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{
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{
"id": 28,
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{
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{
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{
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}
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},
"code": "J04",
"name": "Острый ларингит и трахеит",
"icd_name": "Острый ларингит и трахеит",
"gender": 0,
"age_min": 0,
"age_max": 100,
"cause": [
2
],
"periodicity": 1,
"slug": "j04_ostryy_laringit_i_traheit",
"lead": "Вирусное заболевание верхних и нижних дыхательных путей",
"description": "Характеризуется затруднением дыхания, особенно вдоха. Возникает у детей, больных ОРВИ, и является ее синдромом. 3 % больных нуждаются в лечении в реанимационном отделении. Летальность при этом заболевании стоит на одном из первых мест в педиатрии.",
"etiology": "<p>Может развиваться при гриппе, ОРВИ, кори преимущественно у детей в возрасте от 6 месяцев до 3 лет. В основе заболевания лежат отек слизистой оболочки гортани, особенно ее подсвязочного пространства, рефлекторный <a href=\"/symptom/sudoroga/\" title=\"Перейти на страницу симптома Судорога\">спазм</a> мышц, <a href=\"/symptom/vospalenie/\" title=\"Перейти на страницу симптома воспаление\">воспаление</a> гортани.</p>",
"pathogenesis": "<p>Может развиваться при гриппе, ОРВИ, кори преимущественно у детей в возрасте от 6 месяцев до 3 лет. В основе заболевания лежат отек слизистой оболочки гортани, особенно ее подсвязочного пространства, рефлекторный <a href=\"/symptom/sudoroga/\" title=\"Перейти на страницу симптома Судорога\">спазм</a> мышц, <a href=\"/symptom/vospalenie/\" title=\"Перейти на страницу симптома воспаление\">воспаление</a> гортани.</p>",
"diagnostics": "",
"treatment": "<p>Выделяются пять основных направлений:</p>\r\n<p> </p>\r\n<p>1) организация помощи с учетом сопусттвующих заболеваний</p>\r\n<p>2) лечение больных с осложненными формами – стенозом гортани в стадии компенсации и неполной компенсации;</p>\r\n<p>3) интенсивная терапия при осложнении стенозом гортани в стадии перехода от неполной компенсации к декомпенсации (проведение ингаляций под тентом);</p>\r\n<p>4) интенсивная терапия больных со стенозом гортани в стадии декомпенсации (продленная интубация и трахеостома);</p>\r\n<p>5) реабилитация детей, перенесших продленную интубацию и трахеотомию.</p>",
"prevention": "",
"clinical_picture": "<p>В клинической картине выделяются три основных симптома: изменение <a href=\"/symptom/sluhovye_gallyucinacii/\" title=\"Перейти на страницу симптома Слуховые галлюцинации\">голоса</a>, грубый лающий <a href=\"/symptom/kashel/\" title=\"Перейти на страницу симптома Кашель\">кашель</a>, стенотическое дыхание. Ларинготрахеит острый может протекать по нескольким клиническим вариантам:</p>\r\n<p> </p>\r\n<p>1) острое начало, когда признаки ларинготрахеита острого проявляются внезапно, в отсутствие других симптомов ОРВИ;</p>\r\n<p>2) острое начало на фоне ОРВИ;</p>\r\n<p>3) постепенное нарастание симптомов ларинготрахеита острого на фоне ОРВИ. Рецидивирующая форма заболевания протекает также по одному из этих вариантов.</p>",
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4758,
5046,
5367
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},
{
"id": 6024,
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{
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{
"name": "Астения"
},
{
"name": "утомляемость"
},
{
"name": "Снижение работоспособности"
},
{
"name": "Недомогание"
},
{
"name": "Усталость"
}
],
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{
