ВОзвращает список болезней. Можно фильтр/искать

search, age, gender, parent, symptoms, sort_name, sort_by, rand, branches
GET /disease/?format=api&ordering=-icd_name&page=566
HTTP 200 OK
Allow: GET, HEAD, OPTIONS
Content-Type: application/json
Vary: Accept

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            "etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Основными причинами развития заболевания являются:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">офтальмологические заболевания (глаукома, увеит, ретинит, неврит зрительного нерва, миопия, менингиома, глиома зрительного нерва, локальный орбитальный васкулит и др.)</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">заболевания центральной нервной системы (опухоли головного мозга, гнойно-воспалительные заболевания, абсцессы, менингит, рассеянный склероз и др.)</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">общие, инфекционные, аутоиммунные заболевания (гипертония, атеросклероз системная красная волчанка, болезнь Такаясу, гранулематоз Вегенера, грипп, сифилис и др.)</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">интоксикации (например, лекарственными препаратами, алкоголем, никотином)</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">механические повреждения</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">наследственность</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p>&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При развитии заболевания происходят деструктивные изменения в нервных волокнах, они замещаются глиозной и соединительной тканью.</span></p>",
            "pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Атрофия зрительного нерва возникает в результате патологических изменений в сетчатке и самом зрительном нерве. В зависимости от причины заболевания повреждение зрительного нерва проходит в условиях воспалительного процесса, сосудистых нарушений, интоксикации, травмы, застоя с некоторыми отличиями. Иногда причина атрофии остаётся невыявленной.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Сам механизм развития заболевания заключается в деструкции (повреждении) нервных волокон. Они замещаются соединительной и глиозной тканью. Происходит заращение капилляров, питающих зрительный нерв, в результате чего происходит его истончение.</span></p>\r\n<p>&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При длительном течении процесса и отсутствии своевременного лечения, которое требуется провести в ближайшие сроки, изменения в зрительном нерве становятся необратимыми. Это может привести к полной слепоте глаза.</span></p>",
            "diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При обследовании пациентов с атрофией зрительного нерва необходимо выяснить наличие сопутствующих заболеваний, факт приема медикаментов и контакта с химическими веществами, наличие вредных привычек, а также жалоб, свидетельствующих о возможных интракраниальных поражениях.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При физикальном обследовании офтальмолог определяет отсутствие или наличие экзофтальма, исследует подвижность глазных яблок, проверяет реакцию зрачков на свет, роговичный рефлекс. Обязательно проводится проверка остроты зрения, периметрия, исследование цветоощущения.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Основную информацию о наличии и степени атрофии зрительного нерва получают с помощью офтальмоскопии.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Электрофизиологическое исследование (ЗВП) выявляет снижение лабильности и повышение пороговой чувствительности зрительного нерва. При глаукоматозной форме атрофии зрительного нерва с помощью тонометрии определяется повышение внутриглазного давления. Патология глазницы выявляется с помощью обзорной рентгенографии орбиты. Обследование сосудов сетчатки проводится с помощью флуоресцентной ангиографии. Исследование кровотока в глазничной и надблоковой артериях, интракраниальном участке внутренней сонной артерии производится с помощью ультразвуковой допплерографии.</span></p>\r\n<p>&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При атрофии зрительного нерва, обусловленной инфекционной патологией, информативны лабораторные тесты: ИФА и ПЦР-диагностика, при атрофии наследственного генеза - генодиагностика.</span></p>\r\n<p><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">&nbsp;</span></p>",
            "treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Поскольку атрофия зрительного нерва в большинстве случаев не является самостоятельным заболеванием, а служит следствием других патологических процессов, ее лечение необходимо начинать с устранения причины. Пациентам с интракраниальными опухолями, внутричерепной гипертензией, аневризмой сосудов головного мозга и др. показана нейрохирургическая операция.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Неспецифическое консервативное лечение атрофии зрительного нерва направлено на максимально возможное сохранение зрительной функции. С целью уменьшения воспалительной инфильтрации и отека зрительного нерва проводятся пара-, ретробульбарные инъекции р-ра дексаметазона, внутривенные вливания р-ра глюкозы и кальция хлорида, внутримышечное введение мочегонных препаратов (фуросемида).</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для улучшения кровообращения и трофики зрительного нерва показаны инъекции пентоксифиллина, ксантинола никотината, атропина (парабульбарно и ретробульбарно); внутривенное введение никотиновой кислоты, эуфиллина; витаминотерапия (В2, В6,В12), инъекции экстракта алоэ или стекловидного тела; прием циннаризина, пирацетама, рибоксина, АТФ и др. В целях поддержания низкого уровня внутриглазного давления проводятся инстилляции пилокарпина, назначаются мочегонные средства.</span></p>\r\n<p>&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В случае отсутствия противопоказаний при атрофии зрительного нерва назначается иглорефлексотерапия, физиотерапия (электрофорез, ультразвук, лазеро- или электростимуляция зрительного нерва, магнитотерапия, эндоназальный электрофорез и др.).</span></p>",
