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},
"code": "E15",
"name": "Недиабетическая гипогликемическая кома",
"icd_name": "Недиабетическая гипогликемическая кома",
"gender": 0,
"age_min": 20,
"age_max": 75,
"cause": [
0
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"slug": "e15_nediabeticheskaya_gipoglikemicheskaya_koma",
"lead": " Заболевание, характеризующееся приступами гипогликемии, обусловленными абсолютным или относительным повышением уровня инсулина.\r\n",
"description": "",
"etiology": "<p>Опухоли островков Лангерганса (инсулиномы)</p>\r\n<p>диффузная гиперплазия бета-клеток поджелудочной железы</p>\r\n<p>заболевания ЦНС, печени, внепанк-реатические опухоли</p>\r\n<p>секретирующие инсулиноподобные вещества, опухоли (чаще соединительно-тканного происхождения), усиленно поглощающие глюкозу</p>\r\n<p>недостаточная продукция контринсулярных гормонов.<br /><br /></p>",
"pathogenesis": "<p>Гипогликемия приводит к нарушению функционального состояния ЦНС, повышению активности симпатико-адреналовой системы.<br /><br /></p>",
"diagnostics": "<p>Для диагностики проводят определение уровня сахара в крови, иммунореактивного инсулина и С-пептида (натощак и на фоне пробы с голоданием и глюкозотолерантного теста). Для топической диагностики используют ангиографию поджелудочной железы, ультразвуковое исследование, компьютерную томографию, ретроградную панкреатодуоденографию.<br /><br /></p>",
"treatment": "<p>Лечение инсулиномы и опухолей других органов, обусловливающих развитие гипогликемических состояний, хирургическое. При функциональном гиперинсулинизме назначают дробное питание с ограничением углеводов, кортикостероиды (преднизолон по 5-15 мг/сут). Приступы гипогликемии купируют внутривенным введением раствора глюкозы.</p>",
"prevention": "",
"clinical_picture": "<p>Начало приступа характеризуется ощущением голода, потливостью, слабостью, дрожанием конечностей, тахикардией, чувством страха, бледностью, диплопией, парестезиями, психическим возбуждением, немотивированными поступками, дезориентацией, дизартрией; в дальнейшем наступают <a href=\"/symptom/obmorok/\" title=\"Перейти на страницу симптома Обморок\">потеря сознания</a>, клинические и тонические судороги, иногда напоминающие эпилептический припадок, <a href=\"/symptom/koma/\" title=\"Перейти на страницу симптома Кома\">кома</a> с гилотермией и гипорефлексией. Иногда приступы начинаются с внезапной потери сознания. В межприступном периоде появляются симптомы, обусловленные поражением ЦНС: снижение памяти, эмоциональная неустойчивость, <a href=\"/symptom/prostraciya/\" title=\"Перейти на страницу симптома Прострация\">безразличие</a> к окружающему, потеря профессиональных навыков, нарушения чувствительности, парестезии, симптомы пирамидной недостаточности, патологические рефлексы.<br /><br /></p>",
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5132
]
},
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