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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">plasur</journal-id><journal-title-group><journal-title xml:lang="ru">Вопросы реконструктивной и пластической хирургии</journal-title><trans-title-group xml:lang="en"><trans-title>Issues of Reconstructive and Plastic Surgery</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1814-1471</issn><publisher><publisher-name>АНО "НИИ микрохирургии"</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.52581/1814-1471/90/04</article-id><article-id custom-type="elpub" pub-id-type="custom">plasur-286</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>ПЛАСТИЧЕСКАЯ ХИРУРГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PLASTIC SURGERY</subject></subj-group></article-categories><title-group><article-title>Изменения вариабельности сердечного ритма после проведения ринохирургических вмешательств</article-title><trans-title-group xml:lang="en"><trans-title>Changes in heart rate variability after rhinosurgical interventions</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-6412-6750</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Нашван</surname><given-names>А.</given-names></name><name name-style="western" xml:lang="en"><surname>Nashvan</surname><given-names>A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Нашван Алькхатиб – аспирант кафедры пластической хирургии факультета непрерывного медицинского образования </p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><bio xml:lang="en"><p>Alkhatib Nashvan, post-graduate student, the Department of Plastic Surgery</p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><email xlink:type="simple">nashvan.alkh@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3860-8348</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Маркушин</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Markushin</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Маркушин Александр Александрович – аспирант кафедры пластической хирургии факультета непрерывного медицинского образования </p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><bio xml:lang="en"><p>Aleksandr A. Markushin, post-graduate student, the Department of Plastic Surgery</p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><email xlink:type="simple">info@markushin.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-2281-2889</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тимошенко</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Timoshenko</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Тимошенко Александр Владимирович – аспирант кафедры пластической хирургии факультета непрерывного медицинского образования </p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><bio xml:lang="en"><p>Aleksandr V. Timoshenko, post-graduate student, the Department of Plastic Surgery</p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8416-8238</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Котов</surname><given-names>В. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Kotov</surname><given-names>V. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Котов Владислав Николаевич – ординатор кафедры пластической хирургии факультета непрерывного медицинского образования </p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><bio xml:lang="en"><p>Vladislav N. Kotov , resident, the Department of Plastic Surgery</p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><email xlink:type="simple">fnkc.vladislav@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6134-3080</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кастыро</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kastyro</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кастыро Игорь Владимирович – д-р мед. наук, профессор кафедры пластической хирургии факультета непрерывного медицинского образования </p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><bio xml:lang="en"><p>Igor V. Kastyro, Dr. Med. sci., Professor, the Department of Plastic Surgery</p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><email xlink:type="simple">ikastyro@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3309-4683</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Попадюк</surname><given-names>В. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Popadyuk</surname><given-names>V. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Попадюк Валентин Иванович – д-р мед. наук, профессор, зав. кафедрой оториноларингологии </p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><bio xml:lang="en"><p>Valentin I. Popadyuk, Dr. Med. sci., Professor, head of the Department of Otorhinolaryngology</p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><email xlink:type="simple">popadyuk_vi@pfur.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5766-9416</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ганьшин</surname><given-names>И. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Ganshin</surname><given-names>I. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ганьшин Игорь Борисович – д-р мед. наук, профессор, зав. кафедрой пластической хирургии факультета непрерывного медицинского образования </p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><bio xml:lang="en"><p>Igor B. Ganshin, Dr. Med. sci., Professor, head of the Department of Plastic Surgery</p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><email xlink:type="simple">gibdoc@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8533-301X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Карташева</surname><given-names>А. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Kartasheva</surname><given-names>A. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Карташева Алла Фёдоровна – д-р мед. наук, профессор, зав. кафедрой пластической и эстетической хирургии ФГБУ ФНКЦ ФМБА; профессор кафедры пластической хирургии факультета непрерывного медицинского образования ФГАОУ ВО «Российский университет Дружбы народов им. П. Лумумбы»</p><p>117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><bio xml:lang="en"><p>Alla F. Kartasheva, Dr. Med. sci., Professor, head of the Department of Plastic and Aestetic Surgery, Federal Scientific and Clinical Center, the Federal Medical and Biological Agency of Russia; Professor of the Department of Plastic Surgery, the Patrice Lumumba Peoples' Friendship University of Russia (RUDN University)</p><p>6, Mikloukho-Maklay st., Moscow, 117198</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Российский университет Дружбы народов имени Патриса Лумумбы (РУДН)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Patrice Lumumba Peoples’ Friendship University of Russia (RUDN University)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Российский университет Дружбы народов имени Патриса Лумумбы (РУДН);&#13;
