CORRECTION OF TOBACCO ADDICTION IN PATIENTS AFTER SURGERIES FOR OBLITERATING ATHEROSCLEROSIS OF LOWER EXTREMITIES IN PATIENTS WITHIN A REHABILITATION PROGRAM

Ukraine belongs to countries with a high prevalence of smoking. In our time, 51% of men of working age are smoking in urban areas and 60% in rural ones. Over the 20-year period, the prevalence of smoking among urban women of working age has increased from 5 to 20%. Such a disease as obliterating atherosclerosis of the lower extremities can be observed in smokers. This disease is a consequence of the narrowing of the vessels of the lower extremities due to the presence of cholesterol plaques on the walls of the vessels. Such a disease promotes the development of the so-called intermittent lameness, the temporary occurrence of leg pain in walking. And this happens as a result of vascular spasm, a disruption of the blood supply caused by nicotine. The purpose of the study: development of tactics for correction of tobacco addiction in patients after surgical interventions for obliterative atherosclerosis of the lower extremities within the framework of the rehab program. Materials and methods. The analysis of 59 medical records of patients after surgical interventions with obliterating atherosclerosis of the lower extremities has been performed. The structure of interventions and their complications during the ten months of 2017 has been analyzed. Exception criterion is patients with obliterative atherosclerosis of the lower extremities with diabetes mellitus. Analysis and synthesis of scientific sources, analysis of medical records. The research has been conducted on the basis of the Ivano-Frankivsk city hospital No. 1, in the surgical department. Results of the study. According to our research, most patients with this diagnosis are males. When developing a rehab program for patients after surgical interventions for obliterative atherosclerosis of the lower extremities, all the staff, involved in this process, and ideally it should be a multidisciplinary team (a physician, a nurse, a physiotherapist, an ergotherapist, a psychologist), should fully understand their importance in combating smoking ; their efforts should be aimed at eliminating 3 main obstacles to smoking cessation: insufficient patient awareness of the consequences of smoking; lack of personal motivation to quit smoking; formed nicotine addiction. In today's Ukrainian health care system, the percentage of patients with obliterative atherosclerosis of the lower extremities who have received rehabilitation assistance is extremely low. After leaving the hospital, patients are subjected to dispensary supervision for a long time. This supervision, as a rule, is of a formal nature. There is no secondary prevention of this disease and the importance of preventive measures, aimed at eliminating the causes of the disease and preventing further complications are underes-timated. The effectiveness of provided rehabilitation services is not being evaluated. Conclusions. Such patients need rehabilitation in-terventions, depending on the stage of the disease, the type of surgical intervention in the early postoperative period and under hospital care. At present, rehab programs with an individual multidisciplinary approach, aimed at restoring activities, as well as programs that take into account risk factors, concomitant pathology and, above all, the causes of the disease have not been developed.