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"code": "L28",
"name": "Простой хронический лишай",
"icd_name": "Простой хронический лишай и почесуха",
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"lead": "Нарушение здоровья, относящееся к группе дерматит и экзема",
"description": "",
"etiology": "<p>Основным патогенетическим фактором является повышенная чувствительность кожи к раздражителям, по-видимому, за счет разрастания нервных окончаний, и предрасположенность к гиперплазии эпидермиса в ответ на механическую травму. В возникновении заболевания важную роль играют функциональные нарушения нервной и эндокринной систем, аллергическое состояние организма, заболевания желудочно-кишечного тракта. Указывают также на наследственную предрасположенность.</p>",
"pathogenesis": "<p>Патофизиологические процессы, лежащие в основе расстройства, неизвестны, однако могут включать нарушение восприятия и обработки нервной системой ощущения зуда. Кожа, склонная к развитию экзематозных заболеваний (например, атопического дерматита), более склонна к лихенификации.</p>",
"diagnostics": "<p>Диагноз устанавливается при осмотре. Полностью сформировавшаяся бляшка имеет внешнюю зону, состоящую из дискретных коричневатых папул, и центральной зоны, представленной сливающимися папулами, покрытыми чешуйками. К клинически похожим состояниям относятся микоз гладкой кожи, красный плоский лишай и псориаз; простой хронический лишай можно отличить от этих состояний при помощи микроскопического исследования соскоба во влажном препарате с гидроксидом калия и биопсии.</p>",
"treatment": "<p style=\"display: inline !important;\"> </p>\r\n<p>Первичная терапия пациента заключается в его обучении и разъяснении эффектов расчесывания и трения. Вторичное лечение состоит в применении глюкокортикостероидных препаратов (например, триамцинолона ацетонида, флуоцинонида); хирургической пленки, пропитанной флурандренолидом (накладывается утром и меняется на новую пленку вечером, может оказаться более предпочтительной, поскольку окклюзия предотвращает расчесывание). Маленькие зоны поражения можно обколоть (внутриочаговые инъекции) длительно действующим глюкокортикостероидным препаратом, например триамценолона ацетонидом 2,5 мг/мл (разведенным в физиологическом растворе) в дозе 0,3 мл/см2 площади очага поражения; лечение можно повторять каждую 3–4-ю неделю. Пероральный прием антигистаминных препаратов, блокирующих H1-рецепторы, может оказать положительный эффект. Мази также могут быть действенными. Крем с капсаицином местного применения может быть также полезным, но жжение в начале может сделать эту терапию неприемлемой для пациентов.<br /> <br /> Ключевые моменты</p>\r\n<ul>\r\n<li>Хроническое шелушение приводит к дальнейшему зуду, создавая порочный круг.</li>\r\n<li>Зуд, сухость, шелушение, гиперпигментированность, лихениеновые бляшки возникают неправильной овальной или угловой формы на ногах, руках, шее и верхней части туловища, а иногда в аногенитальной области.</li>\r\n<li>Диагноз устанавливается на основе результатов клинических исследований, но исследование влажного препарата с гидроксидом калия и биопсия могут помочь в дифференциальной диагностике.</li>\r\n<li>Пациенты должны быть осведомлены о замкнутом круге, который начинается с царапин и продолжается зудом; кортикостероиды местного применения и антигистаминные препараты помогают контролировать зуд.</li>\r\n</ul>",
"prevention": "",
"clinical_picture": "<p align=\"justify\">Заболевание начинается с зуда кожи. Симптомы простого хронического лишая локализуются преимущественно на задней и боковой поверхностях шеи, в подколенных и локтевых сгибах, аногенитальной области, на внутренней поверхности бедер, в межъягодичных складках. Но очаги могут появляться и на других участках кожного покрова, в том числе на волосистой части головы. В начале кожа в местах зуда внешне не изменена. Со временем под влиянием расчесов появляются полигональные папулы плотной консистенции, местами покрытые муковидными чешуйками. Папулы сливаются и образуют бляшки овальной или округлой формы, которые имеют цвет от розового до буровато-красного. Кожа утолщается, становится грубой, выражен кожный рисунок (лихенификация). На высоте развития заболевания в очаге различают три зоны. Периферическая, или наружная, зона пигментации окружает очаг поражения в виде пояса и обычно пи наружная, ни внутренняя границы неясны. Средняя, папулезная, зона состоит из узелковых высыпаний бледно-розового, сероватого или желтоватого цвета, величиной от булавочной головки до небольшой чечевицы. Папулы неправильной формы и нерезко ограничены, почти не возвышаются над окружающей кожей. Их поверхность утолщена, гладкая и в результате расчесов часто покрыта кровянистой корочкой. Внутренняя зона характеризуется выраженной инфильтрацией кожи. Нередко эта зона является единственным проявлением в клинической картине болезни.