scholarly journals Results of the optimization of diagnostic and treatment algorithm in patients with acute paraproctitis of anaerobic etiology

2019 ◽  
Vol 178 (3) ◽  
pp. 39-42
Author(s):  
K. I. Sergatskiy ◽  
V. I. Nikolsky
Keyword(s):  
Comparison Group ◽  
Treatment Algorithm ◽  
Main Group ◽  
Treatment Results ◽  
Treatment Methods ◽  
Group 4 ◽  
Number Of Patients ◽  
All Cause Mortality ◽  
General Number

The OBJECTIVEwas to analyze the treatment results of patients with acute anaerobic paraproctitis in 2009–2017.MATERIAL AND METHODS. The treatment results of 71 patients with acute anaerobic paraproctitis were analyzed. All patients were divided into 2 groups depending on the applied diagnostic and treatment methods.RESULTS. General number of patients who required several operative sanation was 47 (66.2 %). 9 (26.5%) patients died in the comparison group, 4 (10.8 %) patients died in the main group.CONCLUSION. The optimization of diagnostic and treatment algorithm in patients with acute anaerobic paraproctitis allowed to reduce the all-cause mortality in patients with acute paraproctitis from 1.2 to 0.5 % (p<0.01), and mortality in patients with acute anaerobic paraproctitis from 26.5 to 10.8 %.

scholarly journals Peculiarities of early diagnosis and tactics of treatment in an acute pancreatitis in pregnant women

2018 ◽  
Vol 85 (6) ◽  
pp. 13-17
Author(s):  
Ya. P. Feleshtynskyi ◽  
О. V. Golyanovskyi ◽  
Т. P. Pavliv
Keyword(s):  
Acute Pancreatitis ◽  
Early Diagnosis ◽  
Pregnant Women ◽  
Comparison Group ◽  
Early Stage ◽  
Treatment Algorithm ◽  
Main Group ◽  
Diagnosis And Treatment ◽  
Treatment Results ◽  
Standard Methods

Objective. Improvement of the treatment results of an acute pancreatitis in pregnant women, using enhanced early diagnosis and tactics of treatment. Маterials and methods. Analysis of the diagnosis and treatment results was conducted in 123 pregnant women, suffering an acute pancreatitis. In the main group (61 pregnant women) the elaborated algorithm of diagnosis and treatment for an acute pancreatitis in the period 2012 - 2018 yrs was applied, while in a comparison group (62 pregnant women) - the standard methods of diagnosis and treatment in an acute pancreatitis for the period of 2006 - 2012 yrs. Results. In the main group in 100% of the patients an acute pancreatitis was revealed on early stage. This have had guaranteed the effect obtaining from the conservative therapy in 27 (44.3%) pregnant women, using miniinvasive surgical interventions - in 31 (50.8%) and to prevent postoperative lethality. In a comparison group in 26 (41.9%) patients an acute pancreatitis diagnosis was established in (8 ± 2.1) days after the disease beginning. In a comparison group the conservative treatment effect was observed in 21 (33.9%) patients only. Two (3.2%) pregnant women died. Conclusion. Application of the diagnostic-treatment algorithm, comparing with standard methods, permits to diagnose an acute pancreatitis in pregnant women on early stage, to reduce the complications and lethality rate.

scholarly journals EXPERIENCE OF TREATMENT OF NEWBORN CHILDREN WITH GASTROSCHISIS

2015 ◽  
Vol 174 (6) ◽  
pp. 46-51
Author(s):  
B. N. Bisaliev ◽  
N. A. Tsap
Keyword(s):  
Surgical Treatment ◽  
Hospital Stay ◽  
Enteral Feeding ◽  
Comparison Group ◽  
Main Group ◽  
Comparative Assessment ◽  
Treatment Results ◽  
Treatment Methods ◽  
Primary Radical ◽  
Operative Methods

