VERTEBROGEN PATOLOGIYA VA TOS A’ZOLARI DISFUNKSIYASI BILAN KECHUVCHI BEMORLARNI BOSHQARISH STRATIFIKATSIYASI: MULTIDISTSIPLINAR YONDASHUV
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miellopatiya, tos a’zolari disfunktsiyasi, umurtqa kanali stenozi, posttravmatik kaskad, metall konstruksiyalar, xavfni stratifikatsiya qilish, multidistsiplinar yondashuv, umurtqa pog‘onasining degenerativ o‘zgarishlari, urodinamik buzilishlar, orqa miya shikastlanishi bo‘lgan bemorlarni reabilitatsiya qilish.##article.abstract##
Dolzarbligi. Umurtqa pog‘onasi va orqa miya patologiyalari O‘zbekiston Respublikasida muhim tibbiy-ijtimoiy muammolardan biri hisoblanadi. Umurtqa kanali stenozi, metall konstruksiyalar mavjudligi va degenerativ o‘zgarishlar bilan kechuvchi, «posttravmatik kaskad»ni shakllantiruvchi qo‘shma patologiyalarni boshqarish alohida murakkablik tug‘diradi.
Maqsad. Vertebrogen patologiya va tos a’zolari disfunktsiyasi (TAD) mavjud bemorlarni boshqarish bo‘yicha klinik-demografik ko‘rsatkichlar, neyrovisualizatsiya natijalari va xavf omillariga asoslangan stratifikatsiya algoritmini ishlab chiqish.
Materiallar va usullar. Miellopatiya va TAD aniqlangan 250 nafar bemorning tibbiy hujjatlari retrospektiv tahlil qilindi (o‘rtacha yosh 38,6 ± 12,4 yil). ASIA shkalasi asosida nevrologik baholash, urodinamik tekshiruvlar, MRT/KT va statistik tahlil usullari qo‘llanildi.
Natijalar. Bemorlarda posttravmatik miellopatiya ustunlik qildi (68%), ularning 82% ida «posttravmatik kaskad» tipidagi degenerativ o‘zgarishlar aniqlandi. Umurtqa kanali stenozining 50% dan ortiq bo‘lishi TAD og‘irligi bilan yuqori darajada bog‘liq bo‘ldi (r = 0,82; p < 0,001). Siydik tutilishi (62%) ko‘proq bo‘yin umurtqa pog‘onasi shikastlanishlarida kuzatildi. Asosiy xavf omillari: 50 yoshdan katta bo‘lish, stenozning 70% dan ortiq darajasi va siydik tutilishining mavjudligi.
Xulosa. Bemorlarni uch bosqichli stratifikatsiya qilish va differensial boshqaruv taktikalari taklif etildi. Davolash samaradorligini oshirish uchun nevrolog, vertebrolog, urolog va reabilitatsiya mutaxassisini o‘z ichiga olgan multidistsiplinar yondashuv zarurligi tasdiqlandi.
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