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"lead": "злокачественное опухолевое поражение отделов тонкого кишечника: двенадцатиперстной, тощей или подвздошной кишки.",
"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;\">Точные причины возникновения онкологических образований в тонком отделе кишечника до сих пор не выяснены. Однако достоверными данными подтверждено, что это заболевание у большинства пациентов развивается на фоне хронических патологий органов желудочно-кишечного тракта, а также при воспалительных процессах, протекающих в различных отделах кишечника. Специалисты предполагают, что возникнуть рак тонкого кишечника может вследствие следующих недугов:</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;\">дуоденит;</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;\">колит;</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;\">энтерит;</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;\">язвенная болезнь;</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;\">болезнь Крона;</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;\">целиакия;</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;\">синдром Пейтца-Егерса;</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;\">доброкачественные образования в кишечнике;</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;\">генетические патологии;</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;\">злокачественные новообразования других внутренних органов.</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;\">Риск получить диагноз возрастает при наличии вредных привычек, неправильном питании (при употреблении в пищу красного мяса, острых, жирных и копченых блюд и отсутствии в меню достаточного количества овощей и фруктов – источников пищевых волокон). Спровоцировать преобразование клеток в раковые может и радиоактивное излучение.</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;\">Диагностика с применением специального оборудования помогает достоверно установить местонахождение злокачественного образования, определить его тип и строение, степень развития и многое другое.</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;\">Наиболее информативными методами 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;\">скрининг тест на рак кишечника (кал на скрытую кровь - иммунохимический тест Colon View) помогает обнаружить онкологию на ранней стадии, так как при раке тонкого кишечника явно выраженная кровь в кале появляется только при сильном кровотечении, но чаще всего кровотечения бывают в небольшом количестве, невидимые глазом, поэтому анализ на скрытую кровь в кале, позволяет заподозрить заболевание;</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;\">фиброгастродуоденоскопия;</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;\">контрастная рентгеноскопия;</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;\">ирригоскопия;</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;\">колоноскопия;</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;\">гистологическое исследование образцов опухоли;</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;\">УЗИ брюшной полости;</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;\">МКТ брюшной полости и другие (лучше написать просто КТ брюшной полости)</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;\">Также проводят ряд дополнительных лабораторных исследований крови и мочи для определения в организме специфических антигенов, индикана и онкомаркеров.</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;\"> </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;\">При операбельности рака тонкого кишечника наиболее эффективно проведение широкой резекции пораженного участка кишки и лимфоузлов, иссечение брыжейки. Протяженность тонкого кишечника позволяет выполнять радикальное удаление опухоли в границах здоровых тканей. Целостность ЖКТ восстанавливается путем наложения энтероэнтероанастомоза (тонкой кишки в тонкую) или энтероколоанастомоза (тонкой кишки в толстую).</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;\">При раке 12-перстной кишки показана дуоденэктомия, иногда с дистальной резекцией желудка или резекцией поджелудочной железы (панкреатодуоденальная резекция). При запущенном раке тонкого кишечника, не позволяющем осуществить радикальную резекцию, производится наложение обходного анастомоза между непораженными петлями кишки. Хирургический этап лечения рака тонкого кишечника дополняется химиотерапией; этот же метод может являться единственным способом лечения неоперабельных опухолей.</span></p>",