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"description": "\r\nТуберкулез нервной системы обычно наблюдается в форме туберкулезного менингита (воспаление мягких мозговых оболочек) и солитарных (одиночных) туберкулем мозга. Туберкулезное воспаление мозговых оболочек является одной из самых тяжелых форм туберкулеза\r\n\r\nВ последние годы туберкулезный менингит встречается в 7—9% случаев. Он может быть единственной локализацией туберкулезного процесса, но чаще (70—80% случаев) развивается при самых различных формах легочного и внелегочного туберкулеза.",
"etiology": "<p>Возбудителями туберкулёза являются микобактерии — кислотоустойчивые бактерии рода Mycobacterium. Всего известно 74 вида микобактерий. Они широко распространены в почве, воде, среди людей и животных. Однако туберкулёз у человека вызывает условно выделенный комплекс, включающий в себя Mycobacterium tuberculosis(человеческий вид), и другими близкородственными видами) или иначе палочками Коха</p>\r\n<p>Микобактерии туберкулеза передаётся воздушно-капельным путём при разговоре, кашле и чихании больного.</p>\r\n<p>Палочкой туберкулезную микобактерию назвали не случайно: она тонкая, 1-10 мкм в длину и 0,2-0,6 мкм в ширину, прямая или слегка искривленная, концы скругленные, поверхность тела может быть слегка зернистой. МБТ уникальна тем, что под воздействием различных факторов среды она может дробиться на мелкие частички, или наоборот, слепляться, а затем снова возвращаться в обычную форму и становится возбудителем заболевания.</p>\r\n<p>Туберкулезные микобактерии могут долго жить во внешней среде. На пыльном тротуаре они остаются жизнеспособными 10 дней, между книжных страниц – 3 месяца, в воде – 5 месяцев. МБТ не любят солнечного света, но выдерживают нагревание до 80 градусов Цельсия пять минут. В засушенном виде бактерии сохраняются в течение 6 мес, а в замороженном – 30 лет.</p>\r\n<p>МБТ не имеют органоидов движения – ни жгутиков, ни ресничек – поэтому остаются там, где их «высадил» носитель. Для роста и размножения им нужна температура от 29 до 42 градусов Цельсия, оптимальные условия – 37-38 градусов, так что организм человека создает для этого просто идеальные условия.</p>",
"pathogenesis": "<p>Туберкулезный менингит развивается у лиц, инфицированных МБТ, больных туберкулезом легких или других органов. У детей он возникает как осложнение первичного туберкулезного комплекса или туберкулеза внутригрудных лимфатических узлов, у взрослых — как осложнение диссеминированного (гематогенного) туберкулеза. Туберкулезный менингит может быть единственным клиническим проявлением активного туберкулезного процесса, когда источник метастазирования МБТ клиническими методами не обнаруживается. Туберкулема мозга является вторичным заболеванием, т. е. возникает при наличии туберкулеза легких, внутригрудных лимфатических узлов или других органов, наиболее часто в фазе диссеминации.</p>\r\n<p>Туберкулез нервной системы и мозговых оболочек возникает гематогенным (через кровь), лимфогенным (по лимфатическим сосудам) или периневральным (по току спиномозговой жидкости) путями при распространении МБТ из очагов в легких, пораженных внутригрудных лимфатических узлов или других внелегочных очагов.</p>\r\n<p>Первый этап развития туберкулезного менингита — гематогенный, который завершается прорывом гематоэнцефалического барьера и инфицированием сосудистых сплетений головного мозга.</p>\r\n<p> Второй этап — ликворогенный. Микобактерии туберкулеза из сосудистых сплетений попадают в спинномозговую жидкость, оседают на основании мозга, что приводит к поражению мягкой мозговой оболочки.</p>",