Академия постдипломного образования ФГБУ ФНКЦ ФМБА России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Patrice Lumumba Peoples’ Friendship University of Russia (RUDN University);&#13;
Academy of postpillar education of the FSBI FNCC FMBA Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>02</day><month>12</month><year>2024</year></pub-date><volume>27</volume><issue>3</issue><fpage>40</fpage><lpage>52</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Нашван А., Маркушин А.А., Тимошенко А.В., Котов В.Н., Кастыро И.В., Попадюк В.И., Ганьшин И.Б., Карташева А.Ф., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Нашван А., Маркушин А.А., Тимошенко А.В., Котов В.Н., Кастыро И.В., Попадюк В.И., Ганьшин И.Б., Карташева А.Ф.</copyright-holder><copyright-holder xml:lang="en">Nashvan A., Markushin A.A., Timoshenko A.V., Kotov V.N., Kastyro I.V., Popadyuk V.I., Ganshin I.B., Kartasheva A.F.</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://plasur.elpub.ru/jour/article/view/286">https://plasur.elpub.ru/jour/article/view/286</self-uri><abstract><sec><title>Цель исследования</title><p>Цель исследования: оценить изменения вариабельности сердечного ритма (ВСР), как показателя стрессответа, после проведения ринохирургических вмешательств.</p></sec><sec><title>Материал и методы</title><p>Материал и методы. Проведено исследование ВСР у 98 пациентов в периоперационном периоде, которым выполнялась открытая ринопластика (1-я группа, 33 больных), открытая ринопластика с одномоментной септопластикой (2-я группа, 33 пациента) и септопластика (3-й группа, 32 больных). В процессе исследования у больных оценивали ВСР до хирургических вмешательств, через 3, 6, 24 и 48 ч после их проведения. Оценивали три компонента ВСР: низкочастотный (low frequency, LF), высокочастотный (high frequency, HF) и очень низкочастотный (very low frequency, VLF).</p></sec><sec><title>Результаты</title><p>Результаты. В 3-й группе пациентов HF ВСР статистически значимо (p &lt; 0,001) уменьшился на 3-й и 24-й часы после операции, по сравнению со значениями до операции, но увеличился через 2 сут (p &lt; 0,001). Через 3 ч после операции у пациентов 1-й группы HF ВСР был статистически значимо выше, чем у пациентов 2-й и 3-й групп (p &lt; 0,001). Во 2-й группе статистически значимое снижение HF было отмечено через 3 ч (p &lt; 0,001), 6 ч (p &lt; 0,01), 24 ч (p &lt; 0,05) и 48 ч (p &lt; 0,001) послеоперационного периода, по сравнению со значениями этого показателя до хирургического вмешательства. У больных 3-й группы LF был статистически значимо ниже через 3 и 24 ч (p &lt; 0,001), а также через 6 ч (p &lt; 0,001) после операции, чем до септопластики. Через 3 ч после хирургических вмешательств в группе ринопластики показатели VLF были статистически значимо выше таковых в остальных двух группах (p &lt; 0,001). На 6-й час после хирургических вмешательств статистически значимых различий в группах выявлено не было. Через 24 ч в группе септопластики (3-я группа) значения VLF были статистически значимо ниже, чем в 1-й и во 2-й группах (p &lt; 0,01).</p></sec><sec><title>Заключение</title><p>Заключение. Септои риноспетопластика вызывают неадекватный ответ со стороны симпатической нервной системы в первые часы после хирургического вмешательства, что проявляется недостаточной мощностью LF и свидетельствует о нарушении адаптационных ответов. Снижение мощности VLF в первые 3 ч после септои риносептопластики свидетельствует о выраженном стрессорном воздействии, которое приводит к низким адаптивным возможностям, по сравнению с ринопластикой, т.е. к дезадаптации в указанный срок.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Purpose</title><p>Purpose: to study changes in heart rate variability (HRV), as an indicator of the stress response, after rhinosurgical interventions.</p></sec><sec><title>Material and methods</title><p>Material and methods. A study of heart rate variability was conducted in 98 patients in the perioperative period who underwent open rhinoplasty (1st group, 33 patients), open rhinoplasty with simultaneous septoplasty (2nd group, 33 patients), and septoplasty (3rd group, 32 patients). Heart rate variability was assessed before surgery, 3, 6, 24 and 48 hours after surgery. The low frequency component (LF), high frequency component (HF), and very low frequency component (VLF) of HRV were studied.</p></sec><sec><title>Results</title><p>Results. In the 3rd group of patients, compared with the data before surgery, the high-frequency component of HRV significantly decreased on the 3rd  and 24th  hours after surgery (p &lt; 0.001), but increased after two days (p &lt; 0.001). 3 hours after surgery, HF HRV in patients of 1st group was significantly higher than in patients of groups 2nd and 3rd (p &lt; 0.001). In the second group, a significant decrease in HF was noted in the first 3 (p &lt; 0.001), 6 hours (p &lt; 0.01), 24 hours (p &lt; 0.05) and 48 hours (p &lt; 0.001) of the postoperative period, compared with data before surgery. In 3rd group, at intervals after surgery of 3 and 24 hours (p &lt; 0.001), as well as 6 hours (p &lt; 0.001), LF was significantly lower than before septoplasty. 3 hours after surgery, the VLF in the rhinoplasty group was significantly higher than in the other groups (p &lt; 0.001). At the 6th hour there were no differences between the groups. After 24 hours, in the septoplasty group, VLF was significantly lower than in 11st and 2nd groups (p &lt;0.01).</p></sec><sec><title>Conclusion</title><p>Conclusion. Septoand rhinosptoplasty provoke an inadequate low response from the sympathetic nervous system in the first hours after surgery, which is manifested by low LF power and indicates a violation of adaptive responses maladaptation. A decrease in VLF power in the first 3 hours after septoand rhinoseptoplasty indicates a pronounced stressor effect, which leads to low adaptive capabilities compared to rhinoplasty, that is, maladaptation within the specified period.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>септопластика</kwd><kwd>ринопластика</kwd><kwd>стресс</kwd><kwd>вариабельность сердечного ритма</kwd><kwd>вегетативная нервная система</kwd></kwd-group><kwd-group xml:lang="en"><kwd>septoplasty</kwd><kwd>rhinoplasty</kwd><kwd>stress</kwd><kwd>heart rate variability</kwd><kwd>autonomic nervous system</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">Гилева К.С., Адамян Р.Т., Вербо Е.В., Аллахвердиева Э.З., Давыдов Д.А. Устранение дефектов наружного носа. 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