"prevention": "<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;\">Снизить до абсолютного минимума риск возникновения рака тонкого кишечника невозможно, однако существует ряд профилактических мер, которые помогают избежать формирования опухолей в кишечнике:</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;\">Регулярно проходить профилактические осмотры в профильной клинике.</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;\">Придерживаться принципов здорового образа жизни и питания.</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;\">Вовремя и до конца лечить заболевания желудочно-кишечного тракта.</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;\">Ежегодный анализ кала на срытую кровь (тест Colon View, с помощью которого можно достоверно определить скрытую кровь в кале и выявить рак кишечника на ранней стадии).</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;\">Обращаться к врачу при появлении любых тревожных симптомов со стороны системы пищеварения.</span></li>\r\n</ul>\r\n<p> </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;\">Распознать рак тонкого кишечника, симптомы которого меняются в зависимости от стадии заболевания, поначалу очень нелегко, ведь эта разновидность заболевания отличается полным отсутствием симптоматики на начальных этапах развития патологического процесса. Заметные признаки появляются лишь тогда, когда опухоль приводит к появлению язв или сужает просвет кишки.</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;\">Симптомы ранней стадии рака:</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;\">тошнота и отрыжка;</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;\">диарея или запор;</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;\">тяжесть в желудке;</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;\">вздутие живота;</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;\">боли в животе спастического характера.</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;\">По мере роста опухоли клиническая картина расширяется, и к озвученным симптомам добавляются сложности с опорожнением из-за ложных позывов к дефекации и/или частичной или полной непроходимостью кишечника, кишечные кровотечения и сильные боли в животе.</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;\">Наряду с этим у больных возникает ряд общих симптомов:</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;\">нарастающая 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;\">утомляемость и общие недомогания;</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;\">потеря аппетита или появление отвращения к пище;</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;\">резкая потеря в весе;</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;\">анемия и возникшая вследствие нее бледность кожных покровов и слизистых;</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;\">головокружение;</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;\">стойкое повышение температуры тела до субфебрильных значений.</span></li>\r\n</ul>\r\n<p> </p>",
"image": null,
"image_alt": null,
"standard_type": 0,
"danger": 68,
"published": 1,
"parent": null,
"block_rubric": 22,
"standards": []
},
{
"id": 7929,
"symptoms": [
{
"id": 2991,
"synonyms": [
{
"name": "Болезненный живот"
}
],
"body_points": [
{
"x": 464,
"y": 4201,
"r": 605
}
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},
"code": "C23",
"name": "Рак желчного пузыря",
"icd_name": "Рак желчного пузыря",
"gender": 0,
"age_min": 50,
"age_max": 100,
"cause": [
3,
0
],
"periodicity": 4,
"slug": "c23_rak_zhelchnogo_puzyrya",
"lead": "это заболевание, при котором злокачественные (опухолевые) клетки поражают ткани желчного пузыря. ",
"description": "Рак желчного пузыря и желчевыводящих протоков встречается сравнительно редко. Рак желчного пузыря – это онкологическое заболевание, происходящее из желчного пузыря. Женщины подвержены ему в 1,5 раза больше, чем мужчины",
"etiology": "<p>раку желчного пузыря наиболее подвержены женщины. Свой негативный вклад здесь также вносит возраст человека, а также его образ жизни и питание. Повышает риск заболевания раком и наличие у пациента хронических заболеваний органов ЖКТ и наличие у него камней. С особым вниманием к своему здоровью должны относиться лица, ранее перенесшие рак других органов, здесь очень высок риск повторного развития болезни. Также не следует забывать о наследственности. Зачастую в семьях, где ранее уже встречались онкологические заболевания, формируется генетическая предрасположенность к заболеванию раком.</p>",
"pathogenesis": "",
"diagnostics": "<p>Диагноз рак желчного пузыря не может быть поставлен только на основании лабораторных анализов. Обычные рентгенологические исследования также не помогают в диагностировании рака желчного пузыря. Частые и плохо поддающиеся лечению воспаления желчного пузыря могут быть признаком наличия в нем опухоли. УЗИ или компьютерная томография (КТ) может показать утолщение стенки желчного пузыря и/или увеличенные лимфатические узлы. Различить изменения, вызванные воспалением, может быть весьма сложно.</p>\r\n<p>При обследовании на предмет распространенности рака УЗИ и КТ используют в качестве дополняющих друг друга процедур. Для диагностики рака зачастую прибегают к осмотру желчных протоков с помощью контрастного вещества. На сегодняшний день эту манипуляцию чаще всего проводят с помощью эндоскопии (внутреннего исследования) двенадцатиперстной кишки (ERC-исследование). Такое исследование, как магнитно-резонансная холангиография (МР-холангиография) на аппарате МРТ хорошо определяет непроходимость желчных протоков и показывает её локализацию.</p>",
