2 Ç̲ÑÒ / CONTENT ÒÅÎÐÅÒÈ×ÍÀ ² ÅÊÑÏÅÐÈÌÅÍÒÀËÜÍÀ THEORETICAL AND EXPERIMENTAL ÌÅÄÈÖÈÍÀ MEDICINE Êðèëþê Â.Î., Ãàð³ÿí Ñ.Â. Âïëèâ Kryliuk V.O., Garian S.V. Influence is- ³øå쳿-ðåïåðôó糿 íà ìîðôîëîã³÷í³ çì³íè chemia-reperfusion on the morphological âåëèêèõ ñóãëîá³â íèæí³õ ê³íö³âîê çà óìîâ changes large joints of the lower extremities ïîºäíàíî¿ àáäîì³íî-ñêåëåòíî¿ òðàâìè 4 under combined abdomino-skeletal injury Ñîðîê³íà Î.Ã., Ïîïîâ Ì.Ì., Ëÿäîâà Ò.²., Sorokina O.G., Popov M.M., Liadova T.I., Îãí³âåíêî Î.Â., Ñàââî Î.Ì. Îñîáëèâîñò³ Ognivenko O.V., Savvo O.M. Features ïåðåá³ãó õðîí³÷íî¿ Åïøòåéíà–Áàðð â³ðóñíî¿ of the course of chronic Epstein–Barr viral ³íôåêö³¿ 9 infection ÏÑÈÕ²ÀÒвß, ÍÀÐÊÎËÎÃ²ß PSYCHIATRY, NARCOLOGY ÒÀ ÌÅÄÈ×ÍÀ ÏÑÈÕÎËÎÃ²ß AND MEDICAL PSYCHOLOGY Ãåðàñèìóê Â.À., Àã³øåâà Í.Ê. Ðîëü Gerasimuk V.A., Agisheva N.K. The role ³ ì³ñöå ñòðåñ-äîëàþ÷î¿ ïîâåä³íêè and place of stress-coping behavior â ôîðìóâàíí³ ïñèõîëîã³÷íî¿ äåçàäàïòàö³¿ in the formation of psychological maladap- ó äðóæèí, ÷îëîâ³êè ÿêèõ ñòðàæäàþòü tation in wives of patients with paranoid íà øèçîôðåí³þ 14 schizophrenia Êîñåíêî Ê.À. Ñòðóêòóðíî-ôåíîìåíî- Kosenko K.A. Structural-phenomenological ëîã³÷íà õàðàêòåðèñòèêà àãðåñèâíîñò³ characteristics of aggressiveness and hostile ³ âîðîæèõ ðåàêö³é ó êîìàíäíîãî ñêëàäó reactions in the command warehouse of the òîðãîâåëüíîãî ³ ïàñàæèðñüêîãî commercial and passenger navy ìîðñüêîãî ôëîò³â 25 Êðèâèöüêèé Â.Î. Ñòàí ïñèõîåìîö³éíî¿ Kryvytskyi V. The state of the psycho-emotio- ñôåðè ó õâîðèõ íà õðîí³÷íèé ïðîñòàòèò nal sphere in patients with chronic prostatitis ç ð³çíèì ñòàíîì ïîäðóæíüî¿ çàäîâîëåíîñò³ 33 with different status of marriage satisfaction Êðèâîí³ñ Ò.Ã. Àíàë³ç îñîáèñò³ñíî-ïîâå- Krivonis T.G. Personal and behavioral ä³íêîâèõ ïðîô³ë³â ó îíêîëîã³÷íèõ ïàö³ºí- profiles in cancer patients, depending ò³â çàëåæíî â³ä ¿õ êë³í³÷íèõ, ñ³ìåéíèõ on their clinical, family and gender features òà ãåíäåðíèõ îñîáëèâîñòåé 41 Ìàðóòà Í.