The article presents an analysis of 10-year treatment results of 62 children with gastroschisis. Children were divided into two groups and it depended on the applied surgical treatment. An elimination of congenital eventration using Bianchi method was performed for children of the main group. The operative methods such as siloplasty, Gross operation, alloplasty and primary radical abdominoplasty were performed for children of comparison group. Comparative assessment of efficacy of the treatment methods of gastroschisis showed, that Bianchi method had a number of advantages: an early transition to independent breath and enteral feeding, shortening of hospital stay, decrease of the rate of lethality from 66,6% to 14,2%.

scholarly journals CURRENT ASPECTS OF DIAGNOSTICS AND TREATMENT OF ACUTE BILLARIAN PANCREATITIS

2018 ◽  
Vol 14 (3-4) ◽  
pp. 74-79
Author(s):  
I.V. Kolosovych ◽  
B.H. Bezrodnyi ◽  
I.V. Hanol
Keyword(s):  
Acute Pancreatitis ◽  
Length Of Stay ◽  
Comparison Group ◽  
Abdominal Cavity ◽  
Main Group ◽  
Duct System ◽  
Results Of Treatment ◽  
Positive Clinical Effect ◽  
Number Of Patients ◽  
Comparative Group

Relevance. The article is devoted to the problem of diagnosis and treatment of acute biliary pancreatitis, which remains one of the most common surgical diseases of the abdominal cavity and accounts for 33.2% of the total number of patients with acute pancreatitis. Objective of the work is to improve the diagnosis and results of surgical treatment of patients with acute pancreatitis of biliary etiology. Materials and methods. The results of treatment of 264 patients with acute pancreatitis of biliary etiology are analyzed. Operative treatment was applied in 92 (34,8 %) patients: endoscopic operations were performed in 44 patients (16,7 %). Thus, in 10 (3,8 %) patients, endoscopic papilloprotectomy was performed with the auditory of the duct system and the extraction of concrements. In other cases, organo-preserving intervention was performed without disturbing the morphofunctional integrity of the sphincter apparatus of the duct system: the cannulation in 6 (2,3%) patients, mechanical (balloon) in 5 (1,9 %) cases, pharmacological (myogenic antispasmodic) dilatation of distal duct and a large duodenal papilla in 11 (4,2 %) patients. In residual choledocholithiasis, a technique of papillotomy under the control of choledochoscopy was proposed – 12 (4,54 %) patients. A comparative analysis of the effectiveness of the treatment of patients who used the "open" (comparative group) and noninvasive endoscopic interventions in the early disease (the main group) was performed. Results. So in the main group the length of stay in the hospital was 12±3,2 days, respectively, in the comparison group – 26±4,3 days. In 42 (95,4 %) patients who had undergone endoscopic surgery, a positive clinical effect, a rapid regress of the symptoms of acute pancreatitis was achieved. In two (4,5 %) patients in the main group, the course was complicated by the development of the abscess of the stuffing box, and puncture under ultrasound control was performed. In patients of the comparison group complications arose in 5 (41,6 %) patients, it is noteworthy that all of them had undergone operative interventions, which were limited only to the rehabilitation and drainage of the abdominal cavity, a stuffing box bag. The mortality rate among unopposed was 1,2 % (2 patients), and among the operated – 11,9 % (11 patients). Among prooperated patients who died, 81,8 % (9 people) were elderly patients. Conclusions. The use of minimally invasive endoscopic interventions in the early phase of the disease reduces the length of stay of patients in the hospital from 26±4,3 days (comparison group) to 12 3,2 days (main group) and the number of complications occurring by 37,1 % (P <0, 05). Application of the proposed method of papillotomy under the control of choledochoscopy makes it possible to reduce the risk of perforation of the wall of the duodenum with the development of peritonitis or retroperitoneal phlegmon by 1,2 % (P <0,05).

scholarly journals PREVALENCE OF THE GENERALIZED PERIODONTITIS IN PATIENTS WITH DIFFERENT GROUPS BLOOD IN DEPENDING ON AGE AND PERIODONTAL BIOTYPE