"diagnostics": "<p>Туберкулез нервной системы диагностируется фтизиатром совместно со специалистами в области неврологии. Проводится пункция спиномозговой жидкости, где оценивается ее цвет, прозрачность, давление, клеточный состав. «Золотым стандартом» диагностики туберкулезного менингита является выделение микобактерий из спиномозговой жидкости методом посева. Вместе с тем бактериологическое подтверждение диагноза регистрируется менее чем в 20% случаев. Более высокая чувствительность достигается при выявлении генетического материала микобактерии методом ПЦР — 26,0%, а определение антигенов микобактерий и противотуберкулезных антител — 36%.</p>\r\n<p>Проводится рентгенография органов грудной клетки для выявления первичного очага туберкулезной инфекции.</p>\r\n<p>Компьютерная/магнитно-резонансная томография головного мозга на ранних этапах не позволяет обнаружить изменения, но позднее появляются признаки увеличения желудочков мозга, а также отек мозга и очаговую ишемию. Также данные методы применяются для дифференциальной диагностики с другими церебральными поражениями.</p>\r\n<p>Рентгенограмма черепа позволяет выявить туберкулему при отложении в нем солей кальция. Основными методами визуализации туберкулемы мозга являются КТ и МРТ.</p>\r\n<p>Офтальмоскопия позволяет выявить застойные диски зрительных нервов.</p>",
"treatment": "<p>Больным показан строгий постельный режим. Вставать можно только после купирования менингеальных симптомов, выходить на улицу — только после нормализации показателей спиномозговой жидкости. Для лечения туберкулеза нервной системы применяются противотуберкулезные препараты, разрушающие или препятствующие размножению микробной клетки.</p>\r\n<p>Ориентиром длительности химиотерапии является санация спиномозговой жидкости, лечение после которой продолжают еще 6 мес. В лечении туберкулезного менингита очень важна дегидратационная терапия. Для этого делают «разгрузочные» спинномозговые пункции, а также применяют диуретические препараты под контролем водно-электролитного баланса.</p>\r\n<p>В целях повышения эффективности этиотропной химиотерапии и профилактики осложнений необходимо в острый период заболевания назначать глюкокортикостероидные гормоны. Длительность лечения гормонами — от 4 нед до 2 мес. Всем больным назначают препараты, влияющие на мозговое кровообращение.</p>\r\n<p>В комплексном лечении менингита большое внимание уделяют витаминотерапии. Во время лечения туберкулезного менингита необходимо систематически проводить спинномозговые пункции для контроля за эффективностью лечения. Лечение туберкулем головного мозга — оперативное удаление, техника которого такая же, как и при удалении опухолей мозга. Туберкулему удаляют полностью, вылущивая ее в пределах здоровой ткани. Операционное поле тщательно изолируют во избежание попадания частиц туберкулемы в окружающее субарахноидальное пространство. Хирургическое лечение туберкулем проводят в сочетании спротивотуберкулезной терапией, дегидратационной терапией, общеукрепляющим и последующим санаторным лечением. Длительность лечения определяется течением послеоперационного периода, характером неврологических расстройств и туберкулезного процесса во внутренних органах.</p>",
"prevention": "<p>Основной профилактикой туберкулёза на сегодняшний день является вакцина БЦЖ (BCG). Она защищает от самой опасной формы туберкулёза — туберкулёзного поражения нервной системы. В соответствии с «Национальным календарём профилактических прививок» прививку делают в роддоме при отсутствии противопоказаний в первые 3—7 дней жизни ребёнка. В 7 при отрицательной реакции Манту и отсутствии противопоказаний проводят ревакцинацию.</p>\r\n<p>С целью выявления туберкулёза на ранних стадиях всем взрослым необходимо проходить флюорографическое обследование в поликлинике не реже 1 раза в год (в зависимости от профессии, состояния здоровья и принадлежности к различным «группам риска»).</p>\r\n<p>Необходимо вести здоровый образ жизни:</p>\r\n<ul>\r\n<li>не курить, не употреблять алкогольные напитки и наркотики, т.к. они значительно снижают защитные силы организма;</li>\r\n<li>заниматься физической культурой, спортом и закаливанием, это значительно повысит устойчивость организма к туберкулезу и другим болезням;</li>\r\n<li>полноценно питаться;</li>\r\n<li>стараться избегать нервных стрессов;</li>\r\n<li>соблюдать правила гигиены дома, на улице, в школе, на работе;</li>\r\n<li>по возможности не находиться вблизи кашляющего человека;</li>\r\n<li>соблюдать правила личной гигиены.