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},
"code": "L04",
"name": "Острый лимфаденит",
"icd_name": "Острый лимфаденит",
"gender": 0,
"age_min": 0,
"age_max": 94,
"cause": [
3
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"periodicity": 1,
"slug": "l04_ostryy_limfadenit",
"lead": "острое гнойное воспаление лимфатических узлов.",
"description": "Лимфаденит – неспецифическое или специфическое воспалительное поражение лимфоузлов. Лимфаденит характеризуется местной болезненностью и увеличением лимфатических узлов, головной болью, недомоганием, слабостью, повышением температуры тела. \r\n\r\n",
"etiology": "<p>Возбудителями неспецифического лимфаденита обычно выступает гноеродная флора - стафилококки и стрептококки, а также выделяемые ими токсины и продукты тканевого распада, которые проникают в лимфоузлы лимфогенным, гематогенным или контактным путем. Первичным очагом при неспецифическом лимфадените могут являться гнойные раны, панариции, фурункулы, карбункулы, флегмоны, рожистое воспаление, трофические язвы, тромбофлебит, кариес, остеомиелит. Местные воспалительные процессы чаще сопровождаются регионарным лимфаденитом.</p>\r\n<p>Лимфаденит у детей часто бывает связан с воспалительными процессами ЛОР-органов (гриппом, отитом, хроническим тонзиллитом, ангиной), детскими инфекциями (скарлатиной, дифтерией, паротитом), а также кожными заболеваниями (пиодермией, экссудативным диатезом, инфицированной экземой и др.).</p>\r\n<p>Причиной специфического лимфаденита являются возбудители туберкулеза, сифилиса, гонореи, актиномикоза, чумы, сибирской язвы, туляремии и др. инфекций.</p>",
"pathogenesis": "<p>Инфекция поступает в регионарные лимфатические узлы с током лимфы, оттекающей из первичных гнойных очагов. Лимфаденит может возникнуть и без предшествующего лимфангита, причем первичный очаг бывает настолько ничтожен и так быстро заживает, что к моменту возникновения лимфаденита обнаружить место вхождения инфекции уже не всегда удается. В редких случаях возможно попадание инфекции в лимфатические узлы вместе с кровотоком. Лимфаденит иногда возникает и вследствие непосредственного перехода воспалительного процесса с тканей, окружающих узел.<br /> Лимфаденит следует рассматривать как проявление барьерной функции лимфатической системы, ограничивающей дальнейшее распространение инфекции и ее токсинов. Вместе с тем лимфаденит сам по себе может стать исходным пунктом для развития тяжелого гнойного процесса (аденофлегмона, сепсис).</p>",
"diagnostics": "<p>При постановке диагноза лимфаденит, врач проводит сбор анамнеза, и далее основывается на результатах пальпации тех областей, на которые жалуется пациент.</p>\r\n<p>Далее, обязательно назначается общий анализ периферической крови больного, в котором могут быть все признаки воспалительного процесса (в крови будет обнаружено при этом большое количество лейкоцитов, ускорение СОЭ, токсическая зернистость сегментоядерных нейтрофилов).</p>\r\n<p>Для уточнения и подтверждения диагноза лимфаденита назначается ультразвуковое исследование пораженных лимфатических узлов, пункция этих узлов. После пункции делают посев содержимого для того, чтобы определить сам микроорганизм и его чувствительность к препаратам антибактериального действия.</p>",
"treatment": "<p>Катаральный и гиперпластический острый лимфаденит лечится консервативно. Необходимо создание покоя для области поражения, проведение адекватной антибиотикотерапии на основании чувствительности микробной флоры, УВЧ-терапии, витаминотерапии. При гнойном лимфадените показано вскрытие сформировавшегося абсцесса, аденофлегмоны, дренирование и санация очага по принципам ведения гнойных ран. Назначается активная дезинтоксикационная и антибактериальная терапия.</p>",
"prevention": "<p>К профилактическим методам лимфаденита можно отнести здоровый образ жизни и максимальное избегание инфекционных заболеваний.</p>\r\n<p>Так же профилактическими методами лимфаденита являются методы по предупреждению травм различного характера, методы борьбы с раневой инфекцией, и рационализация лечения воспалительных гнойных заболеваний.</p>\r\n<p> </p>",
