ПРЕЭКЛАМПСИЯНЫ БОЛЖАУДЫҢ ҚАЗІРГІ ЗАМАН МҮМКІНДІКТЕРІ ЖӘНЕ ОНЫҢ АСҚЫНУЛАРЫ. ӘДЕБИЕТТЕРДІ ШОЛУ.
Кіріспе: Бүкіл дүние жүзінде жүктілік кезіндегі гипертензиялық бұзылулар аналар мен перинаталдық аурулардың және өлімнің негізгі себебі болып табылады. Ауыр дәрежедегі преэклампсия диагнозы қойылғаннан кейін, науқасты одан ары қаратай жүргізу тактикасы мен жоспарлаудың басымдылығын анықтау үшін әртүрлі кезеңде ана мен дамып келе жатқан ұрыққа келтірілетін тәуекелді бағалау. Болжамды модель - бұл клиникалық тәжрибенің альтернативтік негізі, пациенттің алдағы уақыттағы нәтижелерін болжау және оларды жақсарту мақсатында шешімдер қабылдау үшін қажет.
Зерттеу мақсаты: преэклампсияны болжау моделдері мен оның асқыну жағдайлары жөніндегі әдеби мәліметтерді талдау.
Әдістері: Соңғы 10 жыл 2009 жылдың қаңтарынан 2018 жылдың маусым айлары аралығында PubMed, Clinical Key, Web of Science Core Collection, eLibrary, Google Scholar 55 ағылшын және орыс тілді жарияланған басылымдарының мәліметтер базасына талдау жасалынды. Енгізілген өлшемдер: болжау құралдары (модельі), құрамында үш немесе одан көп айнымалысы бар басылымдар қолданды және бұл нәтиже ықтималдығын қамтамасыз етеді, не диагностикалық немесе емдік әсері болуы ықтимал, болжау модельінің өнімділігін сипаттау үшін кем-кетігін көрсету немесе/және калибровка қолданды, модельдің ішкі және сыртқы тексерілуі жүргізілді.Іздеу үшін келесі іздеуге қажетті сұраулар қолданылды: «preeclampsia AND prognosis», «preeclampsia AND complications» «EPH AND probability learning», «Hypertension-Edema-Proteinuria Gestosis AND prediction», «преэклампсияны болжау», «предикторы гестоза», «преэклампсияның асқынулары».
Нәтижелері: Табылған және басылымдарда жарияланған зерттеулерде преэклампсия мен аналардың және перинатальдық кезеңнің жағымсыз нәтижелер модельі анықталды. Осы әдеби шолу преэклампсия туындағанда перинатальдық кезеңнің жағымсыз нәтижелерін алдын ала болжау мәселелерін анықтауға көмек берді, осы аталған модельдердің барлығы жалпылама маңызды шектеулерге ие – осылардың барлығы жалғыз ұрықты жүктілік жағдайына қолдануға арналған, модельдердің бағасы салыстырмалы түрде алғанда қымбаттырақ, сондай ақ клиникалық практикаға арналған үлгілердің әсері, төсек-орын саны, қажетсіз диагностикалық және терапиялық шаралар саны, асқынулар жөнінде ешқандай ақпарат табылған жоқ.
Қорытынды: зерттеулерде жүйелі қателер мен шектеулердің болуына байланысты, сондай-ақ валидацияға тиісті сыртқы тексерулердің болмауы, преэклампсияны болжаудың қазіргі модельдері мен оның асқынуларының сенімділігі мен шынайылығы өте күмән тудырады.
Гульнара Т. Нургалиева 1, https://orcid.org/0000-0002-2161-105X
Гульяш А. Танышева 2, http://orcid.org/0000-0002-9074-6302
Гульшат К. Манабаева 1, https://orcid.org/0000-0002-8217-7680
1 Акушерия және гинекология кафедрасы,
2 Акушерия және гинекология бойынша интернатура кафедрасы,
Семей қаласының Мемлекеттік медициналық университеті,
Семей қ., Қaзaқстaн Республикaсы.
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