medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-079medsovet-10082Research ArticleПУЛЬМОНОЛОГИЯ, ОТОЛАРИНГОЛОГИЯPULMONOLOGY, OTORHINOLARYNGOLOGYНеинвазивная респираторная поддержка при кифосколиозеNon-invasive respiratory support in kyphoscoliosishttps://orcid.org/0000-0002-4726-4906НуралиеваГ. С.NuralievaG. S.

Нуралиева Галиа Сериковна, к.м.н., доцент кафедры пульмонологии, Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет); научный сотрудник лаборатории интенсивной терапии и дыхательной недостаточности, Научно-исследовательский институт пульмонологии Федерального медико-биологического агентства

119991, Москва, ул. Трубецкая, д. 8, стр. 2,

115682, Москва, Ореховый бульвар, д. 28

Galiya S. Nuralieva, Cand. Sci. (Med.), Associate Professor of the Department of Pulmonology, Sechenov First Moscow State Medical University (Sechenov University); Researcher of the Laboratory of Intensive Care and Respiratory Failure, Research Institute for Pulmonology of the Federal Medical Biological Agency

8, Bldg. 2, Trubetskaya St., Moscow, 119991,

8, Orekhovy Boulevard, Moscow, 115682

 

galia32@yandex.ruhttps://orcid.org/0000-0002-1314-0091ШмидтА. Е.ShmidtA. E.

Шмидт Анна Евгеньевна, ассистент кафедры пульмонологии

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Anna E. Shmidt, Assistant Professor of the Department of Pulmonology

8, Bldg. 2, Trubetskaya St., Moscow, 119991

a_e_schmidt@mail.ruhttps://orcid.org/0000-0001-9928-926XГайнитдиноваВ. В.GaynitdinovaV. V.

Гайнитдинова Вилия Вилевна, д.м.н., профессор кафедры пульмонологии

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Viliya V. Gaynitdinova, Dr. Sci. (Med.), Professor of the Department of Pulmonology

8, Bldg. 2, Trubetskaya St., Moscow, 119991

ivv_08@mail.ruhttps://orcid.org/0000-0002-2070-3497АвдеевИ. С.AvdeevI. S.

Авдеев Иван Сергеевич, студент Института клинической медицины имени Н.В. Склифосовского

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Ivan S. Avdeev, Student, Sklifosovsky Institute of Clinical Medicine

8, Bldg. 2, Trubetskaya St., Moscow, 119991

ivan.avdeev@list.ruhttps://orcid.org/0009-0002-7864-2399СериковаА. С.SerikovaA. S.

Серикова Аурини Сериковна, докторант кафедры внутренних болезней с курсом нефрологии, гематологии, аллергологии, иммунологии

010000, Астана, ул. Бейбитшилик, д. 49а

Aurini S. Serikova, PhD Student of the Department of Internal Medicine with a Course in Nephrology, Hematology, Allergology and Immunology

49a, Beibitshilik St., Astana, 010000

auriniserikova@gmail.comhttps://orcid.org/0000-0002-5999-2150АвдеевС. Н.AvdeevS. N.

Авдеев Сергей Николаевич, академик РАН, д.м.н., профессор, заведующий кафедрой пульмонологии, Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет); руководитель клинического отдела, Научно-исследовательский институт пульмонологии Федерального медико-биологического агентства

119991, Москва, ул. Трубецкая, д. 8, стр. 2,

115682, Россия, Москва, Ореховый бульвар, д. 28

Sergey N. Avdeev, Acad. RAS, Dr. Sci. (Med.), Professor, Head of the Department of Pulmonology, Sechenov First Moscow State Medical University (Sechenov University); Head of the Clinical Department, Research Institute for Pulmonology of the Federal Medical Biological Agency