2020 ◽  
Vol 73 (1) ◽  
pp. 119-122
Author(s):  
Yurii L. Bandrivsky ◽  
Orysia O. Bandrivska ◽  
Roksolana Yu. Shkrebnyuk ◽  
Volodimira T. Dyryk
Keyword(s):  
Periodontal Disease ◽  
Blood Group ◽  
Comparison Group ◽  
Main Group ◽  
Number Of Patients ◽  
Periodontal Biotype ◽  
Initial Forms

The aim of the study was to investigate the prevalence of generalized periodontitis depending on age and biotype of periodontium. Materials and methods: We examined 855 males aged 20-55 years, who were divided into 2 groups: the main group – 570 surveyed with a generalized periodontitis, the comparison group – 285 dental healthy individuals.The diagnosis of generalized periodontitis was established by the classification Danilevsky M.F. (1994) and refined by using paraclinical indices. The periodontal biotype was determined using Hu-Friedy Colourvue Biotype Probe. Results: As a result of the conducted researches was establish, in the carriers of blood group O (I) and A (II), developed forms of generalized periodontitis were found, on average, 2.7 times more often than the initial forms of the disease. Instead, at the representatives of B (III) and AB (IV) groups blood the frequency of initial GP – I degree was on average, 1.2 times greater than the prevalence of developed forms of generalized periodontitis. Also as a result of our researches, we found that the cluster A1 had 39.30% patients, cluster A2 was found at 28, 77%, and cluster B – 31.93% of the total number of patients with generalized periodontitis. Conclusions: As a result of our research, it was found that in the carriers of the blood group O (I) and A (II), more advanced forms of generalized periodontitis were observed, which was confirmed by the presence of the biotype of the periodontal disease in the cluster A1 and A2.

scholarly journals Standard open operative interventions in surgical treatment of patients, suffering an acute complicated pancreatitis

2018 ◽  
Vol 85 (7) ◽  
pp. 27-29
Author(s):  
V. P. Аndriushchenko ◽  
D. V. Аndriushchenko ◽  
Yu. S. Lysiuk
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Surgical Intervention ◽  
Main Group ◽  
Control Group ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Second Stage ◽  
Standard Operations

Objective. To determine the character and optimal volume of standard open surgical interventions in an acute complicated pancreatitis (ACP) with elaboration of the main technical elements of the operations. Маterials and methods. There were operated 96 patients, suffering ACP. The main group consisted of 47 patients, in whom open interventions were performed primarily in 19, and as the second-stage procedure after application of miniinvasive interventional technologies (МIТ) – in 28. The comparison group consisted of 49 patients, in whom standard operations were done only. Results. Application of MIТ have promoted the indications narrowing for performance of primary open operations more than twice. In the main group the arcuate-like subcostal access was applied predominantly - in 26 (55%) observations (χ²=14.287; р=002), while in a control one – a median upper laparotomy – in 37 (76%) observations (χ²=38.43, р < 0.001). The method of closed draining in accordance to procedure of Beger was used predominantly in the main group of patients – in 43% of observations, comparing with a control group - 9% of observations (χ²=12.965; р=0.003). In 23% patients of the main group and in 26% patients of a control one (χ²=0.0013; р=0.05), when the extended purulent-necrotic inflammation process have presented, a staged sanation was applied, using programmed relaparotomies. Some technical elements of the surgical intervention were improved. Conclusion. Application of standard open operations in accordance to elaborated principle is accompanied by improvement of the treatment results in patients, suffering ACP.

