BOLALARDA PROFIL PATOLOGIYASINI SHAKLLANISHIGA LOR A'ZOLARNING
SURUNLI KASALLIKLARINI TA'SIRI
Международный научный журнал № 7(100), часть 2
«Научный Фокус» ноября, 2023
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Nazirov Dilmurod Muxtorali o‘g‘li
A.G. Ganiyev
Ilmiy raxbar, dots.nt Andijon davlat tibbiyot instituti
Izoh: Ushbu maqolada bolaning sog‘lig‘ini tavsiflash usuli sifatida bolalar aholisini
profilaktik tekshiruvlarning avtomatlashtirilgan tizimi (ASPOND) ishlatilgan. LOR -
patologiyasi bo‘lgan bolalarda nevrozlarning turli shakllari, tiklar va diqqat etishmasligi
giperaktivligi buzilishi o‘zaro bog‘liq bo‘lishi mumkin. Bolaning somatik patologiyasi
profilini hisobga olgan holda, surunkali LOR kasalliklarini davolashni oldini olish yoki
optimallashtirish, polifarmasiyadan qochish, bolaning ota-onasi turli mutaxassisliklar
shifokorlariga tashrif buyurish uchun vaqtni yo‘qotish, asossiz yoki aksincha, asossiz
kechikish. LOR kasalliklarini jarrohlik davolash.
Kalit so‘zlar: bolalar, LOR a’zolari kasalliklari, korrelyatsion bog‘lanish.
Relevance. The formation of a chronic ENT disease in a child cannot be
considered without forming a profile of the entire pathology or deviations in physical
health [3,4,9].
At the same time, there are few works devoted to a comprehensive pediatric
examination of children with diseases of the ENT organs. Series of works by E.V.
Borzov is of interest, dedicated to the study of the characteristics of the functional
state of the central nervous system in children with adenoids, clinical and
hematological characteristics [1,2,4]. There is a good evidence base to explain the
association of neurocognitive impairment in children with adenotonsillar hypertrophy
[5,8]. Most of the works in the “somatic” direction concern the study of the
cardiovascular system with hypertrophy of the pharyngeal and palatine tonsils. A
connection has been established between pathology and enlargement of the left
and/or right ventricle [9], increased pressure in the pulmonary artery [10], sinus
tachycardia and atrioventricular block [6], and an increase in the frequency of mitral
regurgitation [4]. Diseases associated with chronic tonsillitis are diverse and can have
both neuro-reflex and infectious-allergic components [3, 4, 6].
Goals of work. We conducted a study of the correlation between chronic ENT
pathology and other diseases, taking into account age dynamics and hereditary
predisposition in 307 children. By identifying the presence of a connection, assessing
its strength and level of reliability, it is possible to determine the likelihood of the
formation of a characteristic pathology profile in a child with chronic diseases of the
ENT organs.
Materials and methods. The Automated System of Preventive Examinations of the
Child Population (ASPOND) was used as a way to describe the child’s health [7]. The
approach is based on the construction of a pathology profile, which is a set of
anamnestic signs assessed by a group of specialists, characteristics of an objective
examination, complaints sorted into groups of nosologically forms. The pathology
Международный научный журнал № 7(100), часть 2
«Научный Фокус» ноября, 2023
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profile is a diagram on which groups of nosologically forms are displayed along the
abscissa axis, and points of expert assessment are displayed along the ordinate axis. In
fact, the value on the ordinate axis reflects the probability of detecting pathology in the
corresponding group of nosologically forms, and the whole pattern reflects the degree
of complexity of the lesion or the severity of the condition.
The software of the complex allows you to identify deviations in the state of
health in the main forms of childhood pathology in the following courses: allergology,
vasocardiology, gastroenterology, hematology, dermatology, immunology, cardiology,
otorhinolaryngology, neurology, nephrology, ophthalmology, dittology, pulmonology,
rheumatology, dentistry, pathophysiology, surgery, endocrinology The main
conclusion of ASPON-D is a pathology profile with a score proportional to the volume
of chronic abnormalities in a child in the pathology class.
We studied 3 groups of children of the same age (age range 2-18 years, average
age 7.4+-1.2 years) with the same ratio of girls and boys (boys - 48-62%).
Group 1 consisted of 78 children with chronic ENT pathology (adenoids,
hypertrophy of the palatine tonsils, chronic tonsillitis, chronic rhinosinusitis,
polyposis, deviated nasal septum, chronic otitis, secretory otitis) in children living in
Andijan.
