YUQORI JAG’ BUSHLIG’I KISTOZLI SINUSITNING KOMPLEKS TASHXISLASH, DAVOLASH VA PROFILAKTIKASI
##article.subject##:
yuqori jag‘ning surunkali kistoz sinusiti, immunoregulyator indeks, immunogistokimyo, interleykinlar, kistalar##article.abstract##
Kirish: Surunkali kistoz sinusit mahalliy himoya mexanizmlarining zaiflashishi bilan kechadi. Surunkali sinusitning eng keng tarqalgan klinik shakllaridan biri kistoz sinusitdir. Burun yondosh bo‘shliqlari kistalari quloq, tomoq va burunning barcha kasalliklari tarkibida 3,9% va surunkali sinusitlar orasida 12,6% ni tashkil qiladi.
Tadqiqotning maqsadi o‘z vaqtida tashxis qo‘yish, jarrohlik davolash taktikasini shaxsiy tanlash, shuningdek, kasallik qaytalanishining oldini olishga qaratilgan profilaktik chora-tadbirlar tizimini amalga oshirishni ta’minlaydigan kompleks davolash-diagnostika protokolini asoslash va joriy etishdan iborat.
Materiallar va usullar: Klinik tadqiqot Samarqand viloyat tibbiyot markazining otorinolaringologiya bo‘limi bazasida 2021-yildan 2024-yilgacha bo‘lgan davrda o‘tkazildi. Tadqiqotning obyekti sifatida yuqori jag‘ sinusi kistasi tashxisi tasdiqlangan 230 nafar bemorlar olingan. Asosiy guruhdagi bemorlarda (n=115) standart chora-tadbirlar bilan bir qatorda kompleks diagnostika, differensial konservativ va jarrohlik davolash, "operatsiyadan keyingi bosqichma-bosqich reabilitatsiya protokoli" asosida uchlamchi profilaktika o‘tkazildi. Taqqoslash guruhidagi bemorlarga (n=115) davolash standarti bo‘yicha diagnostika, davolash va profilaktika o‘tkazildi.
Natijalar: Infiltratsiyaning uchta morfotipi aniqlandi: eozinofil, limfotsitar va fibrozli aralash leykotsitar-limfotsitar. IGK tahlili immunoregulyator indeks (IRI) nomutanosibligini aniqladi va shu asosda shaxsiylashtirilgan terapiya tayinlandi. Bemorlarda T-limfotsitlar va fagotsitar bo‘g‘in funksional faolligining pasayishi qayd etilgan, bu esa mahalliy va tizimli immunitetning pasayishini ko‘rsatadi. Davolash natijalarining qiyosiy tahlili asosiy guruhdagi bemorlarni olib borishning ishlab chiqilgan taktikasining nazorat guruhiga nisbatan sezilarli afzalligini ko‘rsatdi. Uzoq muddatli davrda (12 oy) asosiy guruhda davolash samaradorligi pastki burun yo‘li va oldingi devor orqali kirishda 100% ga, o‘rta burun yo‘li orqali kirishda esa 94% ga yetdi. Ushbu ko‘rsatkichlar nazorat guruhi natijalaridan sezilarli darajada ustun bo‘lib, bir yildan so‘ng bo‘shliqning yaxshi pnevmatizatsiyasi faqat 87-96% hollarda saqlanib qolgan, retsidivlar chastotasi esa 9% ga yetgan. Asosiy guruhda retsidivlar va jarrohlik aralashuvining samarasizligi holatlarining butunlay yo‘qligi tanlangan yondashuvlarning yuqori ishonchliligi va radikalligini tasdiqlaydi.
Xulosalar: Operatsiyadan keyingi reabilitatsiyaning optimallashtirilgan protokoli bilan birgalikda tabaqalashtirilgan jarrohlik yondashuvini qo‘llash to‘liq immunokorreksiyani ta’minlaydi CD3+ ning me’yorlashuvi, interleykinlar va IgE ning 63 XB/ml gacha pasayishi) va neyropatiyalar xavfini (0%) istisno etadi, bu esa IGX ma’lumotlari asosida terapiyani shaxsiylashtirish va SNOT-22 bo‘yicha hayot sifatini 4,1 ballgacha me’yorlashtirgan holda bemorlarning to‘liq tibbiy-ijtimoiy reabilitatsiyasiga erishish imkonini beradi.
