Хронические болевые синдромы как последствие перенесенного критического состояния: клиническая физиология, диагностика, лечение

А.П. Спасова, В.В. Мальцев

ФГБОУ ВО «Петрозаводскийгосударственныйуниверситет» Министерства образованияинауки РФ, Петрозаводск

Для корреспонденции: Спасова Арина Павловна — канд. мед. наук, доцент кафедры лучевой диагностики и лучевой терапии с курсом критической и респираторной медицины; e-mail: arina22@mail.ru

Для цитирования: Спасова А.П., Мальцев В.В. Хронические болевые синдромы как последствие перенесенного критического состояния: клиническая физиология, диагностика, лечение. Вестник интенсивной терапии. 2017;4:19–28.


В обзоре анализируется распространенность хронических болевых синдромов у пациентов, перенесших критическое состояние. Обсуждаются особенности процессов ноцицепции и формирования чувства боли, анализируются факторы, способствующие переходу острой боли в хроническую, и возможности их коррекции. Рассматриваются клинические и инструментальные методы полноценной оценки хронического болевого синдрома с учетом его специфики, а также основные принципы терапии.

Ключевые слова: хроническая боль, ПИТ-синдром, критическое состояние

Поступила: 25.10.2017


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Синдром последствий интенсивной терапии (ПИТ-синдром)

А.А. Белкин

Клинический институт мозга Уральского государственного медицинского университета, Екатеринбург

Для корреспонденции: Белкин Андрей Августович — д-р мед. наук, профессор Директор Клинического института Мозга Уральского Государственного Медицинского Университета, Екатеринбург; e-mail: belkin@neuro-ural.ru

Для цитирования: Белкин А.А. Синдром последствий интенсивной терапии (ПИТ-синдром). Вестник интенсивной терапии имени А.И. Салтанова. 2018;2:12–23.

DOI: 10.21320/1818-474X-2018-2-12-23


Синдром «последствий интенсивной терапии» — ПИТ-синдром — описывает совокупность ограничивающих повседневную жизнь пациента соматических, неврологических и социально-психологических последствий пребывания в условиях из отделения реанимации и интенсивной терапии (ОРИТ). В разных комбинациях они влияют на увеличение продолжительности пребывания в ОРИТ и снижение качества жизни пациентов спустя несколько лет после возвращения к обычной жизни.  Наиболее распространены и потому изучены среди них: полимионейропатия критических состояний, дисфагия, диссомния, когнитивно-афферентный диссонанс. В заключении авторы призывают к активному внедрению методов диагностики, профилактики и ранней реабилитации ПИТ-синдрома, описанных в специальном национальном руководстве «РебИТ».

Ключевые слова: ПИТ-синдром, полимионейропатия критических состояний, диссомния, дисфагия, когнитивно-афферентный диссонанс, иммобилизация

Поступила: 09.05.2018


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