"clinical_picture": "<p>Острый лимфаденит может проявлять себя в виде общей и местной симптоматики.</p>\r\n<p>Общие симптомы воспаления:</p>\r\n<ul>\r\n<li>повышение температуры до высоких показателей (вплоть до 40°С);</li>\r\n<li>проявление озноба;</li>\r\n<li>сильная мигрень;</li>\r\n<li>общая сильно выраженная слабость;</li>\r\n<li>боль в мышцах;</li>\r\n<li>плохой сон.</li>\r\n</ul>\r\n<p>Местные проявления острого лимфаденита:</p>\r\n<ul>\r\n<li>увеличенные лимфоузлы;</li>\r\n<li>появление красного отека над лимфоузлами;</li>\r\n<li>возникновение заметной опухоли кожных покровов в области лимфоузлов;</li>\r\n<li>болезненные ощущения, как при прощупывании лимфоузлов, так и в состоянии покоя;</li>\r\n<li>повышение местной температуры кожных покровов;</li>\r\n<li>нарушение двигательной функции той области, где расположены лимфоузлы.</li>\r\n</ul>",
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"parent": null,
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{
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{
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"description": "Аффективные эмоциональные расстройства включают в себя комплекс психических патологий, характеризующихся преимущественным изменением эмоциональной сферы, а также настроения или в сторону депрессии, или в сторону приподнятости. При этом часто меняется также уровень активности человека. ",
"etiology": "<p>Существует три группы причин аффективных расстройств: </p>\r\n<ol>\r\n<li>Биологические причины, связанные с обменом веществ в головном мозге. </li>\r\n<li>Генетические. О высокой вероятности того, что в основе этой патологии лежат генные мутации, говорит то, что примерно у половины больных биполярным синдромом, хотя бы один родитель страдает расстройством настроения. </li>\r\n<li>Психосоциальные факторы. </li>\r\n</ol>",
"pathogenesis": "<p>Основной гипотезой патогенеза афферентных психозов в настоящее время (в частности ондогенной депрессии) является сератониновая. Согласно серотониновой гипотезе в основе заболевания лежит снижение уровня серотонина в различных отделах мозга, которые функционально связаны с эмоциональностью. При аффективных расстройствах снижается также функциональная активность белков – переносчиков серотонина через мембрану тромбоцита. </p>\r\n<p> </p>",
"diagnostics": "<p> </p>\r\n<p> </p>\r\n<p>Диагностика аффективных расстройств проводится психиатром. Она начинается с тщательного сбора анамнеза.</p>\r\n<p>Для углубленного изучения особенностей психической деятельности может быть назначено медико-психологическое обследование.</p>\r\n<p>Аффективная симптоматика может наблюдаться на фоне заболеваний: эндокринной системы (адреногенитального синдрома, гипотиреоза, тиреотоксикоза); нервной системы (эпилепсии, рассеянного склероза, опухолей головного мозга); психических расстройств (шизофрении, расстройств личности, деменции). </p>",
"treatment": "<p>При лечении аффективных расстройств используются нормотимики, антипсихотики и антидепрессанты. </p>\r\n<p>Нормотимические препараты обладают антиманиакальными свойствами и способны значительно смягчать выраженность очередной аффективной фазы или предотвращать её наступление. </p>\r\n<p>Антипсихотические препараты используются для купирования маниакальных состояний, состояний с психомоторным возбуждением, а также для лечения маний и депрессий с психотическими признаками (в виде галлюцинаций и бреда). </p>",
"prevention": "<p>Профилактика аффективных расстройств состоит из таких правил: </p>\r\n<ul>\r\n<li>отказ от вредных привычек; </li>\r\n<li>доверительные отношения в семье, особенно между родителями и детьми; </li>\r\n<li>прием лекарств, включающих нейромедиаторы — поможет избежать развития такой проблемы, как сезонное аффективное расстройство, но все медикаменты должны быть выписаны клиницистом; </li>\r\n<li>раннее выявление и комплексное лечение заболеваний, которые могут вызвать коморбидные нарушения; </li>\r\n<li>регулярное прохождение полного профилактического осмотра в медицинском учреждении, в том числе с посещением психиатра — даст возможность на ранних стадиях выявить органическое аффективное расстройство.</li>\r\n</ul>",
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