Резюме
Григоров С.М. Алгоритм індивідуалізації імунопрофілактики ускладненого перебігу пошкоджень лицевого черепа.
За результатами власних досліджень та контент-аналізу фахової літератури доведено, що в системі комплексного лікування пацієнтів з пошкодженнями лицевого черепа слід передбачати застосуваня засобів імуномодуулюючої корекції. Для індивідуалізації потреби у цих засобах опарацьовано алгоритм, застосування якого передбачає проведення периопераційного імунологічного моніторингу.
Ключові слова: хірургічна стоматологія, пошкодження лицевого черепа, ускладнений перебіг, імунопрофілактика

Резюме
Григоров С.Н. Алгоритм индивидуализации иммунопрофилактики осложнённого течения повреждений лицевого черепа.
По результат собственных исследований и контент-анализа специализированной литературы доказано, що в системе комплексного лечения пациентов с повреждениями лицевого черепа следует предусматривать применение средств иммуномодулирующей коррекции. Для индивидуализации применения этих средств разработан алгоритм, которым предусматривается проведение периоперационного иммунологического мониторинга.
Ключевые слова: хирургическая стоматология, повреждения лицевого черепа, иммунопрофилактика.

Summary
Grygorov S.M. Algorithm of individualization of immunoprophylaxy of complicated course facial cranium injuries.
Due to results of original researches and content analysis of specialized literature it was proved, that it is necessary to include immunomodulatory correction remedies in the system of complex treatment of patients with facial cranium injuries. An algorithm, which includes perioperative immunological monitoring, was developed for individualization of prescription of these remedies.
Key words: oral surgery, facial cranium injuries, immunoprophylaxis.

Рецензент: д.мед.н., проф. І.І. Зєльоний

УДК 617.52-001.4/.5-089-08-039.76

Харкіський національний медичний університет МОЗ України

Харьковский национальный медицинский университет

Kharkiv National Medical University

serg_shklyar@ukr.net

The goal of the research consisted in the improvement of prophylaxis of complicated course of facial skeleton damages taking into account the individual formula of immune abnormalities at simultaneous taking into account activity of proinflammatory answer for a traumatic damage.

The goal that is lied in basis of the improved methodology is decided that in the known method of immunoprophylaxis individualization that includes measuring and comparative reference analysis of absolute and relative content of main subpopulations of immunocompetent cells and indicators of the functional state of humoral link of immune defense of patient with next determination of FIA according to the useful model before beginning and no less than in three days after the beginning of integrated treatment, determine interleukine - producting ability of Т-cells after the ratio index of their levels in spontaneous and induced reactions and calculate index Тhelpers / Тsuppressors; and when at the increase of index Тh/Тs is the increase of activity index of  cytokine network (AIcn), that is calculated after the formula AIcn= ILi / ILc, where ILi is a level of content of secretory form  ILi  in the induced reactions, ILc is a level of content of its secretory form in spontaneous reactions, determine a requirement in realization of immunoprophylaxis of CC FSD by including to the integrated treatment  facilities of immunomodulating  correction of Т-cell link.

The increase of accuracy of immunoprophylaxis facilities selection taking into account individual formula of immune abnormalities at the simultaneous taking into consideration  activity of proinflammatory answer for a traumatic damage has a decision role in the effective prophylaxis of CC FSD. Except that by the method it is mediated taken into account present at this category of patients possible abnormalities of integrative function of hypophysis - adrenal - epinephral correlations that are formed owing to the united trauma (commotio) of cerebrum. The mentioned allows to improve diagnostics, prophylaxis and treatment of patients with FSD due to avoidance (in the part of cases) CC at simultaneous reduction of terms of treatment and temporal disability.

The method is executed in the following way. Directly in the conditions of the specialized in-patient department applying standard methods  of immune examination of a patient, before beginning and no less than  in three days after the beginning of integrated treatment, it is determined interleukine - producting ability of Т-cells after the index of correlation of their levels in spontaneous and induced reactions and calculated the index of Тh / Тs and activity index   of cytokine network (AIcn); and when  at the increase of index of Тh/Тs, the increase of activity index of  cytokine network, that is calculated after the formula AIcn= ILi / ILc  where ILi is a level of content of secretory form of interleukine- 1β in the induced reactions, ILc is a level of content of its secretory form in spontaneous reactions, it is determined a requirement in realization of immunoprophylaxis of the complicated course of damages of facial skeleton damages by including to the integrated treatment  facilities of immunemodulating correction of Т-cells link.

Conclusions

1. In the system of integrated treatment of patients with the damages of facial skeleton it should be provided use of facilities of immunemodulating correction.

2. For individualization of requirement in these facilities it is worked out the algorithm [4], application of that envisages realization of preoperative immunologic monitoring after the certain criteria.

3. The aspects of immunoreabilitation of patients with CC FSD in a remote postoperative period need further study.

4. The prospects of further researches are related to development of the integral system of immunoprophylaxis and immunoreabilitation of patients with facial skeleton damages.

Література

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