<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">vsp</journal-id><journal-title-group><journal-title xml:lang="ru">Вопросы современной педиатрии</journal-title><trans-title-group xml:lang="en"><trans-title>Current Pediatrics</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1682-5527</issn><issn pub-type="epub">1682-5535</issn><publisher><publisher-name>Издательство «ПедиатрЪ»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15690/vsp.v13i4.1082</article-id><article-id custom-type="elpub" pub-id-type="custom">vsp-165</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group></article-categories><title-group><article-title>ЭЭФФЕКТИВНОСТЬ ИНГАЛЯЦИЙ ГИПЕРТОНИЧЕСКОГО РАСТВОРА У ДЕТЕЙ С БРОНХИТАМИ И БРОНХИОЛИТАМИ</article-title><trans-title-group xml:lang="en"><trans-title>EFFICIENCY OF HYPERTONIC SOLUTION INHALATION IN CHILDREN WITH BRONCHITIS AND BRONCHIOLITIS</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Симонова</surname><given-names>О. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Simonova</surname><given-names>O. I.</given-names></name></name-alternatives><email xlink:type="simple">oisimonova@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Горинова</surname><given-names>Ю. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Gorinova</surname><given-names>Yu. V.</given-names></name></name-alternatives><email xlink:type="simple">oisimonova@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бакрадзе</surname><given-names>М. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Bakradze</surname><given-names>M. D.</given-names></name></name-alternatives><email xlink:type="simple">oisimonova@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Научный центр здоровья детей, Москва</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Scientific Centre of Children’s Health, Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2014</year></pub-date><pub-date pub-type="epub"><day>02</day><month>08</month><year>2014</year></pub-date><volume>13</volume><issue>4</issue><issue-title>Вопросы современной педиатрии</issue-title><fpage>33</fpage><lpage>39</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Симонова О.И., Горинова Ю.В., Бакрадзе М.Д., 2014</copyright-statement><copyright-year>2014</copyright-year><copyright-holder xml:lang="ru">Симонова О.И., Горинова Ю.В., Бакрадзе М.Д.</copyright-holder><copyright-holder xml:lang="en">Simonova O.I., Gorinova Y.V., Bakradze M.D.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://vsp.spr-journal.ru/jour/article/view/165">https://vsp.spr-journal.ru/jour/article/view/165</self-uri><abstract><p>Основой лечения пациентов с муковисцидозом (МВ) является кинезитерапия — специальная дыхательная гимнастика и дренаж бронхиального дерева. Повышение эффективности комплекса лечебно-реабилитационных мероприятий может быть достигнуто применением метода высокочастотной осцилляции грудной клетки (ВЧОГК). Цель исследования: разработать дополнительные критерии индивидуальной программы занятий по системе ВЧОГК для детей с МВ. Пациенты и методы: в исследовании участвовали 43 ребенка с МВ в возрасте 2 лет 10 мес –17,5 лет, лечение которых включало 14 процедур ВЧОГК. Из них 10 детей первые 4 занятия получили осцилляции, рассчитанные в соответствии с возрастом, а с 5-го занятия — в соответствии с тяжестью течения МВ и показателями объема форсированного выдоха за первую секунду (ОФВ1) — подгруппа I. Пациенты, включенные в подгруппу II (n =33), с первого занятия получали осцилляции, рассчитанные по тяжести течения МВ и в соответствии с показателями ОФВ1. Результаты: В подгруппе I в первые 4 занятия не отмечалось улучшения показателей пикфлоуметрии (р &gt;0,05), жалобы на дискомфорт от процедуры были у всех детей. С 5-го занятия начинала отмечаться клинико-функциональная динамика, к 8-му занятию показатели сравнялись с подгруппой II, в которой положительные изменения регистрировали с первого занятия. К 14-му занятию показатели ОФВ1 улучшились в I и II подгруппе: с тяжелым течением МВ (с 42,5±5,5 до 58,1±1,6%; р =0,015) и с течением средней степени тяжести (с 71,1±1,2 до 80,0±2,8%; р =0,025). Дополнительно у всех больных отметили улучшение показателей пикфлоуметрии и экскурсии грудной клетки (см; р &lt;0,05), в т.