На базе терапевтического отделения консультативной поликлиники осуществляется:
Консультативный прием врачей-неврологов.
ЖАРИКОВА Анжелика Валерьевна |
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Врач невролог, высшей квалификационной категории |
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ЦУКАНОВ Анатолий Николаевич |
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Врач невролог, к.м.н., высшей квалификационной категории |
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ЗАЙЦЕВА Елена Юрьевна |
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Врач невролог, высшей квалификационной категории |
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КРИВОШЕЙ Ольга Александровна |
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Врач невролог, первой квалификационной категории |
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МАЛКОВ Алексей Борисович |
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Врач невролог, первой квалификационной категории |
- ЦУКАНОВА Светлана Анатольевна — врач невролог,высшей квалификационной категории
На приеме пациент получает консультацию специалистов, а так же возможно проведение нейрофизиологических методов обследования.
О нейрофизиологических методах.
На базе терапевтического отделения консультативной поликлиники организована доступная и полная нейрофизиологическая диагностика заболеваний нервной системы. Сегодня врачи-неврологи в кратчайшие сроки для диагностики неврологических заболеваний и выявления ранних осложнений выполняют электронейромиографию по всем основным методикам, в том числе игольчатую, а также вызванные потенциалы (слуховые, зрительные, когнитивные) и проводят ЭЭГ, ЭХОЭС.
ЭЭГ-электроэнцефалография
Метод исследования деятельности головного мозга животных и человека; основан на суммарной регистрации биоэлектрической активности отдельных зон, областей, долей мозга. ЭЭГ применяется в современной нейрофизиологии, а также в неврологии и психиатрии.
ЭЭГ Применима у больных с дебютом различных форм эпилепсий, а также для оценки эффективности проводимой антиконвульсивной терапии, определения критериев отмены антиконвульсантов, используется в диагностике мигрени с целью назначения адекватной терапии лечения мигрени и других форм первичной головной боли. Производится регистрация вызванных потенциалов нервной системы: когнитивных, слуховых, зрительных. Методика позволяет диагностировать демиелинизирующее поражение ЦНС, уточнить степень выраженности и характер когнитивных нарушений, что немаловажно в оценке выраженности функциональных нарушений у больных с заболеваниями нервной системы.
ЭНМГ- электронейромиография
Регистрация и анализ параметров вызванных биопотенциалов мышцы и нерва. В основе ЭНМГ лежит применение электрической стимуляции нерва с последующим анализом параметров, регистрируемых с иннервируемой мышцы или с самого нерва. Метод применим для исследования любого доступного периферического нерва. Однако в практике чаще исследуют срединный, локтевой, большеберцовый, малоберцовый, седалищный, лицевой, межреберные нервы. Возможность проведения стимуляционной и игольчатой миографии.
Сенсорная методика ЭНМГ позволяет диагностировать доклинические стадии сенсорной формы диабетической полинейропатии, избирательное поражение сенсорных порций нервов верхних и нижних конечностей при моно и полиневропатиях, корешковых поражений
Стимуляционная ЭНМГ позволят выявить поражение периферических нервов при мононевропатиях, и множественных невропатиях, корешковых поражений.
Освоена и активно выполняется методика точного выявления места поражения нерва — метод пошагового инчинга. Производится декремент-тест, позволяющий диагностировать нарушение нервно-мышечной передачи (миастению).
Вызванные потенциалы.
Вызванными потенциалами называются биоэлектрические сигналы, которые появляются с постоянными временными интервалами после определенных внешних воздействий. Возможно проведение когнитивных, слуховых, зрительных вызванных потенциалов.
Эхоэнцефалоскопия ЭХО-ЭС
Эхоэнцефалоскопия ЭХО-ЭС широко используется как скрининговый метод при подозрении на опухоль головного мозга, субдуральнаю гематому и гидроцефалию. (ЭхоЭС, синоним — М -метод) — метод выявления внутричерепной патологии, основанной на эхолокации так называемых сагиттальных структур мозга, в норме занимающих срединное положение по отношению к височным костям черепа.
По назначению неврологов проводятся консультации смежных специалистов: кардиолога, нефролога, психотерапевта, эндокринолога, гематолога, хирурга, гастроэнтеролога, а также дообследование в условиях отделения лучевой диагностики (МРТ, КТ, рентген, денситометрия и т.д.) и функциональной диагностики (транскранеальная доплерография, УЗДГБЦА и т.д.).
Диагностика нарушений сна (полисомнография) и СИПАП терапия в ГУ «РНПЦ РМиЭЧ»
У Вас проблема храпа, нарушения и остановки дыхания во сне, повышение артериального давления ночью? Сон – храп – апноэ – ожирение – сонливость?! И Вы еще не обследовались? Сегодня Вам помогут с решением такой проблемы в нашем учреждении.
В ГУ "РНПЦ РМиЭЧ" организована работа кабинета сна для проведения полисомнографии(платные услуги), где работают подготовленные специалисты в области сомнологии.
