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THE CONCLUSION

Thus, it is spent complex mediko - a social estimation soyostojanija health of children 2-7 summer age in various regions Severo - the West of Russia: Komi to republic - 1535 children; to republic Kareliya - 850 children; Novgorod - 1484 children.

In total obsledovanno 3869 children. Feature rayoboty was use of uniform methods of the collecting and data processing agents in all analyzed districts. It allows to speak about high degree nayodezhnosti in revealing of regional features of formation of health at children of preschool age.

Children of Komi of republic are distinguished high by the general pathological porayozhennost - 3336.16 %. At 96,03 % of surveyed children at the moment of survey ustayonovleny deviations in a state of health. 53,68 % of children demand constant observation of doctors-experts, and 14,66 % - additional inspection or treatment in stationary conditions. At 23,06 % of children the third is established or more health group, at 7,17 % - the first group of health. 69,77 % of surveyed children are carried to risk group on formation of a chronic pathology (vtoyoraja health group). 30,03 % are carried to frequent and is long to ill children.

In structure pathological porazhennosti prevail: illnesses of a skin and a hypodermic fat - 15,41 %; illnesses of osteomuscular system and soediniyotelnoj tissues - 14,55 %; illnesses of endocrine system, disorder pita - nija, metabolism and immunity disturbances - 12,95 %; mental rasstrojyostva - 11,11 %; illnesses of organs of digestion - 8,77 %. With the years occurs
Growth of level pathological porazhennosti at the expense of augmentation of occurrence of diseases of endocrine system (thyroid gland disease), nervous system and sense organs (a lesion of an organ of sight), osteomuscular sisteyomy (a posture curvature, a platypodia). porazhennost illnesses of a skin, sisteyomy circulations, occurrence of congenital anomalies with the years umenyoshaetsja. Boys in larger degree are subject to diseases of organs dyyohanija, to alienations, congenital anomalies of development, zabolevayonijam nervous system and sense organs, osteomuscular system. Girls in larger degree are subject to diseases of endocrine system, rasstrojyostvam deliveries, to illnesses of organs of digestion and an uropoiesis. RasprosYOtranennost disturbances of physical development in children of Komi of republic sostayovila 271,01%о. 72,61 % of surveyed children had average indexes fizichesyokogo developments, 16,06 % - low, 9,34 % - high indicators physical razviyotija. Thus at 69,52 % of children development, in 21,37 % - disharmonious, at 9,1 % - sharply disharmonious physical development is established harmonious physical. 52,23 % of surveyed children had average indexes of length of a body, 14,17 % - otyostavanie, and 33,61 % - an advancing of length of a body. At 47,2 % of surveyed children usyotanovleno a normal food, at 32,99 % - insufficient and at 19,81 % of children - izyobytochnoe a food. The number of children with sharp disgarmonichyonym physical development with the years decreases. In comparison with girls in larger degree the macrosomatic type of physical development, superfluous mass of a body is inherent to boys. High level of disturbances of a state of health of children in Komi resyo
To public objasnjaetsja significant influence of negative factors mediko-soYotsialnogo risk in this region.

10,09 % of the surveyed families are carried to semyojam high social risk, 52,86 % - to families of average social risk and only 37,05 % - to "optimum" families. It is necessary to underline a high role in this region of such factors, as presence in a life of the child "stressful" situyoatsy, a dissatisfaction with living conditions (conditions and a way of life); small weight at a birth (intranatal group of factors); complicated techeyonie pregnancy (antenatalnye factors); a chronic pathology at the father (group of the factors influencing before conception of the child). Along with an adverse mediko-social environment in formation of a pathology of children of Komi resyopubliki plays also the anthropogenous influence characterised advanced oil refining by the industry. The appreciable contribution to environmental contamination is taken away to oil refining products. With the account osobenyonostej influences on a state of health of these factors become clear hayorakternye lines of structure pathological porazhennosti this region - zaboyolevanija skins, mainly allergic genesis, congenital anomalies of development, a lesion of organs of digestion. Also it is necessary to consider and klimatoyogeograficheskoe the position of this region leading inactive obrayozu to a life, and, as consequence, to an early lesion of osteomuscular system (posture disturbance, a platypodia). Considering some stimulating vlijayonie on physical development of "an anthropogenous situation", high level poyorazhenija osteal system can be caused still disharmony bystyo
ryh rates rostovyh increases to the demands, imposed STATE VOLUME on the form and the sizes of furniture in preschool centres.

