Наступление паралича

Паралич обычно наступает вследствие повреждения белого вещества.

Поэтому если белое вещество не пострадало, паралич у больного развивается не сразу. Однако в результате изменений, происходящих как реакция организма на травму, через какое- то время нарушается функционирование также и белого вещества, что приводит к параличу. Это может произойти, например, из-за уменьшения притока крови к спинному мозгу.

По мнению Фадена, пока не произошло повреждения белого вещества спинного мозга, можно терапевтическими средствами предотвратить паралич. Из его экспериментов следует, что, будучи применен в этот период (который длится от нескольких минут до нескольких часов), ТВГ приостанавливает процессы нормальной реакции организма на травму позвоночника и тем самым препятствует развитию паралича. В деталях механизм действия гормона пока не ясен. Известно, что он подавляет активность природных опиатов (эндорфинов), играющих роль в реакции организма на травму.

Согласно Фадену, продолжительность оптимального «терапевтического окна» не превышает нескольких часов. Однако жертвы несчастного случая, получившие травму позвоночника, попадают в специализированный медицинский центр или больницу обычно не ранее чем через четыре часа после происшествия. Следовательно, препарат, призванный предотвратить паралич, должен быть введен непосредственно на месте происшествия и его эффект должен длиться как минимум до тех пор, пока пациент не будет доставлен в специализированное лечебное учреждение.

По-видимому, природный ТВГ мало пригоден в таких ситуациях. Этот гормон распадается в организме в течение пяти минут, и, следовательно, для оказания помощи его нужно вводить непрерывно путем внутривенного вливания. Недавно Фаден и его сотрудники начали испытывать искусственный аналог ТВГ производства немецкой фирмы Griinenthal GMBH. Оказалось, что синтетический препарат сохраняет эффективность по меньшей мере несколько часов, причем он даже более действен, чем природный гормон. И в настоящее время именно синтетический гормон вызывает интерес у клиницистов.

 

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