            "prevention": "<p>&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для предотвращения атрофии зрительного нерва необходимо своевременное лечение глазных, неврологических, ревматологических, эндокринных, инфекционных заболеваний; предупреждение интоксикаций, своевременное переливание крови при профузных кровотечениях. При первых признаках нарушения зрения необходима консультация окулиста.</span></p>",
            "clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Выделяют первичную и вторичную атрофию зрительного нерва.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При первичном поражении диск зрительного нерва бледнеет, при этом имеет четкие границы, происходит образование плоской экскавации, сужение артерий сетчатки, концентрическое сужение поля зрения.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Вторичное поражение зрительного нерва формируется как следствие воспалительных или застойных явлений, диск зрительного нерва бледный, с нечеткими границами, происходит расширение вен сетчатки. По мере развития заболевания клиническая картина напоминает первичное поражение зрительного нерва.</span></p>\r\n<p>&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">У больного обычно снижена реакция зрачка на свет, сужено поле зрения, нарушено восприятие цвета. Пациенты жалуются на снижение остроты зрения, которое может постоянно прогрессировать либо стабилизироваться на определенном уровне. Возможна полная утрата зрения.</span></p>",
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            "lead": "нарушение проходимости полости носа, связанное с ее полным или частичным заращением соединительной, хрящевой или костной тканью",
            "description": "",
            "etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Врожденная атрезия хоан связана с нарушением эмбрионального развития в первые месяцы беременности. Она развивается в результате задержки или прерывания процесса отделения носовой полости от глотки. Первоначально разделение носа и глотки происходит образующейся между ними мезенхимальной мембраной, которая в последующем рассасывается, оставляя после себя отверстия &mdash; носовые хоаны. Сохранение мембраны или ее замещение костной тканью приводит к возникновению атрезии хоан.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">К причинам, способным вызвать внутриутробное формирование атрезии хоан, в отоларингологии относят хронические заболевания матери (хронический пиелонефрит, бронхит, сахарный диабет и пр.), перенесенные ею в период беременности инфекции (корь, краснуха, грипп, хламидиоз, токсоплазмоз, микоплазмоз), прием медикаментов с эмбриотоксическим действием (барбитураты, антибиотики и т. п.), воздействие ионизирующего излучения и других тератогенных факторов. Также прослеживается генетическая предрасположенность к возникновению атрезии хоан.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Приобретенная атрезия хоан чаще всего наблюдается после серьезных травм и ожогов носа. Она обусловлена развитием в процессе заживления тканей полости носа соединительнотканных рубцов. В некоторых случаях атрезия хоан развивается в результате рубцевания после перенесенного гнойно-воспалительного процесса в полости носа. Она может возникнуть вследствие сифилиса, дифтерии, скарлатины, кори, системной красной волчанки.</span></p>",
            "pathogenesis": "",
            "diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для диагностики используют следующие методы:</span></p>\r\n<p>&nbsp;</p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li style=\"list-style-type: disc; font-size: 7.5pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">анализ анамнеза;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7.5pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">осмотр полости носа, который проводят с целью установить дифференциальный диагноз с нарушением проходимости носа вследствие попадания в отверстия хоан инородных тел и осмотра слизистой оболочки полости носа;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7.5pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">зондирование носа с целью определить локализацию атрезии и её характер;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7.5pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">эндоскопия полости носа используется как определяющий визуализирующий инструментальный метод диагностики атрезии хоан;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7.5pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">компьютерная томография с послойными снимками для определения характера патологических изменений в полости носа;</span></p>\r\n</li>\r\n</ul>",
            "treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Устранение атрезии хоан проводится хирургическим путем. Операция по восстановлению просвета хоан называется хоанотомия. При двухсторонней полной атрезии операция проводится в экстренном порядке, так как ребенок не может есть без носового дыхания. В случаях частичной и односторонней атрезии сроки операции назначаются индивидуально, в зависимости от состояния ребенка и степени нарушения носового дыхания. Обнаруженные атрезии в более старшем возрасте оперируются в плановом порядке.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Существует несколько доступов при операции хоанотомия:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li style=\"list-style-type: disc; font-size: 8.5pt; font-family: Verdana; color: #545454; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">через полость носа (применяется у новорожденных);</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 8.5pt; font-family: Verdana; color: #545454; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">через верхнюю челюсть (если необходимо вскрыть также и верхнечелюстную пазуху при воспалении в ней. Не используется у новорожденных и детей младшего возраста, так как могут быть повреждены зачатки зубов);</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 8.5pt; font-family: Verdana; color: #545454; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">через твердое небо (обеспечивает хороший доступ, по отдаленным результатам наиболее предпочтительный у детей старшего возраста).</span></p>\r\n</li>\r\n</ul>\r\n<p>&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В послеоперационном периоде в полости носа длительно находятся дренажные трубки для формирования просвета хоан. Проводится регулярный туалет носовой полости, закапывание сосудосуживающих капель, антисептиков, удаляются корки и фибрин. Это важно для хорошего заживления. Полное формирование хоан и восстановление носового дыхания происходит за 1-2 месяца.</span></p>",