</li>\r\n</ul>\r\n<p> </p>\r\n<p>Профилактика заболевания лиц, бывших в контакте с больным:</p>\r\n<ul>\r\n<li>специальное лечение (превентивная терапия и химиопрофилактика) тех людей, у которых имеется высокий риск развития туберкулеза;</li>\r\n<li>людям, недавно бывшим в контакте с больными и инфицированными туберкулезом, необходимо пройти флюорографию и реакцию Манту;</li>\r\n<li>изоляция и лечение заразных больных в противотуберкулезных учреждениях;</li>\r\n<li>дезинфекция;</li>\r\n<li>отстранение больных туберкулезом от определенных видов работ (пищевые производства, животноводческие хозяйства, учреждения коммунального хозяйства, детские учреждения, лечебно-профилактические учреждения, а также профессии, связанные с широким кругом общения);</li>\r\n<li>не допускать больных туберкулезом к прохождению службы в армии и на флоте.</li>\r\n</ul>\r\n<p> </p>",
"clinical_picture": "<p>Туберкулезный менингит обычно развивается постепенно. Больные ощущают недомогание, вялость, раздражительность, светобоязнь, нарушение сна, задержку стула. В этот период может незначительно повышаться температура тела. Затем начинает наростать головная боль, к которой присоединяется рвота, постепенно развиваются менингеальные симптомы, температура тела повышается до 38—39 °С. При отсутствии лечения у больных появляются амышечная слабость, безразличие к окружающему, спутанность сознания, далее развиваются сопорозное состояние, кома, и, как правило к концу третьей недели наступает смерть.</p>\r\n<p>Возможно и «нетипичное» острое начало с высокой лихорадкой и менингеальными симптомами, которое наблюдается в основном у детей младшего возраста. Характерными для туберкулезного менингита являются менингеальный синдром, параличи и парезы черепных нервов и спинномозговых нервных корешков, симптомы поражения вещества мозга. Менингеальный синдром проявляется головной болью, обусловленной воспалением мягкой мозговой оболочки, контрактурами мышц вследствие раздражения нервных корешков. О контрактурах судят по наличию следующих признаков: ригидность затылочных мышц (из-за болезненности невозможно запрокинутую голову нагнуть вперед); симптомы Кернига (невозможно у лежащего на спине больного разогнуть в коленном суставе ногу, согнутую в тазобедренном суставе) и Брудзинского (сгибание головы вызывает сгибание ног); втяжение мышц живота; «поза легавой собаки» - положение больного на боку с запрокинутой головой и подтянутыми к животу ногами.</p>\r\n<p>Характерно поражение черепных нервов с соответствующей неврологической симптоматикой опущение верхнего века, расширение зрачков, нарушение движения глазных яблок, мышц лица, языка, глотательных мышц). При корешковых поражениях у больных обнаруживаются опоясывающие боли вокруг груди, живота, периферические парезы и параличи, нарушения функции тазовых органов (характерны запоры). При появлении очаговых поражений вещества головного мозга появляются гемипарез (ослабление мышц одной стороны тела), гемиплегия (паралич одной стороны тела). Заболевание может сопровождаться вегетососудистыми нарушениями в виде сосудистых реакций, красного стойкого дермографизма, спонтанно возникающих красных пятен на коже, брадикардии (урежение ритма сердца), нарушения сна, аппетита.</p>\r\n<p>Клинические проявления туберкулемы сходны с таковыми при опухолях центральной нервной системы. Иногда течение туберкулем бессимптомное и их обнаруживают лишь на вскрытии (при супратенториальной локализации). Продолжительность заболевания от нескольких месяцев до 2—3 лет.</p>\r\n<p>Встречаются два типа развития болезни. Первый тип — заболевание начинается остро с подъема температуры и напоминает инфекционное заболевание с быстрым развитием симптомов поражения мозга, последующим волнообразным течением и длительно сохраняющейся субфебрильной температурой. При таком течении часто диагностируют менингит и менингоэнцефалит. Второй тип — постепенное начало и медленное развитие болезни с ремиссиями. Течение болезни при этом сходно с таковым при опухолях головного мозга. Для клинической картины туберкулем свойственны мозговые и очаговые симптомы, характер которых зависит от локализации туберкулемы.</p>",