</p>\r\n<p align=\"justify\">В практике дерматовенеролога часто встречаются следующие атипичные и редкие разновидности ограниченного нейродермита:</p>\r\n<p align=\"justify\">Депигментированный нейродермит. При длительном течении ограниченного нейродермита возникают вторичные гипопигментации (витилигоподобные изменения). Считают, что они появляются в результате расчесов. При этом часто создается впечатление, что имеется сочетание двух процессов - нейродермита и витилиго.</p>\r\n<p>Гипертрофический (бородавчатый) нейродермит. При данной форме на фоне типичной клинической картины ограниченного нейродермита имеются отдельные узелковые и даже узловатые высыпания, весьма сходные с таковыми при узловатой почесухе. Такие очаги возникают преимущественно на внутренних поверхностях бедер, по могут локализоваться и па любых других участках.</p>\r\n<p align=\"justify\">В результате сильного зуда кожи головы выпадают волосы, кожа истончается, блестит, но не атрофична, процесс не связан с фолликулярным аппаратом. Такая форма заболевания получила название декальвирующий нейродермит.</p>",
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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;\">Хронический бронхит развивается под воздействием внешних и внутренних факторов, в том числе вредных привычек. Спровоцировать болезнь способны:</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;\">сильное переохлаждение;</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;\">слабый иммунитет;</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;\">частые респираторные заболевания и хронические инфекции – запущенные формы ринитов, тонзиллитов, фарингитов;</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;\">вдыхание слишком горячего или слишком холодного воздуха;</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;\">пересушенный воздух в окружающей среде;</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;\">химический ожог дыхательной системы кислотами, щелочами, хлором и т.п.;</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;\">курение (в том числе пассивное) – токсины и смолы, проникающие в дыхательные пути, разрушают слизистые оболочки бронхов.</span></li>\r\n</ul>\r\n<p> </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 группе риска находятся работники промышленных производств, жители неблагоприятных климатических зон, курильщики, пациенты с хроническими заболеваниями и ослабленным организмом.</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;\">При хроническом бронхите железы слизистой выстилки бронхиальных стенок увеличиваются с изменением состава и количества выделяемого секрета. Слизь становится слишком вязкой, реснитчатый эпителий не справляется с естественным опорожнением бронхиального дерева, и начинается кашель. В самом эпителии при этом наблюдаются дегенеративно-дистрофические процессы, прекращается выработка естественных антибактериальных веществ, что приводит к активному развитию патогенных микроорганизмов.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">Отек, инфекция, частые кашлевые спазмы совместно могут приводить к сужению бронхиального просвета, что становится причиной функциональных нарушений дыхательной системы и кислородного голодания. В альвеолах на выдохе повышается давление, они перерастягиваются и теряют свою эластичность – все это приводит к нарушениям работы сердечно-сосудистой системы и связанным с ней осложнениям – легочному сердцу, сердечной недостаточности.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">Процесс развивается постепенно, начинаясь с легкого утреннего кашля, который, усиливаясь, перетекает в дневной и ночной. Увеличивается количество выделяемой мокроты, прогрессирует одышка – сперва она проявляется лишь при физической активности, а затем и в состоянии покоя.</span></p>\r\n<p> </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;\">Течение болезни сопровождается сменой ремиссий и обострений. При легкой латентной форме полносимптомные обострения почти не наблюдаются. В остальных случаях сложность заболевания определяется в том числе частотой и длительностью рецидивов. </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;\">В диагностике хронического бронхита существенное значение имеет выяснение анамнеза заболевания и жизни (жалоб, стажа курения, профессиональных и бытовых вредностей). Аускультативными признаками хронического бронхита служат жесткое дыхание, удлиненный выдох, сухие хрипы (свистящие, жужжащие), влажные разнокалиберные хрипы. При развитии эмфиземы легких определяется коробочный перкуторный звук. Подтверждающие методы:</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;\">Рентгенологические. Верификации диагноза способствует проведение рентгенографии легких. Рентгенологическая картина при хроническом бронхите характеризуется сетчатой деформацией и усилением легочного рисунка, у трети пациентов – признаками эмфиземы легких. Лучевая диагностика позволяет исключить пневмонию, туберкулез и рак легких. С помощью бронхографии оценивается архитектоника бронхиального дерева, исключается наличие бронхоэктазов.