’rigan bemorlarda sezilarli darajada tez-tez uchraydi, 30,5% ga nisbatan 68,5% (X2 = 17; r<0,001).
Xulosa. Bizning natijalarimizga ko‘ra, bemorlarning 21.8% ishlab turgan yurakda AKSH amaliyotidan keyingi JAKBF kuzatilgan. Buning asosiy sabablari bemorning yoshi, uning yuragining chap bo‘lmachasining kattalashganligi, yondosh kasalliklari va miyokarddagi fibroz sababdir. Posterior perikardiotomiya supraventrikulyar aritmiyani sezilarli darajada kamaytiradi degan xulosaga kelish mumkin. Shuningdek, yurak tamponadasi, tromboemboliya asoratlari, intensiv terapiya bo‘limi va reabilitatsiya bo‘limida yotoq kunlarining uzaytirilishini kamaytiradi va shu bilan klinika resurslarini tejashga tasir ko‘rsatadi.
Mualliflar haqida
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Copyright (c) 2025 О.О. Джаббаров, Г.У. Муллабаева, И.М. Шарипов, Х.Г. Фозилов (Автор)
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