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"lead": "Если горло болит имеет смысл обратиться к врачу",
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},
"code": "J36",
"name": "Перитонзиллярный абсцесс",
"icd_name": "Перитонзиллярный абсцесс",
"gender": 0,
"age_min": 0,
"age_max": 100,
"cause": [
2
],
"periodicity": 1,
"slug": "j36_peritonzillyarnyy_abscess",
"lead": "воспаления лимфаденоидной ткани глотки, преимущественно нёбных миндалин",
"description": "Представляет собой осложнение хронического тонзиллита или острой ангины выражающееся в воспалениях тканей глотки и небных миндалин",
"etiology": "<p>В большинстве случаев возбудителем является стрептококк, реже – стафилококк или пневмококк. При формировании перитонзиллярного абсцесса гноеродные микробы проникают в околоминдальную клетчатку из нагноившихся глубоко расположенных в ткани миндалины фолликулов или из глубоких лакун, достигающих капсулы миндалин, и вызывают там <a href=\"/symptom/vospalenie/\" title=\"Перейти на страницу симптома воспаление\">воспаление</a> с образованием нарыва.</p>",
"pathogenesis": "",
"diagnostics": "<p>Диагноз не представляет особых затруднений. Обычно перитонзиллярному абсцессу предшествует ангина, совокупность вышеперечисленных клинических симптомов позволяет установить правильный диагноз.</p>",
"treatment": "<p>Обязательно проведение массивной антибактериальной терапии антибиотиками широкого спектра действия (предпочтительно – полусинтетическим производным пенициллина, цефалоспорина), местно применяют антисептические растворы (борную кислоту, перманганат калия), 40 %-ные спиртовые согревающие компрессы на шею, при сильных болях – обезболивающие средства, при высокой температуре – жаропонижающие. Сформировавшийся <a href=\"/symptom/abscess/\" title=\"Перейти на страницу симптома абсцесс\">абсцесс</a> необходимо вскрыть, удалить гной и санировать полость абсцесса.</p>\r\n<p>Прогноз<br />Благоприятный. После вскрытия абсцесса, удаления гноя и проведения консервативной терапии наступает полное выздоровление.</p>",
"prevention": "<p>Очень важна и заключается в соблюдении гигиены полости рта, лечении хронических тонзиллитов, кариозных зубов и гнойных воспалений придаточных пазух носа. При отсутствии противопоказаний проводится тонзилэктомия.</p>",
"clinical_picture": "<p>Обычно больной, только что перенесший ангину и уже выздоравливающий, начинает опять жаловаться на нарастающие боли при глотании, чаще с одной стороны, температура тела вновь повышается, все явления ангины, но в более тяжелой форме, возобновляются. Резко покрасневшая одна половина мягкого нёба начинает инфильтрироваться, закрывает постепенно миндалину и смещает отечный язычок в противоположную сторону. Боль выражена сильнее, чем при лакунарной или фолликулярной ангине. Она ощущается больным даже в спокойном состоянии, принимает острый, колющий характер, иррадиирует в ухо, усиливается при глотании, кашле, каждом движении. Больной с трудом раскрывает рот, держит голову неподвижно, наклоненной в больную сторону. Шейные и подчелюстные лимфатические узлы увеличиваются. Из-за почти полной неподвижности отечного мягкого неба голос становится гнусавым, больные с трудом принимают пищу, иногда при попытках проглотить даже жидкую пищу последняя часто вытекает из носа.