"treatment": "<p>Наибольший эффект в деле лечения рака желчного пузыря, конечно же, дает хирургическое удаление опухоли, а также близлежащих тканей и лимфососудов. Сама операция носит название холецистэктомии и проводится с использованием лапароскопа. В ходе операции удаляется как сам желчный пузырь, так и окружающие его здоровые ткани, для предотвращения заражения больными клетками тех участков, где производились надрезы, производится резекция и этих тканей. </p>\r\n<full></full><full>Лучевая терапия может использоваться как самостоятельный вид лечения, так и в комплексе с оперативным вмешательством, например, когда требуется существенно уменьшить размеры опухоли. Благодаря высокочастотному воздействию на раковые клетки, удается прекратить их размножение, следовательно, и рост опухоли. Различают внешнюю и внутреннюю лучевую терапию. При проведении внешней терапии воздействие на опухоль оказывает прибор, испускающий радиоактивные лучи. Для внутренней же терапии радиоактивные вещества доставляются к желчному пузырю при помощи специального катетера.</full>\r\n<p>Химиотерапия, курсы которой проводятся в онкоцентре, подразделяется на общую и местную. В ходе общей терапии лекарственные препараты вводятся в кровеносную систему организма больного и разносятся по всем органам и тканям, включая пораженные раком. Это позволяет комплексно воздействовать как на пораженный орган, так и на соседние, что способствует предотвращению развития метастаз и прорастанию опухоли на другие участки. Кроме того возможно проведение регионарной химиотерапии, при которой химические препараты доставляются точечно в пораженные клетки. Преимуществом данного вида процедуры является уменьшение вредного воздействия лекарств на здоровые органы, как следствие, поддержание удовлетворительного самочувствия больного. Кроме того для повышения злокачественных клеток к действию препаратов в нашей клинике применяются радиосенсебилизаторы.</p>",
"prevention": "",
"clinical_picture": "<p><a href=\"/symptom/zheltuha/\" title=\"Перейти на страницу симптома Желтуха\">Желтуха</a>, боль и высокая температура могут свидетельствовать о раке желчного пузыря. <br />Эти и другие проявления могут быть вызваны как раком желчного пузыря, так и другими заболеваниями. При появлении одного из перечисленных симптомов следует проконсультироваться с врачом: <br />- <a href=\"/symptom/zheltuha/\" title=\"Перейти на страницу симптома Желтуха\">Желтуха</a> (желтая окраска кожи и белков глаз). <br />- Боль в верхних отделах живота. <br />- Высокая температура (<a href=\"/symptom/vysokaya_temperatura_38-42/\" title=\"Перейти на страницу симптома Высокая температура 38-42° \">лихорадка</a>). <br />- <a href=\"/symptom/toshnota/\" title=\"Перейти на страницу симптома Тошнота\">Тошнота</a> и <a href=\"/symptom/rvota/\" title=\"Перейти на страницу симптома Рвота\">рвота</a>. <br />- <a href=\"/symptom/meteorizm/\" title=\"Перейти на страницу симптома Метеоризм\">Вздутие</a> живота. <br />- Опухолевые образования в животе.</p>\r\n<full></full>\r\n<p><br /><br />Начало болезни медленное и малозаметное. Нередко клиническая картина долго маскируется проявлениями холелитиаза. Наиболее частым признаком рака желчного пузыря является боль различного характера, обычно тупая и постоянная, возникающая в результате прорастания опухоли в периневральные лимфатические пути. Стойкая тупая боль в правом подреберье у пожилых людей подозрительна на рак желчного пузыря, особенно если она сопровождается субфебрилитетом. Наряду с болями ухудшается аппетит, развиваются диспепсические явления, похудание. <a href=\"/symptom/zheltuha/\" title=\"Перейти на страницу симптома Желтуха\">Желтуха</a> возникает почти в половине случаев. <br /><br />Наиболее характерный признак рака желчного пузыря - прощупываемая плотная бугристая опухоль в правом подреберье. Печень нередко увеличена, иногда в ней прощупываются плотные узлы метастазов. В поздних стадиях могут появиться <a href=\"/symptom/ascit/\" title=\"Перейти на страницу симптома Асцит\">асцит</a> и анемия. Обычны <a href=\"/symptom/vysokaya_temperatura_38-42/\" title=\"Перейти на страницу симптома Высокая температура 38-42° \">лихорадка</a>, лейкоцитоз в крови и повышение СОЭ.</p>",
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"code": "C46",
"name": "Саркома Капоши",
"icd_name": "Саркома Капоши",
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"lead": "Нарушение здоровья, относящееся к группе злокачественные новообразования мезотелиальной и мягких тканей",
"description": "Саркома Капоши – множественные злокачественные образования на коже с поражением ее сосудов. Чаще всего заболевание поражает мужчин. Саркома Капоши проявляется как беспорядочное новообразование сосудов и пролиферация (разрастание) веретенообразных клеток сосудов. \r\n\r\n ",