</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;\">Лабораторные. Микроскопическое исследование мокроты выявляет ее повышенную вязкость, сероватый или желтовато-зеленый цвет, слизисто-гнойный или гнойный характер, большое количество нейтрофильных лейкоцитов. Бактериологический посев мокроты позволяет определить микробных возбудителей (Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis, Klebsiella pneumoniae, Pseudomonas spp., Enterobacteriaceae 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;\">Эндоскопические. Степень активности и характер воспаления при хроническом бронхите уточняется в процессе диагностической бронхоскопии. При трудностях сбора мокроты показано проведение бронхоальвеолярного лаважа и бактериологического исследования промывных вод бронхов.</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;\">Функциональные. Выраженность нарушений функции внешнего дыхания определяется при проведении спирометрии. Спирограмма у пациентов с хроническим бронхитом демонстрирует снижение ЖЁЛ различной степени, увеличение МОД; при бронхиальной обструкции – снижение показателей ФЖЁЛ и МВЛ. При пневмотахографии отмечается снижение максимальной объемной скорости выдоха.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </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;\">Из лабораторных тестов при хроническом бронхите проводятся общий анализ мочи и крови; определение общего белка, белковых фракций, фибрина, сиаловых кислот, СРБ, иммуноглобулинов и др. показателей. При выраженной дыхательной недостаточности исследуются КОС и газовый состав крови.</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;\">Лечение хронического бронхита должно быть комплексным и включать лекарственные средства, физиопроцедуры, физическую активность, коррекцию образа жизни.</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;\">Медикаментозное лечение:</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;\">Антибиотики – с индивидуальным подбором препарата по итогам бактериального анализа с определением штамма возбудителя. Бесконтрольный прием подобных препаратов может усугубить состояние пациента.</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;\">Противовирусные средства – если обострение бронхита проявилось на фоне ОРВИ.</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;\">Муколитики – в период обострения способствуют выведению обильной мокроты.</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;\">Бронхорасширяющие препараты – расслабляют мускулатуру, увеличивая дыхательный просвет для лучшего отхождения мокроты и активного насыщения организма кислородом.</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;\">Иммуностимуляторы и иммуномодуляторы – для стимуляции работы иммунной системы.</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;\">Витаминные препараты для общего укрепления организма.</span></li>\r\n</ul>\r\n<p> </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 обязательном порядке назначают ингаляции лекарственными препаратами, которые позволяют действующим компонентам проникать даже в самые мелкие альвеолы. Для наибольшего удобства пациента используют специальные аппараты – небулайзеры.</span></p>",
"prevention": "<p> </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;\">Профилактическая работа по предупреждению хронического бронхита заключается в пропаганде отказа от курения, устранении неблагоприятных химических и физических факторов, лечении сопутствующей патологии, повышении иммунитета, своевременном и полном лечении острого бронхита.</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;\">Главный симптом заболевания – постоянный «мокрый» кашель. Мокрота особенно обильно отходит по утрам, и по ее состоянию можно судить об интенсивности патологического процесса:</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;\">светлая прозрачная слизь – инфекция не выражена;</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;\">слизь с небольшими гнойными вкраплениями – признак инфекционного процесса;</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;\">сплошная гнойная масса желтого или зеленоватого цвета – гнойный процесс с фиброзным изменением тканей, требуется срочная госпитализация.