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"id": 16,
"disease_count": null,
"name": "клиническая лабораторная диагностика",
"code": "B16",
"branch_medicine_code": "016",
"slug": "klinicheskaya_laboratornaya_diagnostika",
"lead": "Область медицины, включающая в себя лечение 2214 заболеваний. В 886 клиниках России оказывается помощь по этому направлению медицины.",
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},
{
"id": 26,
"disease_count": null,
"name": "общая врачебная практика (семейная медицина)",
"code": "B26",
"branch_medicine_code": "026",
"slug": "obschaya_vrachebnaya_praktika_semeynaya_medicina",
"lead": "Область медицины, включающая в себя лечение 151 заболевания. В 203 клиниках России оказывается помощь по этому направлению медицины.",
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{
"id": 58,
"disease_count": null,
"name": "эндокринология",
"code": "B58",
"branch_medicine_code": "058",
"slug": "endokrinologiya",
"lead": "Область медицины, включающая в себя лечение 730 заболеваний. В 623 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 6,
"disease_count": null,
"name": "генетика",
"code": "B6",
"branch_medicine_code": "006",
"slug": "genetika",
"lead": "Область медицины, включающая в себя лечение 284 заболеваний. В 37 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 15,
"disease_count": null,
"name": "кардиология, детская кардиология",
"code": "B15",
"branch_medicine_code": "015",
"slug": "kardiologiya_detskaya_kardiologiya",
"lead": "Область медицины, включающая в себя лечение 634 заболеваний. В 731 клинике России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 52,
"disease_count": null,
"name": "ультразвуковая диагностика",
"code": "B52",
"branch_medicine_code": "052",
"slug": "ultrazvukovaya_diagnostika",
"lead": "Область медицины, включающая в себя лечение 515 заболеваний. В 980 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 4,
"disease_count": null,
"name": "гастроэнтерология",
"code": "B4",
"branch_medicine_code": "004",
"slug": "gastroenterologiya",
"lead": "Область медицины, включающая в себя лечение 211 заболеваний. В 341 клинике России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 8,
"disease_count": null,
"name": "дерматовенерология и косметология",
"code": "B8",
"branch_medicine_code": "008",
"slug": "dermatovenerologiya_i_kosmetologiya",
"lead": "Область медицины, включающая в себя лечение 376 заболеваний. В 728 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 13,
"disease_count": null,
"name": "диетология",
"code": "B13",
"branch_medicine_code": "013",
"slug": "dietologiya",
"lead": "Область медицины, включающая в себя лечение 114 заболеваний. В 600 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 25,
"disease_count": null,
"name": "нефрология",
"code": "B25",
"branch_medicine_code": "025",
"slug": "nefrologiya",
"lead": "Область медицины, включающая в себя лечение 175 заболеваний. В 146 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 31,
"disease_count": null,
"name": "педиатрия",
"code": "B31",
"branch_medicine_code": "031",
"slug": "pediatriya",
"lead": "Область медицины, включающая в себя лечение 647 заболеваний. В 2328 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 29,
"disease_count": null,
"name": "офтальмология",
"code": "B29",
"branch_medicine_code": "029",
"slug": "oftalmologiya",
"lead": "Область медицины, включающая в себя лечение 851 заболевания. В 696 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 1,
"disease_count": null,
"name": "акушерство и гинекология",
"code": "B1",
"branch_medicine_code": "001",
"slug": "akusherstvo_i_ginekologiya",
"lead": "Область медицины, включающая в себя лечение 739 заболеваний. В 1042 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 53,
"disease_count": null,
"name": "урология, детская урология андрология",
"code": "B53",
"branch_medicine_code": "053",
"slug": "urologiya_detskaya_urologiya_andrologiya",
"lead": "Область медицины, включающая в себя лечение 430 заболеваний. В 596 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 3,
"disease_count": null,
"name": "анестезиология и реаниматология",
"code": "B3",
"branch_medicine_code": "003",
"slug": "anesteziologiya_i_reanimatologiya",
"lead": "Область медицины, включающая в себя лечение 1066 заболеваний. В 376 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 5,
"disease_count": null,