Î., Øåâ÷åíêî–Á³òåíñü- Maruta N.O., Shevchenko–Bitensky K.V. êèé Ê.Â. Ïðîãðàìà ïñèõîñîö³àëüíî¿ Program of psychosocial rehabilitation ðåàá³ë³òàö³¿ ïàö³ºíò³â ç ãàëþöèíàòîðíî- of patients with hallucinatory-paranoid ïàðàíî¿äíèìè ðîçëàäàìè ïðè äåìåíö³ÿõ disorders in dementias of different genesis ð³çíîãî ãåíåçó ³ ñòà䳿 ðîçâèòêó ³ îö³íêà and stage of development and evaluation ¿¿ åôåêòèâíîñò³ 47 of its effectiveness Ìèñóëà Þ.². Ñó÷àñí³ ï³äõîäè äî ë³êóâàííÿ Mysula Yu.I. Modern approaches to the õâîðèõ ç ïåðâèííèì åï³çîäîì á³ïîëÿð- treatment of patients with a primary episode íîãî àôåêòèâíîãî ðîçëàäó 55 of bipolar affective disorder ÅÊÑÏÅÐÈÌÅÍÒÀËÜÍÀ ² Ê˲Ͳ×ÍÀ ÌÅÄÈÖÈÍÀ. 2019. ¹ 4 (85) 3 ²ÍÔÅÊÖ²ÉͲ ÕÂÎÐÎÁÈ INFECTIOUS DISEASES Áóê³é Ñ.Ì. Ãóìîðàëüíà ³ìóííà Bukiy S.M. Humoral immune response â³äïîâ³äü ä³òåé, õâîðèõ íà øèãåëüîç of children with shigellosis and infected òà ³íô³êîâàíèõ öèòîìåãàëîâ³ðóñîì 62 with cytomegalovirus ÍÅÂÐÎËÎÃ²ß NEUROLOGY Âàðåøíþê Î.Â., Â'þí Â.Â. Ïðîãíîñòè÷í³ Vareshniuk O.V., Vyun V.V. Prognostic êðèòå𳿠ðîçâèòêó ïîðóøåíü ìîòîðíèõ criteria for development of impaired motor ôóíêö³é ó íåäîíîøåíèõ íåìîâëÿò function in preterm infants with perinatal ç ïåðèíàòàëüíèì ã³ïîêñè÷íî-³øåì³÷íèì hypoxic-ischemic lesions of the central óðàæåííÿì öåíòðàëüíî¿ íåðâîâî¿ ñèñòåìè 67 nervous system ×åðíåíêî Ì.ª. Äî ïèòàííÿ ïðî íåîá- Chernenko M.E. To the question of the õ³äí³ñòü ðîçðîáêè êîìïëåêñíèõ ðåàá³ë³- need for the development of integrated òàö³éíèõ çàõîä³â ó ïàö³ºíò³â ç íåéðî- rehabilitation measures in patients with äåãåíåðàö³ºþ 72 neurodegeneration Õ²ÐÓÐÃ²ß SURGERY Ïóëÿºâà ².Ñ., Ïðàñîë Â.Î. Ðèçèêè ïîâ- Pulyaeva ².S., Prasol V.O. The riscs òîðíèõ ³íñóëüò³â ³ ðåïåðôóç³éíîãî of repeated strokes and reperfusion ñèíäðîìó ó õâîðèõ ç êðèòè÷íèì ñòåíîçîì syndrome in patients with severe stenosis ñîííèõ àðòåð³é 78 of carotid arteries ×åðêàøåíèíîâ Å.