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},
"code": "B69",
"name": "Цистицеркоз",
"icd_name": "Цистицеркоз",
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7
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"lead": "Цистицеркоз - паразитарное заболевание человека, вызываемое личинками свиного цепня - цистицерками.",
"description": "Цистицеркоз - паразитарное заболевание человека, вызываемое личинками свиного цепня - цистицерками. В данном случае человек становится промежуточным факультативным хозяином гельминта. ",
"etiology": "",
"pathogenesis": "<p>Заражение цистицеркозом происходит при попадании в желудок яиц, онкосфер свиного цепня, развивающихся в организме человека так же, как у основного промежуточного хозяина - свиньи. В желудке под действием пепсина оболочка онкосфер разрушается, освободившиеся шестикрючные зародыши активно вбуравливаются в стенку кишки, попадают в кровеносные суды и гематогенно разносятся по организму, оседая в различных органах, где онкосферы превращаются в цистицерки. Цистиц представляет собой прозрачный пузырек величиной в диаметром от просяного зерна до 1,5 см, наполненный жидкостью, со сколексом внутри. Чаще всего, по мнению многих исследователей цистицеркоз поражает центральную нервную систему (74,5 - 82%), глаза и мышцы. <br /><br />Известны два пути заражения цистицеркозом - экзогенный и эндогенный. При экзогенном заражении онкосферы попадают извне. Так, больные тениозом могут заразиться через собственные грязные руки, лаборанты - в случаях нарушения правил работы с исследуемым материалом, а также любой человек через овощи, ягоды, фрукты, загрязненные онкосферами при удобрении почвы огородов и ягодников необезвреженными нечистотами, инвазированными свиным цепнем. <br /><br />Эндогенным путем заражаются только больные тениозом при антиперистальтике, попадании члеников свиного цепня из кишечника в желудок с последующим их перевариванием и освобождением десятков тысяч яиц. В этих случаях инвазия очень интенсивна. Причины антиперистальтики различны: любое пищевое <a href=\"/symptom/ostraya_intoksikaciya/\" title=\"Перейти на страницу симптома Острая интоксикация\">отравление</a>, алкогольное опьянение, выход из состояния наркоза, а также введение зонда и др. <br /><br />Цистицерки оказывают местное и общее влияние на организм: местное обусловлено механическим их действием и локализацией, а общее связано с поступлением в кровь и ликвор токсических продуктов жизнедеятельности личинок. Наиболее выраженное влияние связано с процессом отмирания цистицерка, усилением рубцово-сморщивающих процессов в его теле и его обызвествлением. В зависимости от локализации различают цистицеркоз мозга, глаза и мышц.</p>",
"diagnostics": "<p>Для цистицеркоза мозга типично клиническое течение болезни, характеризующееся внезапными обострениями и длительными ремиссиями, полиморфизмом неврологической симптоматики с превалированием симптомов раздражения, лимфоидно-нейтрофильным плеоцитозом ликвора (в 93%), эозинофилией крови (не всегда). При его диагностировании также учитываются рентгенологические данные (краниография, рентгенография, энцефало- и вентрикулография, ангиография), результаты серологического исследования - РСК, ELISA, НРИФ, РНГА. <br /><br />Диагноз цистицеркоза кожи, мышц можно поставить на основании биопсии узелков и рентгенографии обызвествленных цистицерков. <br /><br />Цистицеркоз глаза можно определить в результате офтальмоскопии.</p>",
"treatment": "<p>При поражении мягких тканей цистицерками, если они не вызывают механического раздражения и исключено поражение ЦНС и глаз, лечение не проводится, больной остается под наблюдением. Это связано с тем, что специфические препараты вызывают гибель паразитов, продукты распада которых могут давать тяжёлые побочные реакции аллергического характера. <br /><br />Лечение цистицеркоза глаза и единичных цистицерков головного мозга хирургическое. Дополнительно - этиотропная терапия в течение 15 дней перорально на фоне применения дексаметазона по 4-16 мг в сутки. Этиотропная терапия проводится также в неоперабельных случаях цистицеркоза головного мозга. </p>",
"prevention": "<p>Профилактикой цистицеркозов является успешная борьба с тениозом и соблюдение мер личной профилактики.</p>",
"clinical_picture": "<p>Цистицеркоз мозга. По особенностям клиники выделяют следующие четыре формы этого заболевания: <br />1. цистицеркоз больших полушарий; <br />2. цистицеркоз желудочковой системы; <br />3. цистицеркоз основания; <br />4. смешанный цистицеркоз. <br /><br />При первой форме инвазия проявляется симптомами повышенного внутричерепного давления вследствие нарушения ликворооттока (больные жалуются на приступообразные головные боли, <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">головокружение</a>, рвоту; нередко у них выявляется застойный сосок зрительного нерва). Частым симптомом ее являются эпилептические припадки. <br /><br />Наиболее распространенной формой желудочкового цистицеркоза является цистицеркоз IV желудочка. Ему свойственно внезапное и бурное начало, характеризующееся приступами головных болей с рвотой. Типичны для этой формы заболевания брунсовские приступы, связанные с изменением положения головы. У большинства больных наблюдается вынужденное положение тела, так как перемена позы вызывает резкое обострение головной боли и рвоту. <br /><br />Клиника цистицеркоза основания мозга также вариабельна проявляется нарушением ликвороциркуляции. Довольно часто отмечаются вынужденное положение головы, боли в затылочно-шейной области, снижение вкусовой чувствительности, слуха и вестибулярной возбудимости. Могут возникать чувствительные и двигательные расстройства, вплоть до парезов. В 1/5 части случаев заболевания наблюдаются различные психические нарушения. <br /><br />Смешанная форма цистицеркоза мозга протекает тяжело прогноз ее неблагоприятный. Наиболее типичны для нее эпилептический симптомокомплекс, грубые психические нарушения, галлюцинации и др.; спинной мозг поражается редко. <br /><br />Цистицеркоз глаза. Цистицерки могут локализоваться во всех оболочках глаза, что клинически проявляется различным по тяжести и характеру нарушением зрения, до полной его потери, чувством давления и боли. <br /><br />Наиболее прогностически и клинически благоприятной формой является цистицеркоз кожи, подкожной клетчатки, мышц. <br /><br />Цистицеркоз кожи. <br />При расположении личинок в подкожном жировом слое возникают опухолевидные образования, возвышающиеся над поверхностью кожи, при их пальпации можно определить полостный характер опухолей. Наиболее частая локализация: внутренние поверхности плеч, верхняя половина грудной клетки, ладони. <br /><br />Болезнь сопровождается выраженной эозинофилией в крови (до 40%), крапивницей. <br /><br />Цистицеркоз кожи, мышц протекает бессимптомно. <br /><br />Цистицеркоз сердца. <br />При локализации паразитов в сердце, в области предсердно-желудочного пучка, нарушается сердечный ритм. <br /><br />Цистицеркоз лёгких. <br />Цистицеркоз легких в большинстве случаев, протекает без выраженных клинических симптомов и обнаруживается случайно при рентгенологическом исследовании. На рентгенограмме видны круглые тени, в основном интенсивные с четкими границами величиной от зерна перца до маленькой вишни. Эти тени, как правило, разбросаны в обоих легочных полях, число их может быть различным от нескольких единиц до нескольких десятков. Очаги паразитов могут быть частично или полностью обызвествлены.</p>",
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{
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