UMURTQA KANALINING DEGENERATIV STENOZINI DAVOLASHNING SHAXSIYLASHTIRILGAN ALGORITMLARI: KONSERVATIV TERAPIYADAN XIRURGIK DEKOMPRESSIYAGACHA
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umurtqa kanalining degenerativ stenozi; shaxsiylashtirilgan davolash; konservativ terapiya; xirurgik dekompressiya; tazo a'zolar funksiyasining buzilishi; xavf omillari; miyelopatiya; urodinamik buzilishlar##article.abstract##
Umurtqa kanalining degenerativ stenozi (DKS) – surunkali miyelopatiya va nogironlikning yetakchi sababi bo‘lib, davolash strategiyalarini optimallashtirishni talab qiladi. Maqsad: DKS uchun shaxsiylashtirilgan davolash algoritmlarini ishlab chiqish, bemorlar tuzilmasi, xavf omillari va tazo a'zolar funksiyasining buzilishi (TAFB) tahliliga asoslanib.
Material va usullar. DKS bilan 62 bemorning ma'lumotlarini (n=250 kogortaning 25%) retrospektiv tahlili. Kompleks tekshirish nevrologik statusni (ASIA), urodinamik tekshiruvlarni (siydish oqimi, urodinamika, USP shkalasi) va neyrovizualizatsiyani (1,5 Tl MRT, KT-miyelografiya) o‘z ichiga oldi. Statistika: IBM SPSS 26.0 (tasvirlash statistikasi, Spearman korrelyatsiyasi, χ², Mann-Whitney, OR hisobi 95% DI bilan; p<0,05).
Natijalar. Hukmron topilmalar: ko‘krak darajasi shikastlanishlari (Th7–Th12 – 60%), aralash TAFB turi (58%) va stenoz >50% (82%). Og‘ir nogironlikning (mRS 4-5) xavf omillari: yoshi >50 yil
(OR=3,2; 95% DI 1,8–5,7), stenoz >70% (OR=4,1; 95% DI 2,3–7,3), siydishni ushlab qolish
(OR=5,6; 95% DI 3,1–10,2) va ko‘krak lokalizatsiyasi (OR=2,8; 95% DI 1,5–5,1). Konservativ terapiya stenoz <50% va yengil TAFB bilan samarali (68%). Xirurgik dekompressiya stenoz >50%, alomatlar progressiyasi va konservativ davolashning samarasizligi >3-6 oy uchun ko‘rsatilgan.
Xulosa. Stenoz darajasi, shikastlanish darajasi, TAFB turi va xavf omillarini hisobga olgan holda shaxsiy yondashuv DKS bemorlarini boshqarishni optimallashtiradi, nogironlik xavfini kamaytiradi va hayot sifatini yaxshilaydi.
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