Библиографические ссылки
sinuses. Otorhinolaryngology. Eastern Europe. 2021;11(2):169-174. (In Russ.)
Nasretdinova MT, Xayitov AA, Ziyadullayev SX, Vladimirova T.Yu. About specific endonasal extraction of cysts of the maxillary sinus. Journal of Oral Medicine and Craniofacial Research. 2022;1(3):24–26. doi: 10.26739.2181-0966-2020-3-5.
Semenov FV, Gorbonosov IV, Vartanyan MS. Symptomatology of maxillary sinus cysts. Bulletin of Otorhinolaryngology. 2012;(1):8-10. (In Russ.)
Esankulovich K. H., Taxinovna N. M. About specific endonasal extraction of cysts of the maxillary sinus //Central Asian Journal of Medical and Natural Science. – 2021. – Т. 2. – №. 2. – С. 201-204. (in Russ)
Nasretdinova MT, et al. Tactics of Administration of Patients with Chronic Atrophic Rhinitis. Annals of the Romanian Society for Cell Biology. 2021:147-151.
Pierse JE, Stern A. Benign cysts and tumors of the paranasal sinuses. Oral and Maxillofacial Surgery Clinics. 2012;24(2):249-264.
Moon IJ, et al. Mucosal cysts in the paranasal sinuses: long-term follow-up and clinical implications. American Journal of Rhinology & Allergy. 2011;25(2):98-102.
Giotakis EI, Weber RK. Cysts of the maxillary sinus: a literature review. International Forum of Allergy & Rhinology. 2013;3(9):766-771.
Fokkens WJ, et al. European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2020. Rhinology. 2020;58(29):1-464.
Bachert C, Han JK, Desrosiers M, et al. Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps: a pooled analysis of two phase 3 trials. The Lancet Respiratory Medicine. 2021;9(9):1029-1041. doi:10.1016/S2213-2600(21)00114-7.
Varyushina E.A., Bezrukova E.V., Vorobeychikov E.V., Kravchenko E.V., Sukhareva J.V., Aflitonov M.A., Simbirtsev A.S. Study of local inflammatory response in different clinical forms of chronic polypous rhinosinusitis. Medical Immunology (Russia). 2022;24(3):539-552. (In Russ.) https://doi.org/10.15789/1563-0625-SOL-2479
Imamov O. S., Rizaev J. A., Toxtayev G. S. A SURVEY OF BULLOUS DISEASES CLINICOEPIDEMIOLOGICAL CHARACTERISTICS //Central Asian Journal of Medicine. – 2025. – №. 2. – С. 65-70.
Alimdjanovich R. J., Ugli T. N. K. CLINICAL AND ANATOMICAL FEATURES OF NASAL DEFORMITY IN PATIENTS WITH UNILATERAL CLEFT LIP AND PALATE AFTER CHEILOPLASTY //The American Journal of Medical Sciences and Pharmaceutical Research. – 2023. – Т. 5. – №. 08. – С. 13-22.
Фаттаева Д., Ризаев Ж., Рахимова Д. ОСОБЕННОСТИ КЛИНИЧЕСКОГО ТЕЧЕНИЯ ХРОНИЧЕСКОГО ГАЙМОРИТА ПРИ БРОНХО-ЛЕГОЧНОЙ ПАТОЛОГИИ //SCIENTIFIC IDEAS OF YOUNG SCIENTISTS. – 2021. – С. 28.
Polatova Djamila , Madaminov Ahmad, Raximov Nodir . Significance of expression PD-L1 and p53 proteins in human papillomavirus-associated oropharyngeal squamous cell carcinoma// Journal of Biomedicine and Practice. 2022, vol . 7, issue 4, pp . 144-151
Abdurakhmonov F. R., Rakhimov N. M., Abdurakhmonova F. F. Special choices for the treatment of complications of the soft tissue injuries of the facial region //The American Journal of Medical Sciences and Pharmaceutical Research. – 2023. – Т. 5. – №. 10. – С. 24-26.