"name": "гематология",
"code": "B5",
"branch_medicine_code": "005",
"slug": "gematologiya",
"lead": "Область медицины, включающая в себя лечение 984 заболеваний. В 69 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 28,
"disease_count": null,
"name": "оториноларингология",
"code": "B28",
"branch_medicine_code": "028",
"slug": "otorinolaringologiya",
"lead": "Область медицины, включающая в себя лечение 685 заболеваний. В 631 клинике России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 37,
"disease_count": null,
"name": "пульмонология",
"code": "B37",
"branch_medicine_code": "037",
"slug": "pulmonologiya",
"lead": "Область медицины, включающая в себя лечение 145 заболеваний. В 181 клинике России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 55,
"disease_count": null,
"name": "фтизиатрия",
"code": "B55",
"branch_medicine_code": "055",
"slug": "ftiziatriya",
"lead": "Область медицины, включающая в себя лечение 204 заболеваний. В 249 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 50,
"disease_count": null,
"name": "травматология и ортопедия",
"code": "B50",
"branch_medicine_code": "050",
"slug": "travmatologiya_i_ortopediya",
"lead": "Область медицины, включающая в себя лечение 351 заболевания. В 523 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 20,
"disease_count": null,
"name": "лечебная физкультура и спортивная медицина",
"code": "B20",
"branch_medicine_code": "020",
"slug": "lechebnaya_fizkultura_i_sportivnaya_medicina",
"lead": "Область медицины, включающая в себя лечение 412 заболеваний. В 579 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
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{
"id": 27,
"disease_count": null,
"name": "онкология",
"code": "B27",
"branch_medicine_code": "027",
"slug": "onkologiya",
"lead": "Область медицины, включающая в себя лечение 354 заболеваний. В 378 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
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{
"id": 46,
"disease_count": null,
"name": "сурдология оториноларингология",
"code": "B46",
"branch_medicine_code": "046",
"slug": "surdologiya_otorinolaringologiya",
"lead": "Область медицины, включающая в себя лечение 36 заболеваний. В 23 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
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{
"id": 19,
"disease_count": null,
"name": "лабораторная генетика",
"code": "B19",
"branch_medicine_code": "019",
"slug": "laboratornaya_genetika",
"lead": "Область медицины, включающая в себя лечение 27 заболеваний. В 14 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
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{
"id": 9,
"disease_count": null,
"name": "детская онкология",
"code": "B9",
"branch_medicine_code": "009",
"slug": "detskaya_onkologiya",
"lead": "Область медицины, включающая в себя лечение 102 заболеваний. В 16 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
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{
"id": 38,
"disease_count": null,
"name": "радиология и радиотерапия",
"code": "B38",
"branch_medicine_code": "038",
"slug": "radiologiya_i_radioterapiya",
"lead": "Область медицины, включающая в себя лечение 237 заболеваний. В 15 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
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{
"id": 14,
"disease_count": null,
"name": "инфекционные болезни",
"code": "B14",
"branch_medicine_code": "014",
"slug": "infekcionnye_bolezni",
"lead": "Область медицины, включающая в себя лечение 518 заболеваний. В 499 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
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{
"id": 2,
"disease_count": null,
"name": "аллергология и иммунология",
"code": "B2",
"branch_medicine_code": "002",
"slug": "allergologiya_i_immunologiya",
"lead": "Область медицины, включающая в себя лечение 66 заболеваний. В 202 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
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{
"id": 65,
"disease_count": null,
"name": "стоматология терапевтическая",
"code": "B65",
"branch_medicine_code": "065",
"slug": "stomatologiya_terapevticheskaya",
"lead": "Область медицины, включающая в себя лечение 87 заболеваний. В 1270 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
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{
"id": 43,
"disease_count": null,