OPTIMIZATION OF SURGICAL TACTICS FOR TREATING PATIENTS WITH GASTRIC CANCER IN CASE OF VARIANT ANATOMY OF THE CELIAC-MESENTERIC BASIN

2019 ◽  
Vol 65 (4) ◽  
pp. 537-545
Author(s):  
Aleksandr Zakharenko ◽  
Kirill Vovin ◽  
Mikhail Belyaev ◽  
Anton Trushin ◽  
T. Kupenskaya ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Surgical Treatment ◽  
Lymph Node Dissection ◽  
Comparison Group ◽  
Perioperative Complications ◽  
Treatment Algorithm ◽  
Main Group ◽  
Node Dissection ◽  
D2 Lymph Node Dissection

Relevance: The variability of the visceral vessels occurs from 10 to 30%. There are anatomical options in which the main arteries of the stomach depart from the aorta or superior mesenteric artery. The recommended standardized surgical technique for radical treatment of gastric cancer is defined for typical vascular anatomy. Objective: To improve the results of surgical treatment of patients with gastric cancer (GC) by optimizing the diagnostic algorithm and correcting surgical techniques. Material and Methods: The results of surgical treatment of 296 patients with gastric cancer cT1-4N1-2M0, who were treated at I.P. Pavlov First St. Petersburg State Medical University from 2012-2017. In the main group of patients (n = 176), the proposed diagnostic and treatment algorithm was applied (spiral computed tomography in the angiographic mode (SCTA) + with the discharge of the vessel participating in the blood supply to the stomach from the aorta (AO) and / or the superior mesenteric artery (SMA) extended lymph node dissection D2 + № 16a2, № 16b1). All patients were radically operated. The evaluation of the diagnostic characteristics of SCTA was performed. The results of treatment were evaluated in 108 patients of the main group. The comparison group (n = 120) consisted of patients in whom vascular anatomy was not studied. Estimated blood loss, time of operation, the frequency of perioperative complications and long-term survival. Results: In 32,9 % (n = 58) patients, variant anatomy of the visceral vessels of the upper abdominal cavity was detected. Additional arteries with typical trifurcation were found in 21,6 % (n = 38) of cases; celiac trunk bifurcation was determined in 10,2 % (n = 18) of patients; the absence of the celiac trunk and a single celiac-mesenteric trunk were found in 1,1 % (n = 2) of patients. The sensitivity of SCTA was 95,7 %, specificity 94,4 %, total accuracy 95,4 %. As a result of the applied diagnostic and treatment algorithm, the standard volume of D2 lymph node dissection was performed in 124 (70,4 %) patients during the surgical treatment of the main group of patients. Expansion of lymphadenectomy to D2 + was required in 52 (29,5 %) patients. Metastases to lymph nodes of groups № 16a2 and № 16b1 in patients who underwent extended D2 + lymph node dissection were detected in 16 (30,8 %) cases. The average blood loss in the main group was 1,95 times less and amounted to 126,5±22 ml, and in the comparison group - 246,7±34 ml (M ± m, p = 0,0276). A comparison of the average duration of the operation did not show any significant differences: in the comparison group it was 188,2 ± 16,4 minutes, while the main group was slightly lower - 172,3 ± 21,5 minutes. In the main group, the total number of complications was 14 cases (13,5 %) and was significantly lower than in the comparison group - 29 cases (25,9 %). Survival for 1-2-3 years in patients of the main group was higher than the comparison group and amounted to 92,6, 75,0, 53,7 % and 90,8, 71,8, 47,5 %, respectively. The relapsefree 1-2-3-year survival of the group of patients to whom the diagnostic and treatment algorithm was applied was also higher than in the comparison group and amounted to 90,7, 73,1, 48,1 % and 90,8, 68, 3, 44,2 %, respectively. The median survival was significantly better in the main group of patients - 31,4 months, in the comparison group - 28,5 months. Conclusions: Performing SCTA at the preoperative stage is an effective way to visualize the great vessels, allowing to plan the volume of the operation, to avoid perioperative complications. Expanding the volume of lymph node dissection to D2 + № 16a2, № 16b1 when the vessel participating in the blood supply to the stomach from the AO and / or SMA is released, as it allows to improve the long-term results of treatment of patients with gastric cancer, by increasing radical surgery.

The role of elastic bands (kinesiotapes) in complex therapy of patients with temporomandibular joint osteoarthrosis

2021 ◽  
pp. 75-85
Author(s):  
E. A. Bulycheva ◽  
M. A. Postnikov ◽  
D. S. Bulycheva
Keyword(s):  
Temporomandibular Joint ◽  
Exercise Therapy ◽  
Comparison Group ◽  
Mouth Opening ◽  
Masticatory Muscles ◽  
Pain Scale ◽  
Main Group ◽  
Treatment Methods ◽  
Elastic Bands ◽  
Opening Width

Introduction. Temporomandibular joint (TMJ) arthrosis is a chronic disease, characterized by dystrophic and degenerative changes in TMJ with aseptic inflammatory process. The prevelence of TMJ arthrosis in patients with a history of other TMJ disorders varies between 32-39 % of cases. Complex treatment of TMJ arthrosis includes pharmacotherapy, physiotherapy, exercise therapy for TMJ and massage of the masticatory muscles, manual therapy, prosthodontics, but these treatment methods are not always lead to a desired result.The aim of the study is to improve the traditional treament method of patients suffering from TMJ arthrosis by using elastic tapes (kinesiotapes).Materials and methods. 68 patients were examined at the «Galaxy» Beauty Institute Clinic (St. Petersburg) and FSBEI HE SamSMU MOH Russia (Samara). Comparison group of patients was prescribed pharmacotherapy, exercise therapy for TMJ and massage of masticatory muscles, while for the main group of patients the same therapy was enhanced by elastic bands. The effectiveness of therapy was evaluated using a visual-analog pain scale (VAS), mouth opening width and electromyography of the masticatory muscles.Results. Noticeable positive effect in the main group of patients was observed on the 21th day of treatment. By this time patients noticed significant decrease in pain intensity from 8,77±0,8 to 5,19±0,5 (Z1-4=-5,88; p1-4=0,0015) points as well as increase in mouth opening width from 21-23 to 33-35 mm. Similar changes in the comparison group of patients were achieved only by the beginning of fifth week of treatment (Z1-6=-5,58; p1-6=0,0015). The range of mouth opening width increased from 21-23 to 27-29 mm. Amplitude of masticatory muscles biopotentials in maximum intercuspation in patients of the main group almost approached to the normal results by the beginning of the fourth week. In patients of the comparison group the amplitude of masticatory muscles biopotentials remained reduced even by the end of observations (42 day of the study).Conclusion. Thus, the combination of elastic bands applications with conventional treatment methods of TMJ arthrosis greatly increases the effectiveness of therapy and allows to relief pain and normalize bioelectric activity of masticatory muscles in a relatively short time. Due to the simplicity of elastic bands application it is possible to teach patients the technique of self-applying bands and recommend to use them as a prevention of relapse of TMJ arthrosis.

scholarly journals Biliary sludge: pathogenesis, etiology and drug therapy

2021 ◽  
Vol 93 (2) ◽  
pp. 179-186
Author(s):  
I. G. Bakulin ◽  
E. B. Avalueva ◽  
M. U. Serkova ◽  
T. E. Skvortsova ◽  
P. V. Seliverstov ◽  
...  
Keyword(s):  
Complete Resolution ◽  
Comparison Group ◽  
Contractile Function ◽  
Generic Drugs ◽  
Main Group ◽  
Therapeutic Effectiveness ◽  
High Effectiveness ◽  
Biliary Sludge ◽  
Number Of Patients

