vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v18i2.2011vsp-2074Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWАбилитация младенцев с сочетанной перинатальной патологией: возможности персонализации подходов и методовAbilitation of Infants with Combined Perinatal Pathology: Capabilities of Approaches and Methods PersonalizationБарановА. А.BaranovАlexander A.https://orcid.org/0000-0002-2209-7531Намазова-БарановаЛ. С.Namazova-BaranovaLeyla S.

Москва

Moscow

https://orcid.org/0000-0002-8717-2539БеляеваИ. А.BelyaevaIrina A.

доктор медицинских наук, главный научный сотрудник лаборатории неонатологии и проблем здоровья раннего детского возраста НМИЦ здоровья детей; профессор кафедры факультетской педиатрии РНИМУ им. Н.И. Пирогова

119991, Москва, Ломоносовский пр-т, д. 2, стр. 3, тел.: +7 (499) 134-03-92

Moscow

irinaneo@mail.ruhttps://orcid.org/0000-0002-1660-3346АнтоноваЕ. В.АntonovaЕlena V.

Москва

Moscow

https://orcid.org/0000-0001-7398-0562ВишнёваЕ. А.VishnevaЕlena A.

Москва

Moscow

https://orcid.org/0000-0002-6677-2914БомбардироваЕ. П.BombardirovaЕlena P.

Москва

Moscow

СмирновВ. И.SmirnovVladimir I.

Москва

Moscow

https://orcid.org/0000-0003-0039-943XМолодченковА. И.MolodchenkovАlexsei I.

Москва

Moscow

ЗубрихинаМ. О.ZubrikhinaМariay О.

Москва

Moscow

Центральная клиническая больница, МоскваРоссияCentral Clinical Hospital, MoscowRussian FederationЦентральная клиническая больница, Москва; Российский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияCentral Clinical Hospital, Moscow; Pirogov Russian National Research Medical UniversityRussian FederationРоссийский национальный исследовательский медицинский университет им. Н.И. Пирогова; Морозовская детская городская клиническая больницаРоссияPirogov Russian National Research Medical University; Morozovskaya Children's City HospitalRussian FederationНациональный медицинский исследовательский центр здоровья детейРоссияNational Medical Research Center of Children’s HealthRussian FederationЦентральная клиническая больница, Москва; Российский национальный исследовательский медицинский университет им. Н.И. Пирогова; Национальный медицинский исследовательский центр здоровья детейРоссияCentral Clinical Hospital, Moscow; Pirogov Russian National Research Medical University; National Medical Research Center of Children’s HealthRussian FederationФедеральный исследовательский центр «Информатика и управление»РоссияComputer Science and ControlRussian FederationОбщество с ограниченной ответственностью «Технологии системного анализа»РоссияSIA «Technologies for systems analysis»Russian Federation20192206201918291100Copyright © Баранов А.А., Намазова-Баранова Л.С., Беляева И.А., Антонова Е.В., Вишнёва Е.А., Бомбардирова Е.П., Смирнов В.И., Молодченков А.И., Зубрихина М.О., 20192019Баранов А.А., Намазова-Баранова Л.С., Беляева И.А., Антонова Е.В., Вишнёва Е.А., Бомбардирова Е.П., Смирнов В.И., Молодченков А.И., Зубрихина М.О.Baranov А.A., Namazova-Baranova L.S., Belyaeva I.A., Аntonova Е.V., Vishneva Е.A., Bombardirova Е.P., Smirnov V.I., Molodchenkov А.I., Zubrikhina М.О.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/2074

Патологические состояния перинатального периода, в первую очередь перинатальные поражения центральной нервной системы, сопряжены с риском отсроченных нейросоматических заболеваний, нередко приводящих к инвалидности. Успешность реализации индивидуального потенциала компенсации каждого ребенка зависит от динамического анализа состояния пациента на всех этапах наблюдения, персонифицированного выбора необходимых и достаточных методов коррекции полисистемных нарушений. В обзоре отражены современные представления об этиологии и патогенезе основных патологических состояний перинатального периода, выделены ведущие механизмы их развития. Современные неинвазивные диагностические методы позволяют обеспечить коррекцию витальных функций и предупредить каскадные реакции нейронального апоптоза. В раннем неонатальном периоде установлена саногенетическая значимость некоторых лечебных методик (терапевтическая гипотермия, эритропоэтин, кофеин). Бесспорна роль организации внешних факторов, обусловливающих эпигенетическое воздействие: оптимальной нутритивной стратегии и коррекции кишечной микробиоты, мягкой сенсорной и двигательной стимуляции. Успешность абилитации во многом зависит от преемственной командной деятельности специалистов и взаимодействия с семьей. Методы многофакторного статистического анализа позволяют не только прогнозировать исходы перинатальных поражений, но и создавать рабочие математические модели персонифицированного выбора средств абилитации.

Perinatal pathologies and foremost perinatal central nervous system injury are attended with delayed neurosomatic disorders frequently leading to disability. The success of realisation of individual compensation potential of every child depends on dynamics analysis of patient's condition on every survey stage, personalized choice of necessary and sufficient methods of polysystemic diseases correction. The contemporary view on ethiology and pathogenesis of main perinatal pathologies are presented in this review, main mechanisms of its development are also revealed. Recent non-invasive diagnostic technique allow to perform correction of vital signs and prevent cascade reactions of neuronal apoptosis. The sanogenetic importance of some therapeutic interventions (therapeutic hypothermia, erythropoietin, caffeine) is established in early neonatal period. The role of implementation of external factors causing epigenetic effects is clear: optimal nutrition, correction of intestinal microbiota, sensory and motional stimulation. The abilitation success depends largely on successive team activity of specialists and their collaboration with the family. Methods of multifactorial statistical analysis allow not only to prognosticate the outcomes of perinatal affection, but also to create effective mathematical models for personalized choice of facilitation measures.

новорожденныедети раннего возрастаперинатальные поражения мозгаабилитацияинвалидностьnewbornstender age childrenperinatal brain injuryabilitationdisabilityДанный этап исследования выполнен в 2018 г. в ФГАУ «НМИЦ здоровья детей» Минздрава России на средства гранта РФФИ № 17-29-02424/17 «Модели и методы расчета "окна абилитации" восстановления психосоматического здоровья детей с патологией перинатального периода».This stage of research was carried out in 2018 in FSAI «National Medical Research Center for Children's Health» of the Russian Federation Ministry of Health and funded by grant RPFP № 17-29-02424/17 «Models and methods of «abilitation window» calculation of psychosomatic health restoration in children with perinatal pathology».ReferencesWoo Baidal JA, Locks LM, Cheng ER, et al. Risk factors for childhood obesity in the first 1000 days: a systematic review. Am J Prev Med. 2016;50(6):761–779. doi: 10.1016/j.amepre.2015.11.012.Woo Baidal JA, Locks LM, Cheng ER, et al. 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The authors declare that there are no conflicts of interest present.