ЛЕЧЕНИЕ И РЕАБИЛИТАЦИЯ ДЕТСКОГО ЦЕРЕБРАЛЬНОГО ПАРАЛИЧА

Детский церебральный паралич является наиболее распространенной причиной развития инвалидности у детей. В настоящее время это заболевание остается практически неизлечимым, однако реабилитация и лечение пациентов с детским церебральным параличом позволяют улучшить их состояние и качество жизни. В действующем протоколе лечения детского церебрального паралича не отражены рекомендации самых современных исследований, некоторые предлагаемые виды терапии имеют низкий уровень доказательной базы (уровень С). Представленный литературный обзор является ознакомительным материалом для врачей, осуществляющих лечение и реабилитацию детей с детским церебральным параличом. Цель: изучение и оценка наиболее эффективных методов лечения и реабилитации пациентов с детским церебральным параличом. Методы: поиск литературы был осуществлен с использованием баз данных PubMed, Cochrain Library и Google Scholar. Критериями включения были опубликованные исследования о терапии и реабилитации для детей 0-16 лет с церебральным параличом или с риском церебрального паралича. Тип исследования: систематические обзоры, рандомизированные контролируемые исследования и метаанализы; исследования, имеющие заключение по системе классификации, оценки, разработки и экспертизы рекомендаций GRADE (Grading of Recommendations, Assessment, Development and Evaluations). Результаты: найдено 7 506 статей, из которых только 12 подошли к стратегии поиска. Изучаемые методы лечения разделили на 3 группы по уровню эффективности: низкий, средний и высокий. По системе GRADE каждой статье присуждаются баллы, от 1 до 4, где 1 балл означает очень низкую эффективность вмешательства, 2 балла означают низкую эффективность, 3 балла среднюю, 4 - высокую. Выводы, рекомендацией для специалистов будет ознакомиться с существующими видами терапии и реабилитации детского церебрального паралича и уровнями их доказательной базы. Рекомендуется применять виды терапии с высоким уровнем доказательств эффективности, комплексную терапию, так как ни один из видов вмешательств не показал большую эффективность, чем применение комплексного подхода к лечению. Каждому пациенту следует назначить индивидуальный план лечения и реабилитации, учитывая форму, стадию заболевания, наличие осложнений, возраст и наличие ответа на проводимые вмешательства.

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