            "prevention": "<p>&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Профилактические мероприятия по предотвращению врожденных патологий имеют большое значение. Прежде всего, постановка будущей мамы на учет у врача гинеколога. Проведение различных диагностических мероприятий (УЗИ, генетический скрининг и т.д.), позволяет выявить нарушения в развитии плода на самых ранних сроках беременности.</span></p>",
            "clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Симптомы заболевания напрямую зависят от формы патологического процесса. Так односторонняя атрезия хоан часто протекает бессимптомно или симптомы неярко выражены. Такую патологию можно обнаружить не сразу. Напротив, двусторонняя или полная атрезия хоан имеет ряд весьма характерных симптомов. Среди них:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li style=\"list-style-type: disc; font-size: 7.5pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">при полной атрезии у новорождённого ребенка наблюдается отсутствие носового дыхания, и ребенок может дышать только ртом;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7.5pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">при одностороннем процессе носовое дыхание затруднено;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7.5pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">дыхание малыша шумное;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7.5pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">полная или частичная невозможность кормления;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7.5pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">нормально дышать ребенок может только когда не спит и плачет из-за несформированного рефлекса ротового дыхания;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7.5pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">характерные выделения из носа.</span></p>\r\n</li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Если носовое дыхание невозможно, то малышу показана интубация сразу после родов и немедленная операция. В противном случае, у малыша быстро развивается гипоксия (недостаточное количество кислорода как в организме в целом, так и в отдельных органах и тканях), а в некоторых особо тяжелых случаях &mdash; асфиксия (удушье). Такое состояние может стать причиной смерти новорождённого.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При односторонней атрезии симптомы могут быть обнаружены у ребенка не сразу, но ещё в младенческом возрасте у малыша наблюдаются явления затрудненного носового дыхания, гнойные или слизистые выделения из одной половины полости носа. При возникновении подозрений родителям малыша нужно срочно обратиться к отоларингологу или врачу общей практики.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Двусторонняя частичная атрезия может стать причиной хронической гипоксии. Из-за постоянного нарушения кислородного насыщения органов и тканей у ребенка может появиться ряд нарушений физического и психического развития (атипичное формирование лицевого скелета, неправильное прорезывание зубов, отставание в умственном развитии ребенка и т.д.).</span></p>\r\n<p>&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">У взрослых пациентов симптомами частичной атрезии являются затрудненное носовое дыхание, нарушение обоняния и гнойно-слизистое отделяемое из поражённого носового отверстия. У пациента образуется своеобразная пробка из слизи, которая непроизвольно изливается при наклоне головы вниз.</span></p>",
            "image": null,
            "image_alt": null,
            "standard_type": 0,
            "danger": 60,
            "published": 1,
            "parent": 7108,
            "block_rubric": 179,
            "standards": []
        },
        {
            "id": 14256,
            "symptoms": [],
            "alternative_names": [],
            "complications": [],
            "medicine_branches": [],
            "who": [
                {
                    "id": 11754,
                    "gender": 1,
                    "diseased": 213106,
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            "lead": "врожденный порок, при котором отсутствует прямое сосудистое сообщение между правым желудочком и системой легочной артерии",
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            "etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Порок формируется на эмбриональном этапе внутриутробного развития ребенка. Точные причины появления атрезии не установлены. Главными этиологическими факторами считаются тератогенные воздействия на организм матери в первом триместре беременности. Эти причины провоцируют генные мутации, нарушения дифференцировки органов и тканей. Все неблагоприятные факторы разделяют на 3 группы с учетом их природы:</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Физические воздействия. Формированию кардиальных пороков способствует ионизирующее излучение и повышенный радиационный фон. Вероятность атрезии увеличивается при проживании женщины на территории, пострадавшей от аварии на ЧАЭС.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Химические вещества. Тератогенное влияние оказывает ряд медикаментов: цитостатики и иммуносупрессоры, некоторые антибиотики, ингибиторы АПФ. К химическим факторам также относят никотин, употребление алкоголя в период беременности.</span></p>\r\n<p>&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Биологические агенты. Ряд вирусов и бактерий, которые инфицируют организм беременной в I триместре, вызывают нарушения внутриутробного развития. Чаще всего грубые аномалии возникают при заболеваниях из группы TORCH &mdash; токсоплазмозе, краснухе, цитомегаловирусной инфекции.</span></p>\r\n<p><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">&nbsp;</span></p>",