Ã., Êàëìûêîâà À.Ñ. Cherkasheninov E.G., Kalmykova A.S. The Ðåçóëüòàòû ïðèìåíåíèÿ ìàëîèíâàçèâíûõ results of the application of low-invasive ìåòîäîâ ëå÷åíèÿ âàðèêîçíîé áîëåçíè 83 methods for treatment of varicose disease ÑÒÎÌÀÒÎËÎÃ²ß STOMATOLOGY Àñòàïåíêî Î.Î., Êîñòþê Ò.Ì., Astapenko O., Kostiuk T., Lytovchenko N., Ëèòîâ÷åíêî Í.Ì., Òÿæêîðîá Ò.Â. Äîñâ³ä Tyazhkorob T. The application of construc- âèêîðèñòàííÿ ðåçîðáòèâíèõ ìàòåð³àë³â tions made from biodegradable material ó ðåêîíñòðóêòèâíî-â³äíîâí³é õ³ðóð㳿 with bioactive action in reconstructive 88 surgery of maxillofacial area Òåðåõîâ Ñ.Ñ., Õðîë Í.Ñ. Ñèñòåìà öèôðî- Terekhov S.S., Khrol N.S. Digital volume âîãî îá'ºìíîãî ñêàíóâàííÿ äëÿ ï³äâèùåííÿ scanning system for improving the quality ÿêîñò³ ðåòðàêö³¿ ÿñåííîãî êðàþ 96 of garden retraction ÅÊÑÏÅÐÈÌÅÍÒÀËÜÍÀ ² Ê˲Ͳ×ÍÀ ÌÅÄÈÖÈÍÀ. 2019. ¹ 4 (85) 4 ÒÅÎÐÅÒÈ×ÍÀ ² ÅÊÑÏÅÐÈÌÅÍÒÀËÜÍÀ ÌÅÄÈÖÈÍÀ ТЕОРЕТИЧНА І ЕКСПЕРИМЕНТАЛЬНА МЕДИЦИНА https://doi.org/10.35339/ekm.2019.85.04.01 ÓÄÊ 616.3/.71-001-005.1-06:616.137-005.4-007.271-06:611-018.4 Â.Î. Êðèëþê1, Ñ.Â. Ãàð³ÿí2 1ÄÇ «Óêðà¿íñüêèé íàóêîâî-ïðàêòè÷íèé öåíòð åêñòðåíî¿ ìåäè÷íî¿ äîïîìîãè òà ìåäèöèíè êàòàñòðîô ÌÎÇ Óêðà¿íè», ì. Êè¿â 2ÊÇ ÒÎÐ «Òåðíîï³ëüñüêà óí³âåðñèòåòñüêà ë³êàðíÿ» ÂÏËÈ ²ØÅ̲¯-ÐÅÏÅÐÔÓDz¯ ÍÀ ÌÎÐÔÎËÎò×Ͳ Ç̲ÍÈ ÂÅËÈÊÈÕ ÑÓÃËÎÁ²Â ÍÈÆÍ²Õ Ê²ÍÖ²ÂÎÊ ÇÀ ÓÌΠÏΪÄÍÀÍί ÀÁÄÎ̲ÍÎ-ÑÊÅËÅÒÍί ÒÐÀÂÌÈ Âèâ÷åíî îñîáëèâîñò³ ìîðôîëîã³÷íèõ ïîðóøåíü òêàíèí âåëèêèõ ñóãëîá³â íèæí³õ ê³íö³âîê â óìîâàõ ìîäåëüîâàíèõ òðàâì ó ï³çí³ òåðì³íè. Åêñïåðèìåíò ïðîâîäèëè íà 40 ñòàòåâî- çð³ëèõ á³ëèõ ùóðàõ-ñàìöÿõ ë³í³¿ Wistar, ìàñîþ 190–220 ã, ÿê³ çíàõîäèëèñü íà ñòàíäàðò- íîìó ðàö³îí³ â³âàð³þ. ϳääîñë³äíèì òâàðèíàì ìîäåëþâàëè çàêðèòó òðàâìó îðãàí³â ÷å- ðåâíî¿ ïîðîæíèíè, ñêåëåòíó òðàâìó, ìàñèâíó çîâí³øíþ êðîâîâòðàòó òà ³øåì³þ-ðåïåð- ôóç³þ íèæí³õ ê³íö³âîê. Äîñë³äæåííÿ ïðîâîäèëè íà 21-øó äîáó ï³ñëÿ ìîäåëþâàííÿ òðàâì. Óñ³ åêñïåðèìåíòè ç íàíåñåííÿ òðàâì âèêîíóâàëè â óìîâàõ ò³îïåíòàë-íàòð³ºâîãî çíå÷ó- ëåííÿ (40 ìã·êã-1 ìàñè). Âñòàíîâèëè, ùî ïîºäíàíà àáäîì³íî-ñêåëåòíà òðàâìà ó ïîºäíàíí³ ç ³øå쳺þ-ðåïåðôó糺þ íèæí³õ ê³íö³âîê â ï³çí³õ ïåð³îäàõ ï³ñëÿ òðàâìàòè÷íîãî ïåð³îäó ìîæå âèêëèêàòè ðåàêòèâí³ çì³íè ó âåëèêèõ ñóãëîáàõ íèæí³õ ê³íö³âîê. Êëþ÷îâ³ ñëîâà: ïîºäíàíà òðàâìà, ³øåì³ÿ-ðåïåðôóç³ÿ, åêñïåðèìåíò, êîë³ííèé ñóãëîá, êóëüøîâèé ñóãëîá. Âñòóï ñòåìíî¿ çàïàëüíî¿ ðåàêö³¿ íà ðîçâèòîê ï³ñëÿ- Ïîºäíàíà òðàâìà çàëèøàºòüñÿ îñíîâíîþ òðàâìàòè÷íîãî îñòåîàðòðèòó [5, 6]. Îäíàê ö³ ïðè÷èíîþ ëåòàëüíèõ íàñë³äê³â òà òðàâìàòèçìó äîñë³äæåííÿ â îñíîâíîìó ñòîñóþòüñÿ ëîêàëü- ñåðåä îñ³á ïðàöåçäàòíîãî â³êó. Ïðîãíîçóºòü- íèõ òðàâì. ñÿ, ùî ê³ëüê³ñòü òðàâìîâàíèõ îñ³á áóäå çðîñ- Îñíîâîþ óðàæåííÿ ñóãëîá³â âíàñë³äîê òàòè ïðîòÿãîì íàñòóïíèõ 20 ðîê³â [1]. òðàâìàòè÷íèõ ïîøêîäæåíü º çì³íè â õðÿùîâ³é Ïðîâåäåí³ êë³í³÷í³ òà åêñïåðèìåíòàëüí³ òêàíèí³. Ïàòîô³ç³îëîã³ÿ ïðîöåñó ïîëÿãຠó äå- äîñë³äæåííÿ ïîêàçàëè, ùî ïîºäíàíà òðàâìà ãåíåðàö³¿ òà çàãèáåë³ êë³òèí õðÿùà, ðîçâèâàºòü- ïîâ'ÿçàíà ç³ çíà÷íî á³ëüøèì ÷àñîì çàãîºííÿ ñÿ äåïîë³ìåðèçàö³ÿ îñíîâíî¿ ðå÷îâèíè ÿêà âè- ïåðåëîì³â òà á³ëüøîþ ÷àñòîòîþ ðîçâèòêó ðîáëÿºòüñÿ õîíäðîöèòàìè, çíèæóºòüñÿ ê³ëü- óñêëàäíåíü ó ïîð³âíÿíí³ ç ³çîëüîâàíèìè ïåðå- ê³ñòü ãë³êîçàì³íãë³êàí³â, ùî ïðèçâîäèòü äî ïðî- ëîìàìè. Êð³ì òîãî, âèçíà÷åíî, ùî ëîêàëüíà ãðåñèâíî¿ äåãåíåðàö³¿ õðÿùà. Ñïîñòåð³ãàºòü- òà ñèñòåìíà çàïàëüíà ðåàêö³ÿ çíà÷íî âïëèâຠñÿ ðîçðîñòàííÿ ê³ñòêîâî¿ òêàíèíè òà óòâîðåí- íà ïðîöåñè â³äíîâëåííÿ çàãîºííÿ ïåðåëîì³â íÿ îñòåîô³ò³â.  