8, Bldg. 2, Trubetskaya St., Moscow, 119991,

8, Orekhovy Boulevard, Moscow, 115682

serg_avdeev@list.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет); Научно-исследовательский институт пульмонологии Федерального медико-биологического агентстваРоссияSechenov First Moscow State Medical University (Sechenov University); Research Institute for Pulmonology of the Federal Medical Biological AgencyRussian FederationПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationМедицинский университет АстанаКазахстанAstana Medical UniversityKazakhstan2026310520262057278Copyright © Нуралиева Г.С., Шмидт А.Е., Гайнитдинова В.В., Авдеев И.С., Серикова А.С., Авдеев С.Н., 20262026Нуралиева Г.С., Шмидт А.Е., Гайнитдинова В.В., Авдеев И.С., Серикова А.С., Авдеев С.Н.Nuralieva G.S., Shmidt A.E., Gaynitdinova V.V., Avdeev I.S., Serikova A.S., Avdeev S.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/10082

Кифосколиоз – это синдром, характеризующийся чрезмерным искривлением позвоночника во фронтальной и сагиттальной плоскостях, что приводит к нарушению механики дыхания и дыхательной недостаточности. Кифосколиозом страдает около 1% населения, но только в 10% этих случаев наблюдаются значительные клинические симптомы. Причины деформации грудной клетки: идиопатические, врожденные, связанные с нервно-мышечными заболеваниями и приобретенные. При наличии деформации грудной клетки часто наблюдается серьезное нарушение функции легких, которое, вероятно, вызвано искривлением позвоночника и сдавлением органов грудной полости со стороны грудной клетки. Данные изменения способны приводить к нарушению движений диафрагмы – основной дыхательной мышцы, в результате чего снижается эффективность ее работы. Изменение положения грудной стенки, снижение ее эластичности и невыгодное положение дыхательных мышц чаще всего приводят к рестриктивным нарушениям легочной вентиляции. В основе патогенеза дыхательной недостаточности у пациентов с кифосколиозом лежит альвеолярная гиповентиляция, обусловленная изменением архитектоники грудной клетки и структуры легочных объемов, снижением дыхательного усилия при вдохе, уменьшением минутной вентиляции легких и гиповентиляцией во время сна. Цель работы – провести обзор способов коррекции дыхательной недостаточности у пациентов с кифосколиозом, включая оперативные и консервативные методики, с основным фокусом на респираторную поддержку при помощи неинвазивной вентиляции легких. Основным консервативным методом лечения дыхательной недостаточности при кифосколиозе является именно неинвазивная вентиляция, которая способна улучшить выживаемость пациентов, нормализовать газообмен, повысить эффективность работы дыхательных мышц, улучшить качество сна и жизни, а также повысить толерантность к физическим нагрузкам.

Kyphoscoliosis is a syndrome characterized by excessive curvature of the spine in the frontal and sagittal planes, which leads to impaired respiratory mechanics and respiratory failure. Kifoscolioz suffers about 1% of the population, but only in 10% of these cases there are significant clinical symptoms. Causes of chest deformation: idiopathic, congenital, deformations associated with neuromuscular diseases, acquired deformations. In the presence of chest deformation, there is often a serious impairment of lung function, which is likely caused by spinal curvature and compression of the chest cavity organs from the chest. These changes can lead to impaired movements of the diaphragm – the main respiratory muscle, resulting in a decrease in its efficiency. Changes in the position of the chest wall, reduced elasticity, and an unfavorable position of the respiratory muscles often lead to restrictive disorders of pulmonary ventilation. The pathogenesis of respiratory failure in patients with kyphoscoliosis is based on alveolar hypoventilation due to changes in the architecture of the chest and the structure of lung volumes, a decrease in respiratory effort during inspiration, a decrease in minute ventilation and hypoventilation during sleep. The aim of this study is to review the methods for correcting respiratory failure in patients with kyphoscoliosis, including surgical and conservative techniques, with a primary focus on respiratory support using non-invasive ventilation. The main conservative method of treating respiratory failure is respiratory support, namely noninvasive ventilation. This method can improve patient survival, normalize gas exchange, increase the efficiency of the respiratory muscles, improve the quality of sleep and life, and increase exercise tolerance.

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The authors declare that there are no conflicts of interest present.