Group 2 - 45 children from the population of Andijan, examined during
preventive examinations.
Group 3 – 184 children, examined during preventive examinations of the
population of the Andijan region.
Group 2 was introduced in order to minimize deviations caused by the inability to
use multiple correlation due to the nonparametric nature of expert assessments of the
list of ASPND signs. This drawback significantly complicates the assessment of the
relationship in the case of many control factors. The introduction of a control group,
which includes both healthy children and those with other types of pathology, but
without ENT pathology, allows us to minimize the impact of this deficiency. Group 3
was formed to neutralize the consequences of fairly high-quality medical care in
Andijan, smoothing out the severity of signs of pathology.
This group includes children living in the Andijan region with varying, but on
average quite low, levels of medical care, which makes it possible to more fully identify
the range of real correlations.
To identify correlations between chronic ENT pathology and the profile of
somatoneurological diseases in a child, a nonparametric criterion was used - the
Spearman pairwise correlation coefficient.
Research results. Despite the fact that most of the identified correlations are
classified as weak (the correlation coefficient does not exceed 0.5), significantly more
correlations were identified in children with chronic ENT pathology compared to the
control group, and correlations between ENT pathology and other types of pathology
strength; in particular, in 4 cases (classes neurology, nephrology, rheumatology,
Международный научный журнал № 7(100), часть 2
«Научный Фокус» ноября, 2023
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immunology) the value of the correlation coefficient exceeded 0.4. It should also be
noted that a significant connection between chronic ENT pathology and cardiac
(p=0.000) and immunological (p=0.000) pathology, found during examination of
children with chronic ENT diseases, was not found in the control group.
Carrying out mathematical modeling in order to determine the role of the above-
mentioned classes in the formation of clusters of combined somatic and ENT
pathologies revealed that diseases of the classis’s “cardiology”, “allergology”, “speech
therapy”, “immunology”, “neurology”, “rheumatology” have the greatest information
content. It should be noted that the gender of the child does not matter for
classification. A study of the dependence of chronic ENT pathology and other types of
pathology on age also yielded interesting results. The most stable classes of pathology
associated with chronic ENT pathology in all age groups are “cardiology”, “allergology”
(“immunology”), “rheumatology”, “neurology”. The connection with the “speech
therapy” class is maximum in the middle age group (7–10 years). In a multivariate
analysis, associations with the classis’s “nephrology”, “gastroenterology”,
“pulmonology”, “orthopedics”, “nutrition”, in contrast to the assessment of pairwise
connections, become insignificant, since they are obviously realized indirectly. In
future publications, we plan to cover in detail the pathology profile and the most
common nosologically units and syndromes for diseases such as chronic tonsillitis,
adenoids, chronic sinusitis, deviated nasal septum, secretory otitis media and clinical
diagnostic algorithm. to verify the condition of a child with chronic ENT according to
the pathology profile and construct stages of treatment taking into account this profile.
Conclusions: Chronic pathology of the ENT organs, which develops in childhood,
significantly deforms the profile of the child’s pathology.
The most consistent connections have been identified between the pathology of
the ENT organs and such classes of diseases as allergies, cardiorheumatology and
neurology.
Allergies, which are more widespread than indicated in official statistics, can
often be the only universal pathogenesis link in the formation of diseases such as
adenoids, chronic rhinosinusitis, polyposis, exudative otitis media in combination with
bronchial asthma, allergic dermatitis.
Diseases of the cardiorheumatological class, traditionally associated with chronic
tonsillitis, appear to be undergoing pathomorphosis. The number of pronounced forms
of rheumatism has decreased. To diagnose this class of diseases at the present stage, it
is necessary to use more subtle markers detected using ultrasound, Holter monitoring,
studying the structure of the heart rhythm, and immunological studies.
In children with ENT pathology, various forms of neuroses, tics, and attention
deficit hyperactivity disorder may be interrelated.
Taking into account the profile of the child’s somatic pathology allows us to
prevent or optimize the treatment of chronic ENT diseases, avoid polypharmacy, loss
Международный научный журнал № 7(100), часть 2
«Научный Фокус» ноября, 2023
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of time for the child’s parents to visit doctors of various specialties, unjustified or,
conversely, unjustified delay. surgical treatment of ENT diseases.
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