ч. и у больных с тяжелым течением МВ (р =0,012). Выводы: эффективность занятий с применением метода ВЧОГК, ориентированных на степень тяжести МВ и показатели ОФВ1, выше, чем применение метода с учетом возраста пациентов.</p></abstract><trans-abstract xml:lang="en"/><kwd-group xml:lang="ru"><kwd>ингаляционный гипертонический раствор</kwd><kwd>хронический бронхиолит</kwd><kwd>мукостаз</kwd><kwd>дети</kwd></kwd-group><kwd-group xml:lang="en"><kwd>inhalation of hypertonic saline</kwd><kwd>chronic bronchitis</kwd><kwd>mycostasis</kwd><kwd>children</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">ООО «ПАРИ синергия в медицине» (представитель в РФ разработчика и производителя ингаляционного оборудования PARI GmbH Specialists in effective inhalation, Германия).</funding-statement><funding-statement xml:lang="en">“PARI synergism in medicine” Ltd.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Mukoaktivnaya terapiya. Pod red. A. G. Chuchalina, A. S. Belevsko go [Mucoactive Therapy. Edited by A. G. Chuchalin, A. S. Belevskii]. Moscow, Atmosfera, 2006. 124 p.</mixed-citation><mixed-citation xml:lang="en">Mukoaktivnaya terapiya. Pod red. A. G. Chuchalina, A. S. Belevsko go [Mucoactive Therapy. Edited by A. G. Chuchalin, A. S. Belevskii]. Moscow, Atmosfera, 2006. 124 p.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Simonova O. I. Vopr. sovr. pediatrii — Current pediatrics. 2013; 12 (4): 136–141.</mixed-citation><mixed-citation xml:lang="en">Simonova O. I. Vopr. sovr. pediatrii — Current pediatrics. 2013; 12 (4): 136–141.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Patrusheva Yu. S., Bakradze M. D. Vopr. diagnostiki v pediatrii — Diagnostics in pediatrics. 2012; 4 (3): 45–52.</mixed-citation><mixed-citation xml:lang="en">Patrusheva Yu. S., Bakradze M. D. Vopr. diagnostiki v pediatrii — Diagnostics in pediatrics. 2012; 4 (3): 45–52.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Simonova O. I., Tomilova A.Yu., Gorinova Yu. V., Surkov A. N., Roslavtseva E. A., Namazova-Baranova L. S. Mukovistsidoz. V serii kn.: Bolezni detskogo vozrasta ot A do Ya. Vyp. 5 [Cystic Fibrosis. In a series of books: Childhood Diseases from A to Z. Vol. 5]. Moscow, Pediatr””, 2014. 84 p.</mixed-citation><mixed-citation xml:lang="en">Simonova O. I., Tomilova A.Yu., Gorinova Yu. V., Surkov A. N., Roslavtseva E. A., Namazova-Baranova L. S. Mukovistsidoz. V serii kn.: Bolezni detskogo vozrasta ot A do Ya. Vyp. 5 [Cystic Fibrosis. In a series of books: Childhood Diseases from A to Z. Vol. 5]. Moscow, Pediatr””, 2014. 84 p.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Mall M., Grubb B. R., Harkema J. R., O'Neal W. K., Boucher R. C. Increased airway epithelial Na+ absorption produces cystic fibrosislike lung disease in mice. Nature Medicine. 2004; 10: 487–493.</mixed-citation><mixed-citation xml:lang="en">Mall M., Grubb B. R., Harkema J. R., O'Neal W. K., Boucher R. C. Increased airway epithelial Na+ absorption produces cystic fibrosislike lung disease in mice. Nature Medicine. 2004; 10: 487–493.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Robinson M., Hemming A. L., Regnis J. A., Wong A. G., Bailey D. L., Bautovich G. J. Effect of increasing doses of hypertonic saline on mucociliary clearance in patients with cystic fibrosis. Thorax. 1997; 52: 900–903.</mixed-citation><mixed-citation xml:lang="en">Robinson M., Hemming A. L., Regnis J. A., Wong A. G., Bailey D. L., Bautovich G. J. Effect of increasing doses of hypertonic saline on mucociliary clearance in patients with cystic fibrosis. Thorax. 1997; 52: 900–903.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Donaldson S. H., Bennett W. D., Zeman K. L., Knowles M. R., Tarran R., Boucher R. C. Mucus clearance and lung function in cystic fibrosis with hypertonic saline. N. Engl. J. Med. 2006; 354: 241–250.</mixed-citation><mixed-citation xml:lang="en">Donaldson S. H., Bennett W. D., Zeman K. L., Knowles M. R., Tarran R., Boucher R. C. Mucus clearance and lung function in cystic fibrosis with hypertonic saline. N. Engl. J. Med. 2006; 354: 241–250.