"name": "сердечно сосудистая хирургия, рентгенэндоваскулярная диагностика и лечение",
"code": "B43",
"branch_medicine_code": "043",
"slug": "serdechno_sosudistaya_hirurgiya_rentgenendovaskulyarnaya_diagnostika_i_lechenie",
"lead": "Область медицины, включающая в себя лечение 110 заболеваний. В 78 клиниках России оказывается помощь по этому направлению медицины.",
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{
"id": 64,
"disease_count": null,
"name": "стоматология и стоматология детская",
"code": "B64",
"branch_medicine_code": "064",
"slug": "stomatologiya_i_stomatologiya_detskaya",
"lead": "Область медицины, включающая в себя лечение 116 заболеваний. В 1200 клиниках России оказывается помощь по этому направлению медицины.",
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{
"id": 10,
"disease_count": null,
"name": "детская хирургия",
"code": "B10",
"branch_medicine_code": "010",
"slug": "detskaya_hirurgiya",
"lead": "Область медицины, включающая в себя лечение 171 заболевания. В 226 клиниках России оказывается помощь по этому направлению медицины.",
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{
"id": 42,
"disease_count": null,
"name": "сексология",
"code": "B42",
"branch_medicine_code": "042",
"slug": "seksologiya",
"lead": "Область медицины, включающая в себя лечение 3 заболеваний. В 9 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
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{
"id": 24,
"disease_count": null,
"name": "нейрохирургия",
"code": "B24",
"branch_medicine_code": "024",
"slug": "neyrohirurgiya",
"lead": "Область медицины, включающая в себя лечение 173 заболеваний. В 95 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
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{
"id": 40,
"disease_count": null,
"name": "ревматология",
"code": "B40",
"branch_medicine_code": "040",
"slug": "revmatologiya",
"lead": "Область медицины, включающая в себя лечение 136 заболеваний. В 177 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
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{
"id": 36,
"disease_count": null,
"name": "психиатрия наркология",
"code": "B36",
"branch_medicine_code": "036",
"slug": "psihiatriya_narkologiya",
"lead": "Область медицины, включающая в себя лечение 149 заболеваний. В 377 клиниках России оказывается помощь по этому направлению медицины.",
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"id": 57,
"disease_count": null,
"name": "хирургия, хиругия (трансплантация органов и тканей) и комбустиология",
"code": "B57",
"branch_medicine_code": "057",
"slug": "hirurgiya_hirugiya_transplantaciya_organov_i_tkaney_i_kombustiologiya",
"lead": "Область медицины, включающая в себя лечение 253 заболеваний. В 632 клиниках России оказывается помощь по этому направлению медицины.",
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"id": 49,
"disease_count": null,
"name": "торакальная хирургия",
"code": "B49",
"branch_medicine_code": "049",
"slug": "torakalnaya_hirurgiya",
"lead": "Область медицины, включающая в себя лечение 34 заболеваний. В 23 клиниках России оказывается помощь по этому направлению медицины.",
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"id": 67,
"disease_count": null,
"name": "стоматология хирургическая",
"code": "B67",
"branch_medicine_code": "067",
"slug": "stomatologiya_hirurgicheskaya",
"lead": "Область медицины, включающая в себя лечение 13 заболеваний. В 630 клиниках России оказывается помощь по этому направлению медицины.",
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{
"id": 32,
"disease_count": null,
"name": "неонатология",
"code": "B32",
"branch_medicine_code": "032",
"slug": "neonatologiya",
"lead": "Область медицины, включающая в себя лечение 54 заболеваний. В 163 клиниках России оказывается помощь по этому направлению медицины.",
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"id": 59,
"disease_count": null,
"name": "эндоскопия",
"code": "B59",
"branch_medicine_code": "059",
"slug": "endoskopiya",
"lead": "Область медицины, включающая в себя лечение 53 заболеваний. В 414 клиниках России оказывается помощь по этому направлению медицины.",
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"id": 66,
"disease_count": null,
"name": "стоматология ортопедическая",
"code": "B66",
"branch_medicine_code": "066",
"slug": "stomatologiya_ortopedicheskaya",