            "pathogenesis": "<p>&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Патофизиологической основной болезни является нарушение оттока крови из правого желудочка в легочную артерию, из-за чего не формируется правильный малый круг кровообращения. В зависимости от варианта атрезии кровь может сбрасываться в систему легочных сосудов через коллатеральные артерии или открытый артериальный проток. Наблюдается хроническая ишемия миокарда правого желудочка, определяются эластоз и фиброэластоз сердечной мышцы.</span></p>",
            "diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Постановка диагноза начинается с врачебного осмотра. Используя стетоскоп, врач тщательно прослушивает сердце. В случае каких-либо отклонений в сердечной деятельности можно услышать шумы. Подробный опрос о симптоматике и особенностях течения заболевания, изучение семейной истории болезней помогают врачу поставить предварительный диагноз.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При дальнейшем диагностировании применяются следующие виды исследований:</span></p>\r\n<p>&nbsp;</p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #808080; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">электрокардиография &mdash; позволяет выявить признаки перегрузки сердца, в том числе правых его отделов, и определить наличие гипертрофии правого желудочка;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #808080; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">рентгенография грудной клетки &mdash; помогает определить увеличение размера сердечной ткани, а также характерные изменения в легочном рисунке;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #808080; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">эхокардиограмма &mdash; исследование способно определить степень нарушения в строении правого желудочка, а также выявить недостаточность трехстворчатого клапана и открытого артериального потока. Картирование в цвете дает визуализацию патологического тока крови, определяет его скорость и объем;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #808080; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">фонокардиография &mdash; регистрирует патологические шумы, обусловленные нарушением гемодинамики. Таким способом можно выявить шум трикуспидальной регургитации;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #808080; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">катетеризация полостей сердца &mdash; данное инвазивное исследование направлено на выполнение прямой манометрии, что позволяет определить давление в обоих желудочках, а также других отделах сердца;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #808080; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">ангиокардиография &mdash; рентгенографическое исследование, позволяющее избирательно изучить отделы сердца и крупные сосуды. В ходе процедуры в кровоток в исследуемой области вводится контрастное вещество, заполняющее просветы сосудов и полости сердца, что позволяет получить изображение с четкими контурами.</span></p>\r\n</li>\r\n</ul>",
            "treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Любой из анатомических вариантов атрезии легочной артерии является абсолютным показанием к оперативному вмешательству, которое проводится в максимально ранние сроки, чаще на первом году жизни ребенка. Перед кардиохирургическим вмешательством назначается медикаментозная терапия антикоагулянтами, антиаритмическими препаратами. Существует 2 варианта оперативного лечения порока:</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Радикальная коррекция. Вмешательство допустимо при удовлетворительном клинико-функциональном состоянии больных. Операция эффективна, если система легочной артерии достаточно развита (атрезии I и II типов) и отсутствуют признаки гипоплазии желудочков сердца.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Паллиативная операция. Хирургический метод направлен на улучшение объема легочного кровотока и стабилизацию состояния ребенка. Паллиативные вмешательства в кардиохирургии предполагают создание системно-легочных анастомозов. В дальнейшем возможно выполнение радикальной коррекции.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Даже после радикальных оперативных вмешательств показан длительный реабилитационный период. Пациенты находятся на лечении в кардиохирургическом стационаре, после чего отправляются на долечивание в амбулаторных условиях. После стабилизации гемодинамики и исчезновения симптомов детям рекомендовано санаторно-курортное лечение. Всех больных ставят на пожизненный диспансерный учет.</span></p>",
            "prevention": "<p>&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Меры первичной профилактики не разработаны.</span></p>",
            "clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Атрезия легочных сосудов относится к &laquo;синим&raquo; сердечным порокам, клинически проявляется сразу после того, как ребенок родился. У новорожденного заметен акроцианоз или диффузный цианоз, на выраженность которого влияют тип атрезии и количество коллатеральных сосудов. Синюшность кожи усугубляется при крике или плаче. Одышка отмечается даже в покое, она значительно усиливается при кормлении ребенка, активных движениях руками, ползании.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">У детей после года наблюдается резкая слабость и одышка при попытке ходьбы. Они могут сделать всего несколько шагов, а затем останавливаются, чтобы отдохнуть и перевести дыхание. Для облегчения состояния дети садятся на корточки. При атрезии легочной артерии характерен медленный прирост массы тела, гипотрофия мышечной ткани. У длительно болеющих пациентов грудная клетка приобретает бочкообразную форму.</span></p>",
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}