</span></li>\r\n</ul>\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;\">Объем мокроты может достигать 100–150 мл в сутки. При длительном процессе, а также в период явного обострения начинают проявляться симптомы интоксикации и гипоксии организма:</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;\">сильная утомляемость;</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;\">физическая слабость;</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;\">потливость, сердцебиение;</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;\">болезненные ощущения в груди;</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;\">синюшность кожных покровов;</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;\">одышка;</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;\">головные боли и головокружения;</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;\">нарушения сна.</span></li>\r\n</ul>\r\n<p> </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;\">Возможно повышение температуры до субфебрильных значений. При врачебном прослушивании работы легких четко выявляются хрипы, жесткое надсадное дыхание. При обструктивной форме может наблюдаться обструкция бронхов, когда их просвет сужается и мешает свободному прохождению воздуха.</span></p>",
"image": null,
"image_alt": null,
"standard_type": 0,
"danger": 54,
"published": 1,
"parent": 6611,
"block_rubric": 104,
"standards": [
5298
]
},
{
"id": 10012,
"symptoms": [],
"alternative_names": [],
"complications": [],
"medicine_branches": [],
"who": [
{
"id": 12022,
"gender": 1,
"diseased": 9236798,
"deaths": 19061,
"danger": 0.0,
"mortality": 0.5,
"outpatient_days": 0,
"hospital_days": 1204,
"diseased_1": 0,
"diseased_1_4": 0,
"diseased_5_9": 1690,
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"diseased_40_44": 962906,
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},
"code": "L24",
"name": "Простой раздражительный [irritant] контактный дерматит",
"icd_name": "Простой раздражительный [irritant] контактный дерматит",
"gender": 0,
"age_min": 0,
"age_max": 100,
"cause": [
0
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"periodicity": 1,
"slug": "l24_prostoy_razdrazhitelnyy_irritant_kontaktnyy_dermatit",
"lead": " воспалительная реакция кожи, возникающая в ответ на прямое воздействие раздражающих веществ (щелочей, кислот, моющих средств, растворителей, хлорной извести и т. п.).",
"description": "Не заразное кожное заболевание",
"etiology": "<p>Простой дерматит возникает от действия химических (концентрированные кислоты, щелочи), физических (высокая или <a href=\"/symptom/ponizhennaya_temperatura_32-35/\" title=\"Перейти на страницу симптома Пониженная температура 32-35°\">низкая температура</a>, лучевое воздействие), механических (давление, трение) и биологических факторов.</p>",
"pathogenesis": "",
"diagnostics": "<p>Диагноз простого контактного дерматита устанавливается дерматологом по характерным клиническим проявлениям и четко прослеживающейся связи возникновения симптомов с воздействием на кожу раздражающего вещества. При подозрении на аллергический характер контактного дерматита необходима консультация аллерголога и проведение накожных аллергических проб. Появление признаков гнойного воспаления говорит о инфицированности места поражения и является показанием для бакпосева отделяемого с обязательным составлением антибиотикограммы.</p>",
"treatment": "<p align=\"justify\">Основной принцип лечения — это определение и устранение причины появления простого контактного дерматита.</p>\r\n<p align=\"justify\">Эритематозный дерматит обычно не требует лечения и самостоятельно проходит при устранении причинного фактора. Для уменьшения симптомов воспаления возможно применение противовоспалительных присыпок или кремов. При буллезном варианте производят прокалывание крупных пузырей без удаления их покрышки. Для профилактики вторичного инфицирования смазывают область пузырей раствором перманганата калия или анилиновых красителей. В лечении некротического дерматита применяют заживляющие мази.</p>\r\n<p align=\"justify\">В тяжелых случаях острого простого контактного дерматита возможно местное применение глюкокортикоидных мазей и системное назначение малых доз кортикостероидов. Присоединение вторичной инфекции является показанием для проведения антибиотикотерапии.</p>",
"prevention": "<p>При хроническом варианте дерматита рекомендовано регулярное использование смягчающих мазей и кремов, при поражении рук — применение защитных перчаток.</p>",