Pathological porazhennost children of republic Kareliya a little niyozhe, than in republic Komi also are made by 2677,65 %. At 93,18 % surveyed deyotej at the moment of survey deviations in a state of health are established. 53,76 % of children demand constant observation of doctors-experts, and 24,47 % - dopolyonitelnogo inspection or treatment in stationary conditions. At 34,47 % deyotej the third is established or more health group, at 4 % - the first group zdoroyovja. 61,53 % of surveyed children are carried to risk group on formation of a chronic pathology (the second group of health). 33,06 % of children are carried to grupyope often and is long the ill.

In structure pathological porazhennosti prevail: illnesses endokyorinnoj systems, disorders of a food, disturbance of a metabolism and immuniteyota - 20,69 %; illnesses of organs of breath - 19,02 %; alienations - 10,06 %; illnesses of a skin and a hypodermic fat - 8,57 %; illnesses of nervous system and sense organs - 6,2 %. With the years there is a growth of level pathological porazhennosti at the expense of augmentation of occurrence of diseases endocrine sisyotemy (thyroid gland diseases), nervous system and sense organs (poyorazhenija a sight organ), diseases of organs of digestion (chronic porayozhenija a gastroenteric tract) and uropoiesises (infectious porazheyonie kidneys and urinary ways, and also dismetabolicheskaja a nephropathy and an urolithiasis). porazhennost illnesses of a skin, organs of breath with a cart
rastom decreases. Boys in larger degree are subject to diseases of organs of breath, alienations, congenital anomalies razyovitija, to illnesses of a skin and a hypodermic fat. Girls in larger degree podyoverzheny to diseases of endocrine system, food disorders, infekyotsionnym to lesions of urinary system, a pathology of an organ of sight, porayozheniju circulation systems (prolaps the mitral valve). RasprostraYOnennost disturbances of physical development in children of republic Kareliya sosyotavila 334,12 %. 68,7 % of surveyed children had average indexes fizicheyoskogo developments, 24,45 % - low, 6,85 % - high indicators physical razviyotija. Thus at 68,09 % of children development, in 21,39 % - disharmonious, at 10,51 % - sharply disharmonious physical razyovitie is established harmonious physical. 49,94 % of surveyed children had average indexes of length of a body, 20,47 % - backlog, and 29,59 % - an advancing of length of a body. At 43,13 % obsledovanyonyh children a normal food, at 33,74 % - insufficient and at 23,13 % of children - a superfluous food is established. The number of children with rezyoko disharmonious, microsomatic type of physical development, vysokiyomi indicators of mass of a body with the years decreases. In comparison with girls in larger degree average indexes of mass of a body, a circle thoracal kletyoki are inherent to boys. To girls in comparison with boys in larger degree it is inherent disyogarmonichnost physical development, a superfluous food or adiposity. VyYOsoky level of disturbances of a state of health of children in republic Kareliya ob - jasnjaetsja significant influence of negative factors mediko-social
Risk in this region. 9,42 % of the surveyed families are carried to families of high social risk, 72,46 % - to families of average social risk and only 18,12 % - to "optimum" families. It is necessary to underline the big role in foryomirovanii pathologies in this region of intranatal factors (a birth trauma of the child, large mass of a body at a birth), a little smaller - factors, vliyojajushchih before conception and during pregnancy (presence of a chronic pathology at mother, application during pregnancy of hormonal preparations), and menyoshuju a role - conditions and a way of life (non-observance by the child of a regimen of day). NaYOrjadu with an adverse mediko-social environment in formation patoyologii children of republic Kareliya are played also by anthropogenous influence, harakteyorizujushcheesja advanced tselljulozo-paper and aluminium promyshlenyonostju. On emission in ground layers of atmosphere of various xenobiotics this region occupies in the lead position. Along with it it is noted and bolyoshy the qualitative contribution to structure of emissions of this region of the substances concerning the first-second class of danger (pjatiokis vanadium, metilmerkaptan, foryomaldegid, sulfuric acid, fluoric hydrogen and fluorides). In water mediums of this region the high maintenance of organic substances as priyorodnogo, and an anthropogenous parentage becomes perceptible. Above told anthropogenous influence on an air and water inhabitancy explains high level in structure pathological porazhennosti this region of diseases endokrinyonoj systems (a thyroid gland lesion); breath organs (early hro -
nizatsija pathologies of the top and bottom respiratory tracts); mochevydelitelnoj systems (dismetabolicheskaja a nephropathy and an urolithiasis).