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Elkins M. R., Robinson M., Rose B. R., Harbour C., Moriarty C. P., Marks G. B. A controlled trial of long-term inhaled hypertonic saline in patients with cystic fibrosis. N. Engl. J. Med. 2006; 354 (3): 229–240.</mixed-citation><mixed-citation xml:lang="en">Elkins M. R., Robinson M., Rose B. R., Harbour C., Moriarty C. P., Marks G. B. A controlled trial of long-term inhaled hypertonic saline in patients with cystic fibrosis. N. Engl. J. Med. 2006; 354 (3): 229–240.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Graeber S. Y., Zhou-Suckow Z., Schatterny J., Hirtz S., Boucher R. C., Mall M. A. Hypertonic saline is effective in the prevention and treatment of mucus obstruction, but not airway inflammation, in mice with chronic obstructive lung disease. Am. J. Respir. Cell &amp; Mol. Biol. 2013; 49: 410–417.</mixed-citation><mixed-citation xml:lang="en">Graeber S. Y., Zhou-Suckow Z., Schatterny J., Hirtz S., Boucher R. C., Mall M. A. Hypertonic saline is effective in the prevention and treatment of mucus obstruction, but not airway inflammation, in mice with chronic obstructive lung disease. Am. J. Respir. Cell &amp; Mol. Biol. 2013; 49: 410–417.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Wark P., McDonald V. M. Nebulised hypertonic saline for cystic fibrosis. Cochr. Database Syst. Rev. 2009; 2: CD001506.</mixed-citation><mixed-citation xml:lang="en">Wark P., McDonald V. M. Nebulised hypertonic saline for cystic fibrosis. Cochr. Database Syst. Rev. 2009; 2: CD001506.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Dellon E. P., Donaldson S. H., Johnson R., Davis S. D. Safety and Tolerability of Inhaled Hypertonic Saline in Young Children With Cystic Fibrosis. Pediatr. Pulmonol. 2008; 43: 1100–1106.</mixed-citation><mixed-citation xml:lang="en">Dellon E. P., Donaldson S. H., Johnson R., Davis S. D. Safety and Tolerability of Inhaled Hypertonic Saline in Young Children With Cystic Fibrosis. Pediatr. Pulmonol. 2008; 43: 1100–1106.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Rosenfeld M., Davis S., Brumback L. Inhaled Hypertonic Saline in Infants and Toddlers with Cystic Fibrosis: Short-Term Tolerability, Adherence and Safety. Pediatr. Pulmonol. 2011; 46 (7): 666–671.</mixed-citation><mixed-citation xml:lang="en">Rosenfeld M., Davis S., Brumback L. Inhaled Hypertonic Saline in Infants and Toddlers with Cystic Fibrosis: Short-Term Tolerability, Adherence and Safety. Pediatr. Pulmonol. 2011; 46 (7): 666–671.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Amin R., Subbarao P., Jabar A., Balkovec S., Jensen R., Kerrigan S. Hypertonic saline improves the LCI in paediatric patients with CF with normal lung function. Thorax. 2010; 65 (5): 379–383.</mixed-citation><mixed-citation xml:lang="en">Amin R., Subbarao P., Jabar A., Balkovec S., Jensen R., Kerrigan S. Hypertonic saline improves the LCI in paediatric patients with CF with normal lung function. Thorax. 2010; 65 (5): 379–383.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Rosenfeld M., Ratjen F., Brumback L., Daniel S., Rowbotham R., McNamara S. Inhaled hypertonic saline in infants and children younger than 6 years with cystic fibrosis: the ISIS randomized controlled trial. JAMA. 2012; 307 (21): 2269–2277.</mixed-citation><mixed-citation xml:lang="en">Rosenfeld M., Ratjen F., Brumback L., Daniel S., Rowbotham R., McNamara S. Inhaled hypertonic saline in infants and children younger than 6 years with cystic fibrosis: the ISIS randomized controlled trial. JAMA. 2012; 307 (21): 2269–2277.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Subbarao P., Stanojevic S., Brown M., Jensen R., Rosenfeld M., Davis S., Brumback L., Gustafsson P., Ratjen F. Lung clearance index as an outcome measure for clinical trials in young children with cystic fibrosis: a pilot study using inhaled hypertonic saline. Am. J. Respir. Crit. Care Med. 2013; 188 (4): 456–460.</mixed-citation><mixed-citation xml:lang="en">Subbarao P., Stanojevic S., Brown M., Jensen R., Rosenfeld M., Davis S., Brumback L., Gustafsson P., Ratjen F. Lung clearance index as an outcome measure for clinical trials in young children with cystic fibrosis: a pilot study using inhaled hypertonic saline. Am. J. Respir. Crit. Care Med. 2013; 188 (4): 456–460.