[心血管疾病:血液循环系统持续紊乱和残疾的评估,残疾严重程度的标准]。

Klinicheskaia meditsina Pub Date : 2017-01-01
M A Shurgaya
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引用次数: 0

摘要

人口健康及其社会和经济福利的一个最重要指标是过早残疾。从2005年到2014年的十年间,有1030万人因残疾而不得不退休。其中老年人的数量是年轻人的2倍,导致残疾的主要原因是血液循环障碍(61.9%)。同时,老年受试者在残废冠心病和特发性高血压组中所占比例分别仅为58.9%和40.9%。ICD第九类和其他分类中与循环障碍相关的心血管系统持续功能障碍的定量评估主要基于以下临床和功能表现的评估:疼痛综合征(心绞痛或心绞痛);高血压综合征;肺动脉高压;心律失常;晕厥。考虑到病理过程的其他方面,如其形式和严重程度,恶化的存在和频率,程度,累及靶器官,并发症。致残心血管疾病的老年学倾向说明了其社会意义(特发性高血压、冠心病、慢性心力衰竭),这要求充分解决保健服务问题,同时考虑到目前的人口状况和患有一些慢性疾病的老年人口的预期寿命增加。
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[CARDIOVASCULAR DISEASES: EVALUATION OF PERSISTING DISORDERS IN THE BLOOD CIRCULATION SYSTEM AND DISABILITY, CRITERIA FOR SEVERITY OF INVALIDISM].

A most important indicator of population health, its social and economic wellbeing is premature disability. 10.3 mln people had to retire from their jobs due to disability during the ten-year period from 2005 to 2014. The number of elderly subjects among them was twice that of the younger ones, with the leading cause of disability being blood circulation disorders (61,9%). At the same time, the fraction of old subjects in the group of invalids suffering from coronary heart disease and idiopathic hypertension accounted for only 58,9% and 40,9% respectively. The quantitative evaluation of persistent dysfunction of the cardiovascular system related to circulatory disturbances included in ICD class IX and to those referred to other classes is based mainly on an assessment of the following clinical and functional manifestations: pain syndrome (cardialgia or angina); hypertensive syndrome; pulmonary hypertension; arrhythmia; syncope. Other aspects of pathological process are taken into consideration, such as its form and severity, presence and frequency of exacerbations, magnitude, involvement of target organs, complications. The gerontological slant of disabling cardiovascular pathology accounts for its social significance (idiopathic hypertension, coronary heart disease, chronic heart failure) which requires the adequate solution of the problem of healthcare provisions taking account of the current demographic situation and increased life expectancy within the older population suffering from a number of chronic diseases.

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