Aim. To evaluate the effectiveness of the use of ursodeoxycholic acid (UDCA) for the treatment of biliary sludge (BS) and to compare the therapeutic effectiveness of the German substance UDCA and generic drugs from other manufacturers. Materials and methods. The study involved 65 patients diagnosed with BS (K80.8). To assess the severity of BS, ultrasound of the gallbladder was performed before treatment, after 1, 3, 6 months during therapy, as well as an assessment of its contractility. All patients were randomized into 2 groups. Patients of the main group received UDCA Ursofalk (Germany) at a dose of 10 mg/kg for at least 6 months. Patients in the comparison group received UDCA (another manufacturer) at a dose of 10 mg/kg for at least 6 months. Results. After 3 months of follow-up, the number of patients with dissolved sludge in the main group was 87.1%, while in the comparison group 50%. In 71% of patients, the normalization of the lean volume of the gallbladder was noted, and in the comparison group only in 47.1%. After 6 months of follow-up, complete resolution of BS in the main group was observed in 93.5% of cases, and in the comparison group in 73.6% of cases. Conclusion. As a result of the study, the high effectiveness of Ursofalk during oral litolysis in patients with stage I GI (BS) in the first 3 months of therapy, as well as the normalization of the contractile function of the gallbladder, were noted.

FEATURES OF DIAGNOSIS AND TREATMENT OF ELDERLY AND SENILE PATIENTS WITH ADHESIVE SMALL BOWEL OBSTRUCTION

2021 ◽  
pp. 33-38
Author(s):  
Б.В. Сигуа ◽  
В.П. Земляной ◽  
С.В. Петров ◽  
Д.Х. Каландарова ◽  
А. Л. Ефимов
Keyword(s):  
Small Bowel ◽  
Mortality Rate ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Comparison Group ◽  
Treatment Algorithm ◽  
Diagnostic Algorithm ◽  
Main Group ◽  
Diagnostic Methods ◽  
Adhesive Small Bowel Obstruction

Спаечная тонкокишечная непроходимость является часто встречающейся патологией с тенденцией к нарастанию, характеризуется сложным патогенетическим течением, с высоким процентным соотношением осложнений и летальных исходов. Среди форм кишечной непроходимости, обусловленных механическим препятствием, острая тонкокишечная непроходимость составляет 64,3-80 % с летальностью 5,1-8,4 % в структуре ургентных заболеваний. Сложность ранней диагностики наряду со стертой клинической картиной, тяжелым течением на отягощенном фоне у лиц пожилого и старческого возраста ведет к поиску новых оптимизированных лечебнодиагностических протоколов. Цель исследования - изучение характера течения спаечной тонкокишечной непроходимости у лиц пожилого и старческого возраста, установление информативности различных методов диагностики, определение показаний к выбору оптимального срока и метода лечения. Проведен сравнительный анализ по результатам лечения 191 пациента 60-90 лет и старше, получавших лечение в хирургических отделениях Елизаветинской больницы (Санкт-Петербург) в период 2016-2019 гг. Все пациенты были разделены на две группы: основную составили 106 пациентов (2018-2019 гг.), группу сравнения - 85 пациентов (2016-2017 гг.). Для всех пациентов основной группы использован усовершенствованный лечебно-диагностический алгоритм с применением оригинальной балльно-оценочной шкалы, который позволил оптимизировать диагностику и улучшить результаты лечения. Пациенты группы сравнения были обследованы в соответствии со стандартными протоколами, оперативное лечение осуществляли исключительно традиционными методами. Применение предложенного лечебно-диагностического алгоритма позволило увеличить вероятность консервативного разрешения острой спаечной тонкокишечной непроходимости с 20 % (17) до 33 % (35), снизить частоту послеоперационных осложнений с 60,2 % (41) до 25,3 % (18), р<0,01, а уровень летальности - с 23,5 % (16) до 7 % (5), р<0,05. Adhesive small bowel obstruction is a common pathology with a tendency to increase characterized by a complex pathogenetic course with a high percentage of complications and deaths. Among the forms of intestinal obstruction caused by mechanical obstacles acute small bowel obstruction ranges from 64,3 to 80 % with a mortality rate of 5,1 to 8,4 % in the structure of urgent diseases. The complexity of early diagnosis along with an erased clinical picture severe course against a burdened background as well as age - in elderly and senile people leads to the search for new optimized treatment and diagnostic protocols. The purpose of this study was to study the nature of the course of adhesive small bowel obstruction in elderly and senile people to establish the information content of various diagnostic methods to determine the indications for the choice of the optimal period and method of treatment. A comparative analysis of 191 patients aged 60 to 90 years and older who received treatment in the surgical departments of St. Elizabeth Hospital (St. Petersburg) in the period from 2016-2019 was carried out. All patients were divided into 2 groups: the main group consisted of 106 patients (2018-2019) the comparison group included 85 patients (2016-2017). All patients of the main group used an improved diagnostic and treatment algorithm with the use of an original point-assessment scale which made it possible to optimize diagnostics and improve treatment results. Patients in the comparison group were examined in accordance with standard protocols and surgical treatment was carried out exclusively by traditional methods. The use of the proposed therapeutic and diagnostic algorithm made it possible to increase the probability of conservative resolution of acute adhesive small bowel obstruction from 20 % (17) to 33 % (35) and to reduce the incidence of postoperative complications from 60,2 % (41) to 25,3 % (18), p<0,01, and the mortality rate from 23,5 % (16) to 7 % (5), p<0,05.