ïàòîëîã³÷íèé ïðîöåñ âòÿãó- [2–4]. þòüñÿ ñèíîâ³àëüíà îáîëîíêà, ô³áðîçíà êàïñó- Îäíèì ³ç íàéá³ëüø ðîçïîâñþäæåíèõ óñê- ëà òà íàâêîëîñóãëîáîâ³ ì'ÿçè. Çã³äíî ç³ ñòàòè- ëàäíåíü ³ ïðè÷èíîþ ³íâàë³äíîñò³, ÷àñòîòà ÿêî¿ ñòè÷íèìè äàíèìè çà ÷àñòîòîþ óðàæåííÿ ïåð- ïîñò³éíî çðîñòàº, º îñòåîàðòðîç. Òðàâìà, çîê- øå ì³ñöå ïîñ³äຠêóëüøîâèé ñóãëîá, äðóãå – ðåìà ñóãëîá³â, º âàæëèâèì ôàêòîðîì ðèçèêó êîë³ííèé, òðåòº – ïëå÷îâèé [7, 8]. ïîñòòðàâìàòè÷íîãî îñòåîàðòðèòó. Íàðàç³ íàó- Ìåòà ðîáîòè – äîñë³äèòè îñîáëèâîñò³ êîâöÿìè ÷³òêî äîâåäåíî íåãàòèâíèé âïëèâ ñè- ìîðôîëîã³÷íèõ ïîðóøåíü òêàíèí âåëèêèõ ñóã- © Â.Î. Êðèëþê, Ñ.Â. Ãàð³ÿí, 2019 ÅÊÑÏÅÐÈÌÅÍÒÀËÜÍÀ ² Ê˲Ͳ×ÍÀ ÌÅÄÈÖÈÍÀ. 2019. ¹ 4 (85) ÒÅÎÐÅÒÈ×ÍÀ ² ÅÊÑÏÅÐÈÌÅÍÒÀËÜÍÀ ÌÅÄÈÖÈÍÀ 5 ëîá³â íèæí³õ ê³íö³âîê â óìîâàõ ìîäåëüîâàíèõ «SWAT®» ( âèðîáíèöòâî ÑØÀ). Ïîïåðåäíüî òðàâì â ï³çí³ òåðì³íè. ïåðåä íàêëàäàííÿì ç îðèã³íàëüíîãî ïîëîòíà Ìàòåð³àë ³ ìåòîäè êðîâîñïèííîãî äæãóòà âèð³çàëè øìàòîê øè- Ðîáî÷îþ ã³ïîòåçîþ åêñïåðèìåíòàëüíîãî ðèíîþ 1,5 ñì òà äîâæèíîþ 10 ñì. Äîñòàòíº äîñë³äæåííÿ º ïðèïóùåííÿ, ùî âèêîðèñòàííÿ ðîçòÿãíåííÿ äæãóòà, äëÿ ïîâíîãî ïåðåòèñêàí- êðîâîñïèííîãî äæãóòà òà ïîäàëüøà ðåïåðôó- íÿ ñóäèí íèæíüî¿ ëàïè òâàðèí, êîíòðîëþâàëè ç³ÿ ³øåì³çîâàíèõ òêàíèí ïðèçâîäèòü äî çíà÷- çà äîïîìîãîþ ñïåö³àëüíèõ ³íäèêàòîð³â, ùî íèõ ñèñòåìíèõ çì³í ³ç ïîäàëüøèì ïîðóøåí- íàíåñåí³ âèðîáíèêîì íà éîãî ïîâåðõíþ. íÿì ôóíêö³îíóâàííÿ âåëèêèõ ñóãëîá³â ó ï³çíüî- Òâàðèí âèâîäèëè ç åêñïåðèìåíòó íà 3, 7, ìó ï³ñëÿòðàâìàòè÷íîìó ïåð³îä³ ïðè ïîºäíàí³é 14 òà 21-øó äîáó ï³ñëÿ ìîäåëþâàííÿ òðàâì. àáäîì³íî-ñêåëåòí³é òðàâì³ íà ôîí³ ã³ïîâîëå- ϳä ò³îïåíòàë-íàòð³ºâèì çíå÷óëåííÿì ïðîâî- ì³÷íîãî øîêó. äèëè çàá³é óñ³õ ùóð³â â³äïîâ³äíî¿ ãðóïè ìåòî- Åêñïåðèìåíòàëüíå äîñë³äæåííÿ âèêîíàíî äîì òîòàëüíîãî êðîâîïóñêàííÿ ç ñåðöÿ. óñòî- íà 40 ñòàòåâîçð³ëèõ á³ëèõ ùóðàõ-ñàìöÿõ ë³í³¿ ëîã³÷í³ çì³íè â òêàíèíàõ êóëüøîâîãî òà êîë³í- Wistar, ìàñîþ 190–220 ã, ÿê³ çíàõîäèëèñü íà íîãî ñóãëîá³â âèâ÷àëè íà 21-øó äîáó ï³ñëÿ- ñòàíäàðòíîìó ðàö³îí³ â³âàð³þ. Óñ³ åêñïåðèìåí- òðàâìàòè÷íîãî ïåð³îäó. Äëÿ ã³ñòîëîã³÷íèõ äî- òè ³ç íàíåñåííÿ òðàâì âèêîíóâàëè â óìîâàõ ò³î- ñë³äæåíü çàáèðàëè òêàíèíí³ çðàçêè êóëüøîâîãî ïåíòàë-íàòð³ºâîãî çíå÷óëåííÿ (40 ìã·êã-1 ìàñè).