Pathological porazhennost children of of Novgorod in comparison with drugiyomi analyzed regions low enough - 1736,78 %. At 81,58 % obsleyodovannyh children at the moment of survey deviations in a condition zdoroyovja are established. 44,28 % of children demand constant observation of doctors-experts, and 20,58 % - additional inspection or treatment in stationary conditions. At 23,29 % of children the third is established or more health group, at 18,48 % - peryovaja health group. 58,23 % of surveyed children are carried to risk group on formation of a chronic pathology (the second group of health). 32,23 % of children are carried to group often and is long the ill. In structure pathological porazhennosti prevail: illnesses of organs of breath - 21,13 %; alienations - 18,08 %; illnesses of endocrine system, food disorder, on - rushenija a metabolism and immunity - 12,44 %; illnesses of nervous system and oryoganov feelings - 7,86 %, illnesses of a skin and a hypodermic fat - 7,71 %. With vozrasyotom frequency of diseases of nervous system and sense organs (payotologija a sight organ), rachiocampsises is enlarged. porazhennost zabolevayonijami skins (inflammatory character) with the years decreases. Boys in larger degree are subject to diseases of organs of breath (chronic payotologija the top respiratory tracts), to alienations, illnesses of nervous system and sense organs. At them are more often taped congenital anomayolii developments. Girls in larger degree are subject to diseases endokrinyo
Ache systems, to food disorders, illnesses mochevydelitelnoj systems (an infectious lesion of kidneys and urinary ways). Prevalence of disturbances of physical development in children of of Novgorod has made 268,79 %. 67,41 % of surveyed children had average indexes of physical development, 26,1 % - low, 6,49 % - high indicators of physical development. Thus at 66,77 % of children development, in 23,46 % - disyogarmonichnoe, at 9,77 % - sharply disharmonious physical development is established harmonious physical. 53,85 % obyosledovannyh children had average indexes of length of a body, 22,35 % - backlog, and 23,8 % - an advancing of length of a body. At 50,42 % of surveyed children a normal food, at 24,94 % - insufficient and at 24,63 % of children - a superfluous food is established. The number of children with sharply disharmonious, mik - rosomaticheskim type of physical development, low indicators of length teyola, thorax circles with the years decreases. With the years the number of children with macro-and mesosomatic types of physical development on harmonious type, vyyosokimi indicators of length of a body and a thorax circle is enlarged. To boys, in comparison with girls in larger degree average indexes of length of a body, a wide thorax, superfluous mass of a body, makrosomatotip, disgarmonichnost physical development are inherent. In comparison with boys in larger degree disturbances of physical development as a whole, nizyokie indicators of length of a body, masses of a body, fatness, and also mikrosomaticheyosky type of physical development are inherent to girls. Anthropogenous influence in surveyed region of of Novgorod on research conditions has been shown to a minimum - in issledovayo
nie children living in most ecologically favorable districts of a city are included. The state of health of children in this region would be possible priyoznat for ideal, if not high enough level of mediko-social adverse factors. Bad living conditions, abusings alkoyogolem and smoking in surveyed families provide high level psihiyocheskih disorders, the tendency to microsomatic type physical razyovitija, low tempo increases masso-rostovyh indicators.

At comparison of a state of health of children 2-7 summer age, prozhiyovajushchih in various regions of the Northwest of Russia, are taped many the general patterns in structure pathological porazhennosti and physical razyovitii. In all regions frequency of diseases endokyorinnoj systems (at the expense of thyroid gland lesions) with the years is enlarged; illnesses of nervous system and sense organs (at the expense of a lesion of an organ of sight), a chronic pathology of a gastroenteric tract, a rachiocampsis. On the contrary, with the years in all regions decreases porazhennost illnesses of a skin and podyokozhnoj fats (at the expense of inflammatory character of a lesion), acute zaboyolevany respiratory tracts, hernias of an abdominal cavity. Girls in comparison with boys in larger degree are subject to a pathology of endocrine system (both at the expense of thyroid gland lesions, and at the expense of food disorders), to illnesses of genitourinary organs (at the expense of an infectious aetiology of a lesion). Boys in comparison with girls in larger degree are subject psihicheyoskim to disorders (at the expense of neurotic disorders), to illnesses nervous sisyo
Theme and sense organs (without authentic patterns on separate nozoloyogicheskim to forms of this class), to illnesses of organs of breath (at the expense of a chronic pathology of the top respiratory tracts), to illnesses of osteomuscular system, congenital anomalies of development. It provides higher level at boys of the general pathological porazhennosti. With the years it is enlarged koyolichestvo children with meso-and macrosomatic type of physical development at the expense of augmentation of rates of the growth, causing prevalence of quantity of children with a growth advancing over children with growth backlog. It corresponds obshcheyoprinjatomu to allocation of the age period of 5-7 years as period "the first vytjayogivanija". Mainly at 2-4 summer age in comparison with girls average indexes of length of a body or extreme degrees of an advancing of length of a body, higher indicators of a circle of a thorax, mesosomatic type on physical developments on harmonious type are inherent to boys. Girls in comparison with boys high prevalence of disturbances of physical development, backlog in length of a body (basically at the expense of extreme steyopenej), body mass (basically at the expense of extreme degrees) distinguishes, low indicators okyoruzhnosti a thorax, microsomatic type of physical development.

