Karulina Y. Impaired motor function of the upper digestive tract in older children with autonomic dysfunction syndrome and ways to correct them

The dissertation is devoted to solving the problem of improving the treatment of children with autonomic dysfunction syndrome by studying the type of motor dysfunction of the upper digestive tract and the appointment of treatment regimens depending on the type of motor disorders. A comprehensive clinical, laboratory and instrumental examination of 109 children aged 6-16 years with autonomic dysfunction and complaints from the digestive system was conducted. Clinical symptoms of diseases were studied taking into account complaints and anamnestic data, results of objective examination, general clinical examination of blood and urine, biochemical examination of blood, examination of helminth eggs, electrocardiography data, consultations of specialists, ultrasound examination of abdominal organs. The condition of the mucous membrane of the stomach and duodenum and the presence of motor-evacuation disorders in the form of reflux was assessed by fibroesophagogastroduodenoscopy. Determination of the evacuation function of the stomach was performed during ultrasound examination by filling. All children were studied the autonomic regulation of heart rhythm by cardiointervalography. Levels of situational (reactive) and personal anxiety were diagnosed using the Spielberger–Khanin test. A group of children with autonomic dysfunction syndrome and motor disorders of the upper digestive tract was identified. The clinical manifestations, risk factors, types of disorders of the motor function of the upper digestive tract in the syndrome of autonomic dysfunction in children, the connection of these disorders with H. pylori. All surveyed children were divided into 2 representative groups. The main group – 87 children with autonomic dysfunction syndrome and motor dysfunction of the upper digestive tract and the comparison group – 22 children with autonomic dysfunction syndrome without motor dysfunction of the upper digestive tract. In order to treat children of subgroup IA with autonomic dysfunction syndrome and acceleration of motor function UPDT were divided into 2 therapeutic subgroups: ІA1 – received only basic therapy of VD syndrome and ІA2 – received in addition to basic therapy SVD correction of motor UPDT. Patients of subgroup ІB were also divided into 2 subgroups: subgroup ІB1 – received only basic therapy SVD and subgroup ІB2 received in addition to basic therapy SVD correction of motor dysfunction UPDT. The effectiveness of treatment of autonomic dysfunction syndrome was proved taking into account the type of motor disorders of the upper digestive tract. Key words: autonomic dysfunction; motor function; children