EVALUATION OF NEUROLOGICAL DEFICIENCY IN PATIENTS WITH INSULT WORKING IN THE CONDITIONS OF EXPOSURE TO HARMFUL PRODUCTION FACTORS
Maria Viktorovna YASHNIKOVA1,2
1Novosibirsk State Medical University of Minzdrav of Russia
2City Clinical Emergency Hospital № 1
Keywords: инсульт, мужчины, шкала NIHSS, неврологический дефицит, производственные факторы
Abstract
The question on the peculiarities of stroke course in persons working under the influence of unfavorable occupational factors has not been sufficiently studied. The aim of the study was to assess the severity of stroke and the severity of the neurological deficit in the acute period of stroke in men exposed to occupational factors of physical and chemical nature. The analysis of the recovery dynamics in the acute period of stroke in 241 patients (the main group) exposed to harmful occupational factors (general vibration, production noise, electromagnetic radiation (EMR), toxic-dust factor) was carried out. The comparison group consisted of 76 patients with stroke who did not work under the influence of harmful occupational factors. To objectify the severity of the condition and assess the severity of the neurological deficit, the National Institutes of Health Stroke Scale (NIHSS) was used in the scores for admission and dynamics of an acute stroke on day 21 of the disease (NIHSS 1 and NIHSS 2). An initially expressed deficit (NIHSS 1 scale) in patients with stroke in the main group was established, compared with the comparison group, and the highest indicator was found in men who contacted EMR. Significant differences between the indices of the initial neurological deficit of the main group and the comparison group were revealed only among young men who had contact with EMR, as well as with the toxic-dust factor. The best dynamics of recovery in the acute period of stroke was found in the comparison group, and in the main group among young people, except for the production group with the influence of the toxic-dust factor. In patients with ischemic stroke, the minimal neurological deficit to the end of the acute period was in the comparison group, and in the main group - in young men who had the influence of general vibration, as well as noise. The severe course of hemorrhagic stroke was established in the comparison group, and in the main group - among patients who had contact with EMR. The elderly of the main group had the maximum severity of the neurological deficit, with the exception of patients who had the effect of a toxic-dust factor.
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