THE ROLE AND CORRECTION OF SEXUAL DYSFUNCTION AS A COMPONENT OF THE QUALITY OF LIFE IN PATIENTS OPERATED ON FOR CEREBRAL ANEURYSM RUPTURE

Svitlana O. Lytvak, Maksym V. Yeleynik, Liliia V. Chobitko, Olena Lytvak, Hennadiy P. Pasichnyk, Wojciech Dąbrowski
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Abstract

Introduction. Hemorrhagic stroke due to the rupture of the intracranial aneurysm (IA) is a typical clinical manifestation of the disease and one of the main causes of disability, affecting the quality of life in operated patients. The aim. To determine the feasibility and safety of implementing protocols for diabetes mellitus (DM) treatment as part of rehabilitation interventions in patients who have undergone surgery for the rupture of intracranial aneurysm (IA) in the brain. Materials and methods. To determine the effectiveness and safety of implementing diabetes mellitus (DM) treatment protocols in individually developed rehabilitation interventions following surgery for the rupture of intracranial aneurysm (IA) in the brain, a retrospective cohort study was conducted in parallel groups. Results. Sexual dysfunctions (SD) resulting from the rupture of IA are multifactorial. The causes of SD can be categorized as primary, secondary, and tertiary. Primary causes include damage to brain structures by hemorrhagic stroke or vascular ischemic events affecting sexual functioning, pre-existing medical conditions, and side effects related to medication therapy during treatment. Secondary causes encompass persistent sensorimotor disturbances due to a prior stroke. Issues related to cognitive, behavioral, and psychosocial adaptation constitute tertiary causes of SD. The effective and prompt correction of sexual dysfunction in patients following the rupture of cerebral blood vessel aneurysms largely depended on the proper administration of anesthesia during surgical interventions and intensive therapy in the perioperative period. This includes preoperative preparation and patient analgesia, the administration of anesthesia, and adequate postoperative care. Conclusions. The application of SD correction in men as part of rehabilitation measures from the 6th to the 24th month after surgical treatment of intracranial aneurysm (IA) has a positive impact, reducing SD regression from 88.9% (n=56/63) to 34.9% (n=22/63).
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性功能障碍作为脑动脉瘤破裂手术患者生活质量组成部分的作用和纠正方法
导言。颅内动脉瘤(IA)破裂导致的出血性中风是该疾病的典型临床表现,也是致残的主要原因之一,影响手术患者的生活质量。我们的目的是确定将糖尿病(DM)治疗方案作为脑颅内动脉瘤(IA)破裂手术患者康复干预的一部分的可行性和安全性。材料和方法。为了确定在脑颅内动脉瘤(IA)破裂手术后单独制定的康复干预中实施糖尿病(DM)治疗方案的有效性和安全性,我们进行了一项平行分组的回顾性队列研究。研究结果颅内动脉瘤破裂导致的性功能障碍(SD)是多因素的。导致性功能障碍的原因可分为原发性、继发性和三级。原发性原因包括出血性中风或影响性功能的血管缺血性事件对大脑结构造成的损害、原有的疾病以及治疗期间与药物治疗相关的副作用。继发性原因包括先前中风导致的持续感知运动障碍。与认知、行为和社会心理适应相关的问题构成了性功能障碍的三级原因。脑血管动脉瘤破裂后患者性功能障碍的有效和及时矫正在很大程度上取决于手术干预期间的适当麻醉和围手术期的强化治疗。这包括术前准备和患者镇痛、实施麻醉和充分的术后护理。结论。作为康复措施的一部分,在男性颅内动脉瘤(IA)手术治疗后的第 6 个月至第 24 个月进行 SD 矫正具有积极影响,可将 SD 回归率从 88.9%(n=56/63)降至 34.9%(n=22/63)。
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