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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">lvrach</journal-id><journal-title-group><journal-title xml:lang="ru">Лечащий Врач</journal-title><trans-title-group xml:lang="en"><trans-title>Lechaschi Vrach</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1560-5175</issn><issn pub-type="epub">2687-1181</issn><publisher><publisher-name>ООО «Издательство "Открытые системы"»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.51793/OS.2022.25.11.015</article-id><article-id custom-type="elpub" pub-id-type="custom">lvrach-994</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>АКТУАЛЬНАЯ ТЕМА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>TOPICAL THEME</subject></subj-group></article-categories><title-group><article-title>Нутритивная поддержка как неотъемлемая часть ведения пациента с инсультом в острой стадии заболевания и на этапе реабилитации</article-title><trans-title-group xml:lang="en"><trans-title>Nutritional support as an integral part of the management of a patient with stroke in the acute stage of the disease and at the stage of rehabilitation</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ковальчук</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kovalchuk</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Виталий Владимирович Ковальчук, д.м.н., профессор, заслуженный врач России, председатель Общества реабилитологов Санкт-Петербурга, руководитель Центра медицинской реабилитации, заведующий отделением реабилитации пациентов с заболеваниями центральной нервной системы </p><p>196601, Санкт-Петербург, ул. Госпитальная, 7/2 литер А</p></bio><bio xml:lang="en"><p>Vitalii V. Kovalchuk, Dr. of Sci. (Med.), Professor, Honored Doctor of Russia, Chairman of the Society of Rehabilitation Physicians of St. Petersburg, Head of the Center for Medical Rehabilitation, Head of the Department of rehabilitation of patients with diseases of the central nervous system</p><p>7/2 letter A Hospitalnaya str., St. Petersburg, 196601</p></bio><email xlink:type="simple">vikoval67@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Санкт-Петербургское государственное бюджетное учреждение здравоохранения Городская больница № 38 имени Н. А. Семашко</institution><country>Россия</country></aff><aff xml:lang="en"><institution>St. Petersburg State Budgetary Healthcare Institution City Hospital No. 38 named after N. A. Semashko</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>30</day><month>11</month><year>2022</year></pub-date><volume>1</volume><issue>11</issue><fpage>90</fpage><lpage>95</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Ковальчук В.В., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Ковальчук В.В.</copyright-holder><copyright-holder xml:lang="en">Kovalchuk V.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.lvrach.ru/jour/article/view/994">https://journal.lvrach.ru/jour/article/view/994</self-uri><abstract><p>Настоящая статья раскрывает особенности и последствия нутритивного дефицита для состояния пациентов, перенесших инсульт, показывает важность осуществления нутритивной поддержки как в острой стадии заболевания, так и на этапе реабилитации. Одним из факторов, ухудшающих реабилитационный потенциал после инсульта, является нутритивный дефицит, который повышает риск возникновения неблагополучных исходов у пациентов с инсультом, в связи с чем вопросы питания должны находиться в центре внимания специалистов, участвующих в проведении восстановительного лечения. Нутритивный дефицит оказывает следующее негативное влияние непосредственно на процесс восстановления пациента после инсульта: снижение степени восстановления двигательных и когнитивных функций, низкий уровень социально-бытовой адаптации и качества жизни. 50% пациентов, перенесших инсульт, имеют недостаточность питания при поступлении в реабилитационные центры. Проведение парентерального питания более трех дней чревато серьезными осложнениями вследствие отсутствия стимулирующего воздействия пищи. Во всех случаях, когда это возможно, выбор способа нутритивной поддержки должен склоняться в сторону энтерального питания. Энтеральное питание в течение восстановительного периода инсульта преследует решение задач профилактики развития недостаточности питания и обусловленных данной недостаточностью осложнений, лечебное питание является компонентом терапии с целью улучшения ее переносимости, оказывает психологическое благоприятное воздействие – ускорение социализации и возможности возвращения к нормальному питанию. В статье представлены особенности и принципы осуществления различных способов питания пациентов, перенесших инсульт. Особое внимание уделено методу питания сипингом, осуществляемым на этапе реабилитации, приведены основные критерии выбора оптимальной смеси для подобного питания, обоснована эффективность применения с этой целью питательной смеси, которая наиболее полно отвечает всем представленным в статье требованиям, предъявляемым к подобным смесям.</p></abstract><trans-abstract xml:lang="en"><p>This article reveals the features and consequences of nutritional deficiency for the condition of stroke patients, shows the importance of nutritional support both in the acute stage of the disease and at the stage of rehabilitation. One of the factors that worsen the rehabilitation potential after a stroke is nutritional deficiency, which increases the risk of adverse outcomes in patients with stroke, and therefore nutrition should be the focus of attention of specialists involved in rehabilitation treatment. Nutritional deficiency has the following negative impact directly on the process of recovery of a patient after a stroke: a decrease in the degree of recovery of motor functions, a decrease in the degree of recovery of cognitive functions, a low level of social adaptation, a low level of quality of life. 50% of stroke patients are malnourished upon admission to rehabilitation centers. Conducting parenteral nutrition for more than three days is fraught with serious complications due to the lack of a stimulating effect of food. Whenever possible, the choice of nutritional support should lean towards enteral nutrition. Enteral nutrition during the recovery period of a stroke is aimed at solving the problems of preventing the development of malnutrition and complications caused by this malnutrition, therapeutic nutrition is a component of therapy in order to improve its tolerance, has a psychologically beneficial effect – accelerating socialization and the possibility of returning to normal nutrition. The article presents the features and principles of the implementation of various methods of nutrition in patients who have had a stroke. Particular attention is paid to the method of siping nutrition, carried out at the stage of rehabilitation, the main criteria for choosing the optimal mixture for such nutrition are given, the effectiveness of using a nutrient mixture for this purpose, which most fully meets all the requirements for such mixtures presented in the article, is substantiated.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>инсульт</kwd><kwd>реабилитация</kwd><kwd>нутритивный дефицит</kwd><kwd>нутритивная поддержка</kwd><kwd>сипинг</kwd></kwd-group><kwd-group xml:lang="en"><kwd>stroke</kwd><kwd>rehabilitation</kwd><kwd>nutritional deficiency</kwd><kwd>nutritional support</kwd><kwd>siping</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Compher C., Chittams J., Sammarco T. 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