"lead": "Область медицины, включающая в себя лечение 6 заболеваний. В 987 клиниках России оказывается помощь по этому направлению медицины.",
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"id": 68,
"disease_count": null,
"name": "челюстно лицевая хирургия",
"code": "B68",
"branch_medicine_code": "068",
"slug": "chelyustno_licevaya_hirurgiya",
"lead": "Область медицины, включающая в себя лечение 13 заболеваний. В 42 клиниках России оказывается помощь по этому направлению медицины.",
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"id": 12,
"disease_count": null,
"name": "диабетология",
"code": "B12",
"branch_medicine_code": "012",
"slug": "diabetologiya",
"lead": "Область медицины, включающая в себя лечение 33 заболеваний. В 15 клиниках России оказывается помощь по этому направлению медицины.",
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},
"code": "N17",
"name": "Острая почечная недостаточность",
"icd_name": "Острая почечная недостаточность",
"gender": 0,
"age_min": 0,
"age_max": 100,
"cause": [
"0"
],
"periodicity": 1,
"slug": "n17_ostraya_pochechnaya_nedostatochnost",
"lead": "внезапно развивающееся полиэтиологическое состояние, которое характеризуется серьезными нарушениями функции почек",
"description": "<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;\">Острая почечная недостаточность – это потенциально обратимое, внезапно наступившее выраженное нарушение или прекращение функции почек.</span></p>",
"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;\">Преренальная (гемодинамическая) острая почечная недостаточность возникает вследствие острого нарушения гемодинамики, может развиваться при состояниях, которые сопровождаются снижением сердечного выброса (при тромбоэмболии легочной артерии, сердечной недостаточности, аритмии, тампонаде сердца, кардиогенном шоке). Нередко причиной становится уменьшение количества внеклеточной жидкости (при диарее, дегидратации, острой кровопотере, ожогах, асците, вызванном циррозом печени). Может формироваться вследствие выраженной вазодилатации при бактериотоксическом или анафилактическом шоке.</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;\">Ренальная (паренхиматозная) ОПН провоцируется токсическим или ишемическим поражением почечной паренхимы, реже - воспалительным процессом в почках. Возникает при воздействии на почечную паренхиму удобрений, ядовитых грибов, солей меди, кадмия, урана и ртути. Развивается при бесконтрольном приеме нефротоксичных медикаментов (противоопухолевые препараты, ряд антибиотиков и сульфаниламидов). Рентгенконстрастные вещества и перечисленные препараты, назначенные в обычной дозировке, могут стать причиной ренальной ОПН у больных с нарушением функции почек.</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;\">Кроме того, данная форма ОПН наблюдается при циркуляции в крови большого количества миоглобина и гемоглобина (при выраженной макрогемаглобинурии, переливании несовместимой крови, длительном сдавлении тканей при травме, наркотической и алкогольной коме). Реже развитие ренальной ОПН обусловлено воспалительным заболеванием почек.</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;\">Постренальная (обструктивная) ОПН формируется при остро возникшей обструкции мочевыводящих путей. Наблюдается при механическом нарушении пассажа мочи при двухсторонней обтурации мочеточников камнями. Реже возникает при опухолях предстательной железы, мочевого пузыря и мочеточников, туберкулезном поражении, уретритах и периуретритах, дистрофических поражениях забрюшинной клетчатки.</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 острой почечной недостаточности необходимо:</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;\">Анализ крови;</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;\">Исследование мочи;</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;\">Посев мочи;</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;\">Определение общего объема циркулирующей крови;</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;\">ЭКГ;</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;\">Артериография (при подозрении на сужение почечной артерии либо на расслаивающую аневризму брюшной аорты);</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;\">Каваграфия (при подозрении на восходящий тромбоз нижней полой вены);</span></li>\r\n<li><span style=\"background-color: transparent; font-size: 7pt; font-family: Verdana; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">УЗИ;</span></li>\r\n<li><span style=\"background-color: transparent; font-size: 7pt; font-family: Verdana; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Изотопное динамическое сканирование почек;</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;\">Томография;</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;\">Хромоцистоскопия;</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;\">Ретроградная пиелография.