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Davis S. D., Rosenfeld M., Brumback L. Infants PFTs as an endpoint in the infant study of inhaled saline randomized controlled trial. Pediatr. Pulmonol. 2012; 35: 225.</mixed-citation><mixed-citation xml:lang="en">Davis S. D., Rosenfeld M., Brumback L. Infants PFTs as an endpoint in the infant study of inhaled saline randomized controlled trial. Pediatr. Pulmonol. 2012; 35: 225.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Elkins M., Dentice R. Timing of hypertonic saline inhalation for cystic fibrosis. Cochr. Database Syst. Rev. 2012; 2: CD008816.</mixed-citation><mixed-citation xml:lang="en">Elkins M., Dentice R. Timing of hypertonic saline inhalation for cystic fibrosis. Cochr. Database Syst. Rev. 2012; 2: CD008816.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Gorinova Yu. V., Simonova O. I., Tomilova A.Yu., Roslavtseva E. A. Vopr. sovr. pediatrii — Current pediatrics. 2013; 5: 30–38.</mixed-citation><mixed-citation xml:lang="en">Gorinova Yu. V., Simonova O. I., Tomilova A.Yu., Roslavtseva E. A. Vopr. sovr. pediatrii — Current pediatrics. 2013; 5: 30–38.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Mukovistsidoz. Pod red. N. I. Kapranova, N.Yu. Kashirskoi [Cystic Fibrosis. Edited by N. I. Kapranov, N.Yu. Kashirskaya]. Moscow, Medpraktika-M, 2014. pp. 423–425.</mixed-citation><mixed-citation xml:lang="en">Mukovistsidoz. Pod red. N. I. Kapranova, N.Yu. Kashirskoi [Cystic Fibrosis. Edited by N. I. Kapranov, N.Yu. Kashirskaya]. Moscow, Medpraktika-M, 2014. pp. 423–425.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Quan J. M., Tiddens H. A., Sy J. P., McKenzie S. G., Montgomery M. D., Robinson P. J. Pulmozyme Early Intervention Trial Study Group. A two-year randomized, placebo-controlled trial of dornase alfa in young patients with cystic fibrosis with mild lung function abnormalities. J. Pediatr. 2001; 139: 813–820.</mixed-citation><mixed-citation xml:lang="en">Quan J. M., Tiddens H. A., Sy J. P., McKenzie S. G., Montgomery M. D., Robinson P. J. Pulmozyme Early Intervention Trial Study Group. A two-year randomized, placebo-controlled trial of dornase alfa in young patients with cystic fibrosis with mild lung function abnormalities. J. Pediatr. 2001; 139: 813–820.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Clement A., Tamalet A., Le Roux E., Ravilly S., Fauroux B., Jais J. P. Long term effects of azithromycin in patients with cystic fibrosis: a double-blind, placebo-controlled trial. Thorax. 2006; 61: 895–902.</mixed-citation><mixed-citation xml:lang="en">Clement A., Tamalet A., Le Roux E., Ravilly S., Fauroux B., Jais J. P. Long term effects of azithromycin in patients with cystic fibrosis: a double-blind, placebo-controlled trial. Thorax. 2006; 61: 895–902.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Rabin H. R., Butler S. M., Wohl M. E. B., Geller D. E., Colin A. A., Schidlow D. V. Pulmonary exacerbations in cystic fibrosis. Pediatr. Pulmonol. 2004; 37: 400–406.</mixed-citation><mixed-citation xml:lang="en">Rabin H. R., Butler S. M., Wohl M. E. B., Geller D. E., Colin A. A., Schidlow D. V. Pulmonary exacerbations in cystic fibrosis. Pediatr. Pulmonol. 2004; 37: 400–406.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Wark P. A., McDonald V., Jones A. P. Nebulised hypertonic saline for cystic fibrosis. Cochr. Database Syst. Rev. 2005; 20: CD001506.</mixed-citation><mixed-citation xml:lang="en">Wark P. A., McDonald V., Jones A. P. Nebulised hypertonic saline for cystic fibrosis. Cochr. Database Syst. Rev. 2005; 20: CD001506.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Suri R., Metcalfe C., Lees B., Grieve R., Flather M., Normand C. Comparison of hypertonic saline and alternate-day or daily recombinant human deoxyribonuclease in children with cystic fibrosis: a randomised trial. Lancet. 2001; 358: 1316–1321.</mixed-citation><mixed-citation xml:lang="en">Suri R., Metcalfe C., Lees B., Grieve R., Flather M., Normand C. Comparison of hypertonic saline and alternate-day or daily recombinant human deoxyribonuclease in children with cystic fibrosis: a randomised trial. Lancet. 2001; 358: 1316–1321.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