However, along with the general patterns of dynamics of a condition zdoroyovja at children of preschool age distinct features formiyorovanija health in each analyzed region are taped also:

- Republic Komi. In this region the highest level of the general pathological porazhennosti which is provided with the authentic is established
Prevalence in comparison with other regions of diseases nervous sisteyomy and sense organs, congenital anomalies of development, illnesses of organs pishcheyovarenija, skins, osteomuscular system, alienations. In it reyogione a larger specific gravity of children with macrosomatic type fiyozicheskogo the developments, more expressed tempo increases masso-rostoYovogo an indicator becomes perceptible;

- Republic Kareliya. On pathological porazhennosti this region zayonimaet intermediate position. In comparison with other regions authentically higher level of diseases of endocrine system, disorders of a food, illnesses of system of a circulation, breath organs, moyochevydelitelnoj systems here is noted. In this region a larger specific gravity of children with mesosomatic type of physical development, average tempo increases masso-rostovyh indicators becomes perceptible;

- Novgorod. In this region the lowest level patoloyogicheskoj porazhennosti is established. However, in comparison with other regions in Novgorod higher level of alienations is noted. In this region a larger specific gravity of children with mikrosomatotipom, disgaryomonichnostju developments, at the expense of disharmony of tempo increases of the basic anyotropometricheskih indicators to age specifications becomes perceptible.

Differences in a state of health of children correlate with differences in kliyomaticheskoj, an "anthropogenous" situation, and also in mediko-social okruzheyonii children in compared regions. With advancement on the North grows kolichestyo
In children with an osteal pathology. Moderate "technogenic" influence stimulates physical development of the child. Impurity of air pool causes lesions of the top and bottom respiratory tracts, water pool - lesions of a gastroenteric tract and urinary ways. Significant emission alleryogennyh products is closely bound to growth of an inflammatory lesion of integuments.

The carried out discriminant analysis has allowed to establish priyooritetnost influences of mediko-social factors of formation of a pathology in each surveyed region:

In republic Kareliya the powerful contribution (in decreasing order of the importance) in foryomirovanie health such factors, as a birth trauma, body mass at a birth above bring 4000 gramme, presence of chronic diseases at mother to zayochatija the child, application during pregnancy of hormonal preparations, non-observance by the child of a regimen of day, a food, age of mother by a birth reyobenka stashe 35 years, presence of chronic diseases at the father before conception rebenyoka, the early termination of natural feeding, smoking of mother to nasyotuplenija pregnancy, the low material income of a family.

In Komi to republic adverse factors are located in sledujuyoshchem an order: presence in a life of the child of "stressful" situations, mass at rozhyodenii less than 2000 gramme, presence of chronic diseases at the father before conception of the child, the complicated current of pregnancy, bad living conditions, naliyochie abortions at mother till a birth of the child, abusing alcohol mother
During pregnancy, unwillingness to have children, application during time beremenyonosti hormonal preparations, late labours (after 42 weeks gestatsii).

In Novgorod: bad living conditions, presence somatic zaboyolevany during pregnancy, presence in a life of the child "stressful" situayotsy, threat of an abortion during pregnancy, presence chronic zabolevayony at mother before conception of the child, later the first applying to a breast, mass at a birth more than 4000 gr. Or less than 2000 gr., age of mother by the moment rozhyodenija the child less than 18 years, a birth trauma of the child.

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Scientific source Homich Michael Mihajlovich. COMPLEX MEDIKO-SOCIAL ESTIMATION of HEALTH of CHILDREN VISITING PRESCHOOL INSTITUTIONS, In VARIOUS REGIONS of the NORTHWEST of Russia. The dissertation on competition of a scientific degree of the candidate of medical sciences. St.-Petersburg - 1996. 1996

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