<br /> <a href=\"/symptom/abscess/\" title=\"Перейти на страницу симптома абсцесс\">Абсцесс</a> может развиться в самой миндалине, но чаще он локализуется в околоминдальной клетчатке сверху или позади миндалин. <a href=\"/symptom/abscess/\" title=\"Перейти на страницу симптома абсцесс\">Абсцесс</a>, развивающийся в самой миндалине, обычно не достигает больших размеров, так как строение миндалины, пронизанной глубокими лакунами, облегчает вскрытие абсцесса в одну из лакун. <a href=\"/symptom/abscess/\" title=\"Перейти на страницу симптома абсцесс\">Абсцесс</a> миндалины проявляется краснотой, припухлостью и выпячиванием ее в полость зева, затруднения дыхания и глотания наблюдаются редко. Через 2–3 дня сглаженные, выпирающие в одном месте контуры сильно покрасневшей миндалины указывают на место образования гнойника, очень часто <a href=\"/symptom/abscess/\" title=\"Перейти на страницу симптома абсцесс\">абсцесс</a> вскрывается самостоятельно, обычно во время сна. Наиболее часто формируется верхний или передневерхний околоминдаликовый <a href=\"/symptom/abscess/\" title=\"Перейти на страницу симптома абсцесс\">абсцесс</a>, он образуется между передневерхней поверхностью нёбной дужки и миндалиной, здесь расположено наибольшее количество легко инфицируемой со стороны миндалины рыхлой клетчатки. Миндалина, покрытая воспаленной передней дужкой, постепенно отодвигается кнутри, книзу и несколько кзади. Отечность язычка и дужек бывает наибольшей при этой локализации абсцесса, наблюдается усиленное отделение слюны и вязкой слизи, отхаркивание которой сопровождается резкой болезненностью. В связи с этим больной не может очистить полость рта и глотки, появляется неприятный гнилостный <a href=\"/symptom/zapah_izo_rta/\" title=\"Перейти на страницу симптома Запах изо рта\">запах изо рта</a>. Наружный околоминдальный <a href=\"/symptom/abscess/\" title=\"Перейти на страницу симптома абсцесс\">абсцесс</a> формируется значительно реже, но отличается наиболее длительным и тяжелым течением и вызывает тяжелые осложнения. <a href=\"/symptom/abscess/\" title=\"Перейти на страницу симптома абсцесс\">Абсцесс</a> развивается кнаружи от миндалины, вызывая увеличение и болезненность под углом нижней челюсти, кпереди от грудиноключично-сосцевидной мышцы. Голова находится в вынужденном положении, наклонена в больную сторону, иногда наступает <a href=\"/symptom/trizm/\" title=\"Перейти на страницу симптома Тризм\">сведение челюстей</a> (<a href=\"/symptom/trizm/\" title=\"Перейти на страницу симптома Тризм\">тризм</a>). Резко выражены симптомы интоксикации: высокая температура, <a href=\"/symptom/golovnaya_bol/\" title=\"Перейти на страницу симптома Головная боль\">головная боль</a>. В зеве воспалительные изменения менее интенсивны, чем под углом нижней челюсти снаружи. Миндалина оттеснена к средней линии.</p>",
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"image_alt": "Ангина флегмонозная",
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"parent": null,
"block_rubric": 103,
"standards": [
4688
]
},
{
"id": 6582,
"symptoms": [
{
"id": 2691,
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{
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{
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{
"name": "Изменение вкуса"
},
{
"name": "Запахи искаженные"
},
{
"name": "Искаженный вкус"
},
{
"name": "Безвкусное"
},
{
"name": "Безвкусие"
}
],
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"lead": "Может свидетельствовать о проблемах в центральных отделах головного мозга или других серьёзных заболеваниях",
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},
{
"id": 2746,
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{
"name": "Астения"
},
{
"name": "утомляемость"
},
{
"name": "Снижение работоспособности"
},
{
"name": "Недомогание"
},
{
"name": "Усталость"
}
],
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{
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},
"code": "J01",
"name": "Острый синусит",
"icd_name": "Острый синусит",
"gender": 0,
"age_min": 0,
"age_max": 100,
"cause": [
2
],
"periodicity": 1,
"slug": "j01_ostryy_sinusit",
"lead": "Воспалительное заболевание околоносовых пазух бактериальной, вирусной, грибковой или аллергической природы. \r\n",
