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research and treatment Methods

The special questionnaire has been developed for children with a constipation syndrome (the appendix 1) in which the basic attention was given to revealing of clinical signs conducting it: duration of intervals between certificates of a defecation and to their features (duration natuzhivanija, incomplete oporozhnenie, morbidity, etc.), to character and frequency of a chair, and also the factors provoking its delay.

The special attention was given to feeding of the child of 1st year to a life,
To diet with the indicating of frequency rate of food intake, to a way of life of the child (a regimen of day, a regimen of a defecation, an alimentary regimen, playing sports), and also its genetic predisposition to constipation occurrence. Data on earlier spent inspections and treatment of the child, and also its efficiency at various stages of rendering of medical aid were considered also.

In questioning which was spent anonymously, 205 respondents have taken part. Questionnaires were filled with parents together with children.

Criterion of diagnostics of a constipation (the Roman criteria III (2006)) ) Was disturbance of function of the colon, expressed in age urezhenii a defecation rhythm, its difficulty, presence of sensation incomplete oporozhnenija and dense or bugorchatogo character of a chair [137]. The diagnosis an acute constipation has been put children if the above described symptoms arose against a normal chair and repeated no more than 3 months. If the given complaints disturbed more than 25 % of time during, at least 12 weeks for last 12 months without acceptance of purgatives, the chronic constipation [4, 67] was diagnosed. At an estimation of a rhythm of defecations specific features of secretory function of a colon, characteristic for each period of children's age were considered. Thus, the most physiologic at children is more senior 3 years the independent daily chair corresponding 3 - to 4 type of the form of a feces on the Bristol scale, with absence compelled natuzhivanija was considered at a defecation and feelings incomplete oporozhnenija an intestine after.

Inspection of children with a constipation syndrome was complex and included obshcheklinicheskie the methods provided by mediko-economic standards (the anamnesis collecting, the general survey, an estimation of physical development, laboratory and tool inspections).

Clinical survey was spent by a standard technique, with application of the standard methods of survey, a palpation, a percussion, auscultation, calculation of frequency of warm reductions and frequency of breath, anthropometry (measurement of growth, weight). At survey the attention to a constitution of the child, a condition of a food was paid,
Integuments and a subcutaneously-fatty layer, the sizes and the stomach form. The constipation seldom proceeds as the isolated syndrome, usually it is combined with a lesion of the top departments of a digestive tube (VOPT) and zhelchevyvodjashchih ways, therefore survey began immediately with a mouth: the mucosa, tongue, a condition of an adamantine substance of tooth was estimated. The special attention was given to data of a palpation of a forward abdominal wall, with accent on morbidity presence on a colon course, an inflation, rumbling and a condition of distal departments of an intestine (a spastic stricture, character of a peristalsis, fecal masses in a lumen). Survey of proctal area was obligatory. At survey of proctal area the fundament locating, presence of a hyperemia of perianal area or fecal masses round it, and as cracks or expanded hemorrhoidal veins was estimated.

Laboratory inspection included the general analysis of blood and urine, the biochemical analysis of blood, an urine diastase, koprogramma, the feces analysis on a dysbacteriosis (under indications).

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Scientific source IPATOV ANDREY ALEKSANDROVICH. EFFICIENCY of ACUPUNCTURE In COMPLEX TREATMENT of CHILDREN With the CONSTIPATION SYNDROME. The DISSERTATION on competition of a scientific degree of the candidate of medical sciences. Moscow - 2014. 2014

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