"etiology": "<p>Саркома Капоши занимает первое место среди злокачественных новообразований, поражающих больных ВИЧ-инфекцией, достигая цифр 40—60 %. </p>\r\n<p>Вирус герпеса 8-го типа обнаруживается практически у 100 % пациентов, страдающих саркомой Капоши. </p>\r\n<p>К группам риска по развитию саркомы Капоши относятся: </p>\r\n<ul>\r\n<li>ВИЧ-инфицированные мужчины; </li>\r\n<li>пожилые мужчины средиземноморского происхождения; </li>\r\n<li>лица из экваториальной Африки; </li>\r\n<li>лица с пересаженными органами (реципиенты). </li>\r\n</ul>",
"pathogenesis": "<p>Патогенез, также как и причины появления саркомы, до конца не изучен. Основной версией патогенеза начальной стадии считается образование раковых клеток из из эндотелия кровеносных или лимфососудов. </p>\r\n<p>На сегодняшний день ученым удалось выделить цитокины, оказывающие стимулирующее действие на клеточные структуры саркомы Капоши. К ним относят: фактор роста фибробластов, интерлейкин 6, трансформирующий фактор роста. В возникновении опухоли у больных СПИДом большое значение отводят онкостатину. </p>\r\n<p>Саркома Капоши является не совсем обычной злокачественной опухолью. Слабая митотическая активность, зависимость процесса от иммунного статуса пациента, возможность обратного развития очагов опухоли, отсутствие клеточной атипии и гистологическое выявление признаков воспаления подтверждают предположение о том, что в начале своего возникновения саркома Капоши скорее представляет собой реактивный процесс, нежели истинную саркому. </p>",
"diagnostics": "<p>Диагностика саркомы Капоши основана на ее типичных клинических проявлениях и данных биопсииобразований. </p>\r\n<p>Гистологическое исследование выявляет в коже множественные новообразованные сосуды и пролиферацию веретенообразных клеток — молодых фибробластов. Наличие гемосидерина и экстравазатов (геморрагических экссудатов) позволяет отличить саркому Капоши от фибросаркомы. </p>\r\n<p>Пациентам проводят иммуннологические исследования крови и анализ на ВИЧ т вирус герпеса 8 типа. </p>\r\n<p>Для выявления поражений внутренних органов при саркоме Капоши применяют УЗИ брюшной полости и сердца, гастроскопию, рентгенографию легких, сцинтиграфию скелета, КТ почек, МРТ надпочечников и т. п. </p>",
"treatment": "<p>Важным моментом в лечении саркомы Капоши является терапия основного заболевания для повышения иммунного статуса организма. </p>\r\n<p>Системное лечение саркомы Капоши обычно назначается пациентам с благоприятным иммунологическим фоном при бессимптомном течении болезни. Оно состоит в интенсивной полихимиотерапии. </p>\r\n<p>В лечении классической и эпидемической формы саркомы Капоши успешно применяются интерфероны: α-2a, α-2b и β. Они препятствуют пролиферации фибробластов и способны инициировать разрушение (апоптоз) опухолевых клеток. </p>\r\n<p>Местное лечение саркомы Капоши включает криотерапию, инъекции химиотерапевтических препаратов и интерферона в опухоль, аппликации динитрохлорбензола и мази проспидия хлорида, др. методы. При наличие болезненных и крупных очагов поражения, а также для лучшего косметического эффекта проводится локальное облучение. </p>",
"prevention": "<p>Основной мерой профилактики заболевания является своевременное и правильное лечение иммунодефицитных состояний. Так, применение антиретровирусных препаратов у ВИЧ-инфицированных больных позволяет длительное время поддерживать нормальную функцию иммунной системы, тем самым предотвращая появление саркомы Капоши.</p>",
"clinical_picture": "<p>Симптомы саркомы Капоши: </p>\r\n<ul>\r\n<li>сформировавшаяся опухоль на коже или слизистой рта имеет тёмный цвет. Если на неё надавить, то она не будет бледнеть; </li>\r\n<li>для опухолей характерна симметричность поражения;</li>\r\n<li>сформированная саркома Капоши имеет чёткую форму и лишь немного возвышается над кожей; </li>\r\n<li>на ранних стадиях развития, сформированные на слизистой рта или коже пятна, имеют небольшие размеры и гладкую поверхность. По мере своего роста они начинают немного шелушиться. На поздних стадиях центр опухоли западает и может изъязвляться; </li>\r\n<li>такого симптома, как боль, при саркоме Капоши обычно не наблюдается. Иногда в месте локализации ракового образования отмечается жжение или зуд; </li>\r\n<li>часто при поражении слизистой рта в патологический процесс вовлекается небо и лимфоузлы, расположенные ближе всего к саркоме. </li>\r\n</ul>\r\n<p>При поражении слизистой рта наблюдается появление следующих симптомов: </p>\r\n<ul>\r\n<li>болевые ощущения во рту; </li>\r\n<li>затруднение приёма пищи, если саркома локализуется ближе к горлу во рту; </li>\r\n<li>некоторое затруднение дыхания. Особенно ярко данный симптом проявляется, если образование сформировалось не только во рту, но и на слизистой верхних воздухоносных путей. </li>\r\n</ul>",
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