"description": "Острое воспаление придаточных пазух носа. Различают гайморит (воспаление слизистой оболочки верхнечелюстной (гайморовой) пазухи), фронтит (воспаление лобной пазухи), этмоидит (воспаление решетчатого лабиринта) и сфеноидит (воспаление клиновидной пазухи).",
"etiology": "<p>Основными возбудителями при остром синусите являются Streptococcus pneumoniae и Haemophilus influenzae, которые высеваются более чем в 50% случаев заболевания. Реже встречаются M. catarralis, Str. pyogenes, Staph. aureus, анаэробы, вирусы. Синусит, развившийся на фоне респираторных инфекций верхних дыхательных путей, традиционно относят к внебольничным формам заболевания. Кроме того, в последнее время выделяют нозокомиальный (внутрибольничный) синусит, возникающий после длительной тампонады полости носа, назогастрального зондирования или назотрахеальной интубации. При этой форме основные возбудители – анаэробы, группа энтеробактерий, реже золотистый стафилококк и грибы.<br></p><p><br>Острое <a href=\"/symptom/vospalenie/\" title=\"Перейти на страницу симптома воспаление\">воспаление</a> околоносовых пазух может развиться на фоне различных состояний, по происхождению выделяют следующие типы<br></p><p> Травматические<br> Вирусные (развиваются после ОРВИ);<br> Бактериальные;<br> Грибковые (чаще как суперинфекция);<br> Смешанные;<br> Аллергические<br> Медикаментозные</p>",
"pathogenesis": "<p>При остром\r\n воспалении преобладают экссудативные процессы. Первоначально, на ранних\r\n стадиях воспаления <a href=\"/symptom/vypot/\" title=\"Перейти на страницу симптома Выпот\">экссудат</a> серозный, затем слизисто–серозный, а с \r\nприсоединении бактериальной инфекции становится гнойным, содержащим \r\nбольшое количество лейкоцитов и детрита. При этом повышается \r\nпроницаемость капилляров и развивается отек слизистой оболочки.<br><br>Существует\r\n два вида синусита: острый (начинается внезапно) и хронический \r\n(длительный). Синусит часто является результатом вирусной инфекции. \r\nБольшинство синусовых инфекций проходит самостоятельно, но иногда они \r\nперетекают в бактериальную инфекцию – отек, <a href=\"/symptom/vospalenie/\" title=\"Перейти на страницу симптома воспаление\">воспаление</a> и выделение \r\nслизи, вызванные простудой, могут привести к блокировке носовых проходов\r\n и способствовать росту бактерий.<br><br>Острый синусит, и вирусный и \r\nбактериальный, может продлиться 8 недель и дольше. Хронический синусит \r\nможет привести к постоянным изменениям в мембранах слизистой оболочки, в\r\n результате которых пациент становиться более склонными к развитию \r\nсинусовых инфекций.<br></p>",
"diagnostics": "<p>Жалобы. В анамнезе присутствуют хронический отит и/или ренит. Показательна рентгенография черепа в двух проекциях.</p>",
"treatment": "<p>Консервативное. Применяются антибиотики, сосудосуживающие препараты.</p>",
"prevention": "<p><br></p>",
"clinical_picture": "<p>Температура тела повышена. Характерны <a href=\"/symptom/golovnaya_bol/\" title=\"Перейти на страницу симптома Головная боль\">головная боль</a>, давящая боль в области корня носа и переносицы, нередко отмечают отек внутренних отделов верхнего и нижнего века, гиперемию конъюнктивы на соответствующей стороне. Выделения вначале серозные, а затем гнойные. Гнойное <a href=\"/symptom/vypot/\" title=\"Перейти на страницу симптома Выпот\">отделяемое</a> в среднем носовом ходе – признак поражения передних решетчатых клеток, в верхнем носовом ходе – воспаления задних. Резко снижено обоняние, затруднено носовое дыхание. Средняя раковина в большинстве случаев увеличена, гиперемирована. При затрудненном оттоке гноя воспалительный процесс может распространяться на глазничную клетчатку.</p>",
"image": null,
"image_alt": null,
"standard_type": 1,
"danger": 18,
"published": 1,
"parent": null,
"block_rubric": 100,
"standards": [
4758,
4780,
5046,
5233
]
}
]
}