scholarly journals Optimization of Complex Sanatorium-resort Treatment for Patients with Chronic Insomnia by Including Transcranial Magnetic Therapy

2021 ◽  
Vol 20 (2) ◽  
pp. 118-125
Author(s):  
Alexander G. Goryaev ◽  
Tamara V. Kulishova
Keyword(s):  
Quality Of Life ◽  
Comparison Group ◽  
Main Group ◽  
Chronic Insomnia ◽  
Health Resort ◽  
Number Of Patients ◽  
Magnetic Therapy ◽  
Insomnia Severity ◽  
Epworth Scale

Aim. To determine the effectiveness of the transcranial magnetic therapy course inclusion in the sanatorium-resort treatment complex for patients with chronic insomnia. Material and methods. 122 patients with a verified diagnosis of chronic insomnia were examined, the average age was 54.0±0.92 years, of which 68.9% were women and 31.1% were men. The patients were divided into 2 randomized groups: 62 in the main group (who received health resort treatment complex and transcranial magnetic therapy) and 60 in the comparison group (an identical complex without transcranial magnetic therapy). All patients were evaluated for the index of insomnia severity, symptoms of impaired daytime functioning, daytime sleepiness on the Epworth scale, anxiety and depression on the HADS scale, vegetative tone, polysomnography data, and quality of life (SF-36). Results. As a result of the course of treatment, the average index of insomnia severity in the main group decreased from 20.3±0.32 to 13.0±0.38 (p<0.001), in the comparison group from 19.9±0.32 to 15.3±0.29 (p<0.001). Clinically, in addition to improving sleep quality, patients reported improved daytime functioning significantly more pronounced in the main group for most of the analyzed symptoms (p<0.05). A comparative analysis of the daytime sleepiness results assessment on the Epworth scale, anxiety and depression on the HADS scale before and after treatment showed a statistically significant positive trend more pronounced in the main group (p<0.05). The change in the indicators of vegetative tone in patients with chronic insomnia after treatment was expressed in a statistically significant decrease in the number of patients with sympathicotonia by 15.7% (p<0.05) and an increase in the number of patients with normotonic vegetative support by 17.4% (p<0.05). In the comparison group, the results were significantly worse (p<0.05). After the use of therapeutic complexes, there was a favorable reliable dynamic in the change in polysomnography indicators in patients of both groups, however, the positive result in the main group was more pronounced (p<0.05). the resulting positive assessment of the transcranial magnetotherapy application was a statistically significant improvement in the quality of life of patients in the main group (p<0.05). Conclusion. The inclusion of transcranial magnetotherapy in complex health resort treatment treatment can significantly improve the effectiveness of sleep disorders treatment and improve the quality of life of patients with chronic insomnia.

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