"clinical_picture": "<p align=\"justify\">Клиническая дерматология выделяет острые и хронические формы простого контактного дерматита. В зависимости от характера вещества, воздействующего на кожу, и индивидуальных особенностей проницаемости эпидермиса может развиться один из трех вариантов острого контактного дерматита: эритематозный, буллезный или некротический.</p>\r\n<p align=\"justify\">Эритематозный дерматит проявляется покраснением и отеком контактировавшего с раздражителем участка кожи. Болезненность и <a href=\"/symptom/zud/\" title=\"Перейти на страницу симптома Зуд\">зуд</a> выражены слабо. Возможна <a href=\"/symptom/izmeneniya_struktury_kozhi/\" title=\"Перейти на страницу симптома Изменения структуры кожи\">сухость кожи</a> и появление на ней трещин.</p>\r\n<p align=\"justify\">Буллезный вариант простого контактного дерматита представлен пузырями различного размера, наполненными прозрачной жидкостью. Пузыри появляются на гиперемированном фоне и лопаются с образованием эрозий. Характерна болезненность, чувство жара или жжения.</p>\r\n<p align=\"justify\">Некротический дерматит возникает при воздействии едких веществ и характеризуется образованием изъязвлений, поверхность которых покрыта струпом. Выражен болевой синдром. После того, как происходит заживление язв, на коже остаются рубцы.</p>\r\n<p align=\"justify\">Хроническая форма простого контактного дерматита развивается при многократном воздействии слабого раздражителя. Наиболее часто поражается кожа рук. Заболевание, как правило, связано с использованием средств бытовой химии или профессиональной деятельностью. Хронический дерматит характеризуется усилением рисунка кожи, застойной гиперемией, инфильтрацией, сухостью кожи и гиперкератозом. В некоторых случаях наблюдаются атрофические процессы в коже. Субъективные ощущения слабо выражены и мало беспокоят больного.</p>",
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"image_alt": "Контактный дерматит",
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{
"id": 16,
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{
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"image": null
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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;\">Заболевание возникает вследствие попадания и размножения патогенных микроорганизмов в предстательной железе. Предрасполагающие факторы: сахарный диабет, ВИЧ, прием гормональных препаратов, переохлаждение, прочие инфекционно-вирусные заболевания.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">Основными причинами воспаления предстательной железы и мочевого пузыря являются:</span></p>\r\n<p> </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: #666666; 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;\">операции и медицинские манипуляции, вследствие которых происходит травмирование и присоединение вторичной инфекции. К таким манипуляциям относят трансуретральную резекцию, катетеризацию, бужирование, уретроцистоскопию, пиелоскопию, литотрипсию;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #666666; 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;\">урологические заболевания, сопровождающиеся нарушением оттока мочи;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #666666; 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;\">заболевания, передающиеся половым путем;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #666666; 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;\">лечение опухолей в малом тазу методом лучевой терапии.</span></p>\r\n</li>\r\n</ul>",
"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;\">Пути передачи инфекции при простатоцистите: восходящий (через уретру), лимфогенный и гематогенный, нисходящий (микроорганизмы попадают в слизистую пузыря, а затем в простату из почек). В ответ на контакт с возбудителем запускается каскад мезенхимально-сосудистых реакций, направленных на отграничение воспалительного очага и облегчения фагоцитоза. Гуморальные и клеточные системы защиты со временем истончаются и перестают работать.</span></p>\r\n<p> </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;\">Переохлаждение и снижение реактивности иммунитета ведет к прогрессированию воспаления в ацинусах. Их адекватное дренирование происходит только при регулярном семяизвержении, закупорка выводных протоков железы способствует персистированию патогенной микрофлоры. Следствием воспаления является нарушение микроциркуляции: снижается сосудистый тонус, замедляется кровоток, образуются микротромбы в венулах и артериолах. Ишемия и сбой биохимических процессов в простате поддерживают воспалительный процесс, который может распространяться на соседние органы: мочевой пузырь, придатки, семенные пузырьки и пр.