Полисомнография — это метод регистрации различных функций организма в период ночного сна и он используется для выявления причины и оценки тяжести расстройств сна и он является золотым стандартом диагностики синдрома обструктивного апноэ сна (СОАС).
Для определения причины нарушений сна достаточно одного исследования, т.е. одной ночи.
Во время проведения исследования у пациента регистрируются:
- Дыхание (воздушный поток).
- Храп.
- Насыщение гемоглобина артериальной крови кислородом.
- Дыхательные движения грудной клетки и брюшной стенки.
- Положение тела.
- Электрокардиограмма.
- Электроэнцефалограмма.
- Электроокулограмма (движение глаз).
- Электромиограмма (тонус подбородочных мышц).
- Движения нижних конечностей.
- Видеозапись сна.
Полисомнография позволяет диагностировать расстройства сна, в том числе синдром апноэ во сне, который проявляется следующими симптомами:
- храпом;
- остановками дыхания во сне;
- выраженной дневной сонливостью;
- частыми пробуждениями;
- артериальной гипертензией (преимущественно ночью и утром);
- учащенным ночным мочеиспусканием (>2 раз за ночь);
- затрудненным дыханием, одышкой в ночное время;
- отрыжкой и изжогой в ночное время;
- ночной потливостью;
- разбитостью по утрам;
- утренними головными болями;
- снижением потенции;
- депрессией, сниженным фоном настроения, снижением памяти.
СРАР-терапия является единственным надежным способом коррекции ночных дыхательных расстройств при:
- синдроме обструктивного апноэ-гипопноэ сна;
- при явлениях повышенного сопротивления дыхательных путей и ночной гипоксемии у больных с легочной патологией (бронхиальная астма, хронический обструктивный бронхит, муковисцидоз, альвеолиты и т.д.);
- клинически значимых нарушениях дыхания по типу периодического дыхания Чейн-Стокса и синдромом центральных апноэ сна;
- неврологических расстройствах (инсульты, миодистрофии, миопатии и т.д.);
- сердечно-сосудистой патологии (инфаркт миокарда, сердечные аритмии и т.д.) приводящих к нарушению вентиляционно-перфузионных соотношений ;
- метаболических расстройствах, приводящих к нарушению вентиляционно-перфузионных соотношений (сахарный диабет, тиреотоксикоз и т.д.);
Абсолютных противопоказаний к использованию СРАР-терапии НЕТ.
Для проведения полисомнографии в ГУ «РНПЦ РМиЭЧ» можно звонить в кабинет сна по телефонам:
(+375 232) 38 96 63 с 08.00 до 16.00 ежедневно (кроме вторника), вторник — с 12.00 до 18.00
или (+375 232) 38 95 92 — с 10.00 до 15.00 (ежедневно)
Стоимость услуг полисомнографии и метода подбора СИПАП-терапии можно узнать на сайте ГУ«РНПЦ РМиЭЧ» в разделе «Услуги» или по указанным телефонам.
С 2014года в работу отделения внедрен на платной основе новый, нелучевой метод диагностики сколиозов, нарушения осанки, деформации позвоночника и стоп на аппарате ДИЕРС-Форметрик с возможностью 3Д/4Д сканирования позвоночника — компьютерная оптическая топография и компьютерная вестибулография и плантография.
Компьютерная оптическая топография в ГУ «РНПЦ РМиЭЧ» — это метод диагностического измерения и анализа формы спины с помощью оптоэлектронных процессов, которые работают без лучевой нагрузки ионизирующим излучением.
Возможности метода:
- Диагностика сколиоза и кифоза;
- Определение тактики лечения при деформациях позвоночника;
- Установка и коррекция укорочения длины нижних конечностей при перекосе таза;
- Снижение использования рентгенобследований для контроля за лечением заболеваний позвоночника;
Электронейромиография (ЭНМГ) один из самых высокоинформативных инструментальных методов исследования функции и анализа состояния периферической нервной системы.
В результате заболеваний или повреждений, возникающих на пути следования двигательных нервных импульсов, передаваемым по периферическим двигательным нервам к мышцам-исполнителям из головного и спинного мозга, у человека нарушается способность к совершению полноценных движений.
При помощи метода электронейромиографии на современном оборудовании экспертного класса квалифицированными специалистами, имеющими научный и практический стаж работы, проводятся исследования функционального состояния мышц и периферических нервов.
С использованием метода электронейромиографии проводится измерение скорости прохождения импульса по нервным волокнам. Также выявляется локализация повреждения периферических нервов и проводится оценка способности сокращательной функции мышц в ответ на раздражение электрическим импульсом.
Показаниями для проведения электронейромиографии могут быть:
- сотрясения и ушибы головного и спинного мозга;
- неврологические проявления при остеохондрозе различной локализации;
- остаточные явления полирадикулоневритов, радикулоишемии, церебрального и спинального микроинсультов;
- наследственная патология и др.
Объем и тип проводимых тестов назначается в зависимости от клинической ситуации и определяется врачом, проводящим исследование или направившим специалистом.
Функциональная диагностика (ЭКГ, тредмил-тест и др.)
Цены в Минске
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