Baranova V.M., Vasilets V.M., Bovt I.G., Michurin V.M., Dovgusha L.V., Lebedev V.P.
Center for Occupational Pathology of Industrial and Marine Medicine, St. Petersburg
INTRODUCTION The treatment of occupational and professionally conditioned diseases is one of the urgent problems of health care, since the methods of their treatment are numerous and ineffective, and the number of such patients is increasing. This is especially true for the treatment of a combination of several diseases in the same patient: professional and professionally conditioned. The aim of the work was to study the effectiveness of treatment by transcranial electrical stimulation (TES-therapy) for the above comorbidity.
MATERIALS AND METHODS. TES-therapy was carried out in 32 patients who had occupational sensorineural hearing loss with varying degrees of hearing loss, and were also accompanied by occupational diseases of the musculoskeletal system (chronic deforming osteoarthrosis of large joints of the upper extremities, humeroscapular periarthrosis, epicondylosis, myofibrosis of the shoulder, forearm) in combination with professionally caused diseases of the cardiovascular and nervous system (arterial hypertension, asthenovegetative syndrome).
All patients worked in the construction, repair and disposal of ships and ships with nuclear power plants (ship assemblers, electric welders, cutters, assemblers, carvers and gummers) and were exposed to a complex of adverse production factors that significantly exceeded hygienic standards (noise, local and general vibration, physical overload, dust, aerosols of toxic substances, unfavorable microclimatic conditions).
RESULTS. As a result of treatment with TES-therapy, the vast majority of patients (81.3 ± 7.0%) showed an improvement in hearing. The perception of whispered speech in the group as a whole after treatment increased from 3.8 ± 0.08 m to 4.5 ± 0.08 m (р<0,05), and the arithmetic mean of the hearing thresholds of speech frequencies decreased from 16.3±1.6dB to 12.2±1.7dB (р<0,05).
The greatest therapeutic effect was observed in patients with initial and mild hearing loss, and in most cases after the first course of treatment. The majority of patients with diseases of the musculoskeletal system (deforming osteoarthrosis of large joints, humeroscapular periarthrosis) improved (71.9 ± 8.1%), pain in the joints of the upper limbs decreased, the range of motion in the joints increased, an increase in muscle strength and muscle strength was noted. endurance, paresthesia disappeared.
After treatment, there was a clear improvement in the state of the cardiovascular and nervous systems: palpitations, pain in the region of the heart, noise in the head, headaches, fatigue, and irritability disappeared.
The levels of systolic blood pressure in the group as a whole decreased from 149.3±1.1 to 136.4±0.5 mm Hg. (P<0.05), and diastolic blood pressure from 95.0±0.5 to 78.9±0.9 mm. Hg (p<0.05).
In most cases (78.1±7.4%), the disappearance or decrease in the severity of symptoms of astheno-vegetative syndrome was observed after treatment.
FINDINGS. The data obtained make it possible to recommend the TES-therapy method for the treatment of occupational and professionally caused diseases of the hearing organ, musculoskeletal system, cardiovascular and nervous systems, as well as for prophylactic purposes in persons at risk of developing occupational diseases.