</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;\">Для постановки диагноза врач уролог назначает пациенту следующие обследования:</span></p>\r\n<p> </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: #666666; 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;\">общий анализ мочи;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #666666; 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 секрета простаты;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #666666; 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;\">УЗИ органов мочевыделительной системы;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #666666; 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;\">трансректальное УЗИ предстательной железы;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #666666; 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;\">бакпосев секрета простаты и мочи;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #666666; 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;\">ПЦР-диагностика.</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;\">При простатоцистите на фоне поддерживающей сопутствующей патологии и при тяжелом состоянии пациента показана госпитализация в урологический стационар. Комплексное лечение включает:</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;\">Медикаментозную терапию. Кроме антибиотиков при остром процессе назначают уросептики, анальгетики и жаропонижающие. Для поддержания адекватного диуреза проводят инфузионную терапию. Обструктивные симптомы устраняют с помощью альфа-адреноблокаторов. Для нормализации обменных процессов в схему включают средства, восстанавливающие крово- и лимфообращение, поливитаминные комплексы, а для профилактики фиброза – ферментативные препараты.</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;\">Местное воздействие. Простата имеет обширную сосудистую сеть, что повышает концентрацию действующего вещества в ее тканях при трансректальном введении лекарства. В качестве местных агентов применяют суппозитории с противовоспалительным и противоотечным действием, микроклизмы с отварами трав. После купирования острого процесса возможна лазеромагнитотерапия, индуктометрия, массаж, грязевые процедуры и пр. Осуществляют инстилляции мочевого пузыря.</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;\">Оперативное лечение. Большинство пациентов не нуждаются в операции. Показаниями к вмешательству являются гнойно-деструктивный процесс в железе; часто рецидивирующий простатоцистит, устойчивый к антибактериальной терапии; фоновый гнойный простатолитиаз. Возможна открытая простатэктомия, парциальная или тотальная трансуретральная резекция простаты. При острой задержке мочи выводят эпицистостому.</span></li>\r\n</ul>\r\n<p> </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;\"> </span></p>",
"prevention": "<p> </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;\">Профилактика включает раннее выявление болезней мочеполовой сферы, превентивные меры: прием фитопрепаратов, избегание переохлаждения, сдачу анализов в плановом порядке.</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 простатоцистита можно свести к следующему списку:</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: 6.5pt; font-family: Verdana; color: #363636; 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;\">слабость и нарушения сна,</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #363636; 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;\">высокая температура при остром течении или обострении,</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #363636; 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;\">частые позывы в туалет,</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #363636; 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;\">чувство неполного опорожнения мочевого пузыря,</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #363636; 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;\">отсутствие напора у струи мочи,</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 6.5pt; font-family: Verdana; color: #363636; 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;\">изменение свойств мочи: появление осадка, запаха.</span></p>\r\n</li>\r\n</ul>\r\n<p> </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;\">Половина мужчин жалуются на ухудшение эректильной функции: нарушение потенции, раннее семяизвержение, боли во время эякуляции, смазанные ощущения оргазма. Сексуальное желание может снизиться до полного отсутствия, развития депрессии на этом фоне. При отсутствии лечения симптомы простатоцистита ухудшаются, вызывая у мужчин обструктивное бесплодие и пиелонефрит.</span></p>",
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