</span></li>\r\n</ul>\r\n<p> </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;\">В начальной фазе терапия направлена, прежде всего, на устранение причины, которая вызвала нарушение функции почек. При шоке необходимо восполнить объем циркулирующей крови и нормализовать артериальное давление. При отравлении нефротоксинами больным промывают желудок и кишечник. </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;\">Применение в практической урологии таких современных методов лечения как экстракорпоральная гемокоррекция позволяет быстро очистить организм от токсинов, которые стали причиной развития ОПН. С этой целью проводят гемосорбцию и плазмаферез. При наличии обструкции восстанавливают нормальный пассаж мочи. Для этого осуществляют удаление камней из почек и мочеточников, оперативное устранение стриктур мочеточников и удаление опухолей.</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;\">В фазе олигурии для стимуляции диуреза больному назначают фуросемид и осмотические диуретики. Для уменьшения вазоконстрикции почечных сосудов вводят допамин. Определяя объем вводимой жидкости, кроме потерь при мочеиспускании, рвоте и опорожнении кишечника, необходимо учитывать потери при потоотделении и дыхании. Пациента переводят на безбелковую диету, ограничивают поступление калия с пищей. Проводится дренирование ран, удаление участков некроза. При выборе дозы антибиотиков следует учитывать тяжесть поражения почек.</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;\">Гемодиализ назначается при повышении уровня мочевины до 24 ммоль/л, калия – до 7 ммоль/л. Показанием к гемодиализу являются симптомы уремии, ацидоз и гипергидратация. </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 заключается в своевременном лечении заболеваний и предупреждении состояний, которые могут спровоцировать ОПН.</span></p>",
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Клинически начальная фаза обычно не выявляется из-за отсутствия характерных симптомов. Циркуляторный коллапс, возникающий в этой фазе, имеет очень малую продолжительность, поэтому проходит незамеченным. Неспецифичные симптомы ОПН (сонливость, тошнота, отсутствие аппетита, слабость) замаскированы проявлениями основного заболевания, травмы или отравления.</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;\">Олигоанурическая фаза ОПН</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;\">Анурия возникает редко. Количество отделяемой мочи - менее 500 мл в сутки. Характерна выраженная протеинурия, азотемия, гиперфосфатемия, гиперкалиемия, гипернатиемия, метаболический ацидоз. Отмечается понос, тошнота, рвота. При отеке легкого вследствие гипергидратации появляется одышка и влажные хрипы. Больной заторможен, сонлив, может впасть в кому. Нередко развивается перикардит, уремический гастроэнтероколит, осложняющийся кровотечениями. Пациент подвержен инфекции вследствие снижения иммунитета. Возможен панкреатит, стоматит паротит, пневмония, сепсис.</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;\">Олигоанурическая фаза ОПН развивается в течение первых трех суток после воздействия. Позднее развитие олигоанурической фазы считается прогностически неблагоприятным признаком. Средняя продолжительность этой стадии 10-14 дней. Период олигурии может укорачиваться до нескольких часов или удлиняться до 6-8 недель. Продолжительная олигурия чаще возникает у пожилых пациентов с сопутствующей сосудистой патологией. При олигурической стадии ОПН, длящейся более месяца, необходимо провести дополнительную дифференциальную диагностику для исключения прогрессирующего гломерулонефрита, почечного васкулита, окклюзии почечной артерии, диффузного некроза коры почек.</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;\">Диуретическая фаза ОПН</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;\">Длительность диуретической фазы – около двух недель. 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]
}
