kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2019-8-4S-70-81kpccz-652Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ. КардиологияORIGINAL STUDIES. CardiologyВозможность использования электростимуляции скелетных мышц в реабилитации больных после кардиохирургических операцийThe possibility of using skeletal muscle electrical stimulation in the rehabilitation of patients after cardiac surgeryhttps://orcid.org/0000-0002-0963-4793СуминА. Н.SuminA. N.

Сумин Алексей Николаевич - доктор медицинских наук, заведующий отделом мультифокального атеросклероза Федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний»

650002, г. Кемерово, Сосновый бульвар, 6тел. +7 (3842) 64-44-61 

Sumin Alexei N. - M.D., Ph.D., the Head of the Department for Polyvascular and Multivessel Disease, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”

650002, Kemerovo, 6, Sosnoviy Blvd.phone +7 (3842) 64-44-61 

an_sumin@mail.ruhttps://orcid.org/0000-0002-8196-5570ОлейникП. А.OleynikP. A.

Олейник Павел Александрович - аспирант, врач-кардиолог Федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний»

650002, г. Кемерово, Сосновый бульвар, 6

650002, Kemerovo, 6, Sosnoviy Blvd.

БезденежныхА. В.BezdenejnykhA. V.

Безденежных Андрей Викторович - кандидат медицинских наук, старший научный сотрудник Федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний»

650002, г. Кемерово, Сосновый бульвар, 6

650002, Kemerovo, 6, Sosnoviy Blvd.

Федеральное государственное бюджетное научное учреждение «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний»РоссияFederal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”Russian Federation20191601202084S7081Copyright © Сумин А.Н., Олейник П.А., Безденежных А.В., 20202020Сумин А.Н., Олейник П.А., Безденежных А.В.Sumin A.N., Oleynik P.A., Bezdenejnykh A.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/652

Цель. Оценить эффективность применения электромиостимуляции (ЭМС) у пациентов с осложненным ранним послеоперационным периодом кардиохирургических операций.Материалы и методы. В исследование включен 61 пациент (44 мужчин, 17 женщин), от 52 до 70 лет, перенесших оперативное кардиохирургическое вмешательство, с осложненным течением раннего послеоперационного периода, приведшего к увеличению срока нахождения в отделении интенсивной терапии, продления искусственной вентиляции легких. Пациентам выполнялась кистевая и изокинетическая динамометрия нижних конечностей, для оценки исходного состояния мышечного статуса обследуемых пациентов. Тест шестиминутной ходьбы проводился после перевода в отделение кардиохирургии.Результаты. Исходно пациенты основной группы имели низкий функциональный статус скелетной мускулатуры нижних конечностей, по сравнению с группой контроля практически во всех группах мышц нижних конечностей. После курса ЭМС отмечено более выраженное улучшение мышечного статуса по сравнению с группой контроля: выше была степень прироста силы изометрического сокращения для правого и левого разгибателей колена (38,8% и 40,0% против 8,1% и 8,4%, р<0,001), сгибателей правого коленного сустава (23,7% против 10,1%, р = 0,008), левого голеностопного сустава (18,6 против 4,3%, р = 0,010), силы сжатия кисти справа (18,3 против 11,1%, р = 0,042). Помимо прочего, отмечается близкий к достоверному процент прироста пройденной дистанции, по данным теста шестиминутной ходьбы и составляет 119,72% (293 метра), и 87,13% (315 метров) для основной, и контрольной группы соответственно (р = 0,079).Заключение. У больных с осложненным послеоперационным периодом кардиохиуругических операций курс ЭМС не вызывал ухудшения клинического состояния. После курса ЭМС отмечено улучшение силы мышц нижних конечностей, более выраженное по сравнению с группой контроля. Оценка влияния курса ЭМС на клиническое состояние данной категории больных требует последующих исследований. Оценка влияния курса ЭМС на клиническое состояние данной категории больных требует последующих исследований.

Aim. To evaluate the effectiveness of electrical muscle stimulation (EMS) in patients with the complicated early postoperative period after cardiac surgery.Methods. 61 patients (44 men and 17 women) aged 52-70 years with the complicated early postoperative period after cardiac surgery were included in the study. The complications included prolonged length of stay in the intensive care unit and prolonged mechanical ventilation. The initial muscle performance of the lower extremities was measured with the carpal and isokinetic dynamometer in all patients. The six-minute walk test was performed in all patients after they had been transferred to the department of cardiac surgery.Results. Patients in the study group had reduced lower extremity muscle strength at baseline, compared with the control group. After the EMS sessions, the study group patients demonstrated pronounced improvements in muscle performance as compared to the control group. Both knee-joint extension values increased during the isometric contraction as compared to those in the control group (38.8% and 40.0% versus 8.1% and 8.4%, p <0.001), similarly to right knee-joint flexion (23.7% versus 10.1%, p = 0.008), left ankle joint (18.6 versus 4.3%, p = 0.010), right-hand grip strength (18.3 versus 11.1%, p = 0.042). In addition, the six-minute walk test results improved in the EMS group (119.72% (293 meters) and 87.13% (315 meters)) as compared to the control group (p = 0.079).Conclusion. The EMS sessions did not affect the clinical status of cardiac surgical patients with the complicated postoperative period. Moreover, it appeared to be beneficial in terms of the improved lower extremity muscle strength that was more pronounced in the study group than in the control group. Therefore, the effects of EMS on the clinical status of these patients require the further investigation.

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The authors declare that there are no conflicts of interest present.