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17МЕДИЦИНСКИЕ НАУКИ
NEW APPROACHES IN THE TREATMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN
Kodirova Sh.S.
Kodirova Shakhlo Salokhitdinovna - Assistant, DEPARTMENT OF CLINICAL PHARMACOLOGY, SAMARKAND STATE MEDICAL INSTITUTE, SAMARKAND, REPUBLIC OF UZBEKISTAN
Abstract: according to statistics, in young children, respiratory diseases are in the first place, which are one of the main causes of death in this age group. According to the literature, the incidence of pneumonia, severity and prognosis largely depend on a combination of the influence of modifiable and non-modifiable factors on the organism of the child, socio-economic status of the child's family, conditions of infection and accessibility of health care.
Keywords: pneumonia, myocarditis, treatment, children.
Relevance. Respiratory diseases are the most common group of diseases among the child population and occupy the first place in the structure of the overall morbidity of children. The relevance of chronization of bronchopulmonary processes, disability and mortality remains [1, 3]. Myocarditis is a disease of the myocardium of inflammatory origin that occurs under the influence of various infectious and non-infectious factors, characterized by inflammatory infiltration of the myocardium with fibrosis, necrosis and / or degeneration of myocytes [5, 7]. The relevance of studying the treatment of pneumonia in children of early age high and are due to: the significant spread of this disease in children the first year of life (sick for 2%,among children first three years - 0.5-0,6%); the severity of the chronic process in the bronchopulmonary system; high mortality, which is caused by the fact that pneumonia is the main cause of child mortality.
In recent years, an increasing number of myocarditis, but the true frequency of the disease in children is unknown in the absence of unified diagnostic criteria of the disease, even with the
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pathological data and the extraordinary variety of clinical symptoms of the disease (oligosymptomatic from "erased" to severe diffuse myocarditis myocarditis type Fiedler), and almost complete lack of coordinated multicenter studies [2, 4, 6].
Objective: to determine the effectiveness of levocarnitine in children with community-acquired pneumonia on the background of myocarditis.
Materials and methods of research:
Due to the need to optimize the treatment of severe community-acquired pneumonia, we studied 40 patients with community-acquired pneumonia who were on inpatient treatment in the Samarkand Branch of the Republican Center for Emergency Medical Care, in pediatrics departments No. 1,2, who were divided into 2 groups of 20 patients, the first group received standard therapy, the second group received a complex of standard therapy included the use of ceftazidime.
Results of the study:
Upon admission, the general condition was assessed as moderate in children of group I in 2 (10.0%), in 16 - severe (80.0%) and extremely severe in 2 (10.0%), and in children of the second group - moderate in 3 (15.0%), in 14-severe (70.0%) and extremely severe in 3 (15.0%), which indicates the relative same severity of the condition in patients of both groups.
The main pathological syndrome in almost all patients of this group, which causes the severity of the condition, as well as in patients receiving a traditional complex of therapy, was the syndrome of respiratory failure.
The clinical symptom complex was characterized by a combination of symptoms of acute hypoxia and characteristic signs of acute respiratory failure: cyanosis of varying severity from perioral to generalized cyanosis, participation of auxiliary muscles in the act of breathing, inflating of the wings of the nose, paroxysmal cough, impaired consciousness from arousal to coma, pasty skin, signs of peripheral blood circulation disorders.
There were also characteristic physical data in the lungs: box sound during percussion and diffuse expiratory wheezes. The analysis of physical changes in the lungs showed that if the
percussive changes in the lungs were normalized by 4.6±0.3 and auscultative changes by 5.1± 0.3 days against the background of traditional therapy, then in the group with levocarnitine there was a significantly accelerated improvement in these indicators (3.9±0.4; 4.1±0.3; P<0.02). The inclusion of oral levocarnitine in the complex of traditional treatment was ultimately manifested by a decrease in the length of hospital stay of patients in comparison with patients of the second group, on average by 1.0 day, while in patients of the second group it was 4.8±0.3 bed days (P<0.05).
Conclusions: The results obtained indicate a typical clinical manifestation of community-acquired pneumonia against the background of myocarditis, at the same time, the study revealed a high clinical effectiveness of oral administration of levocarnitane, which was manifested in a reduction in the duration of hospitalization and oxygen therapy for the disease in children.
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