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"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;\">Петрозит - это поражение верхушки пирамиды височной кости, которое сопровождается невропатией лицевого нерва, птозом, двоением в глазах, офтальмоплегией.</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;\">Возбудителями болезни чаще всего становятся пневмококки, гемолитические стрептококки и синегнойная палочка. Реже этиологическим фактором являются другие представители кокковой микрофлоры. Описаны единичные случаи височного остеомиелита, вызванного микобактериями туберкулёза. Петрозит у таких пациентов развивался на фоне генерализованного специфического процесса. Очень редко заболевание индуцируется грибками. Распространению инфекции способствуют высокая вирулентность микроорганизмов. К факторам риска развития тяжёлой патологии относятся:</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;\">Гиперпневматизация височной кости. Чаще страдают пациенты с высокой степенью пневматизации пирамиды. Наиболее тяжело болезнь протекает при диплоэтическом (спонгиозном) строении костной ткани, когда в каменистой части присутствует большое количество мелких ячеек, заполненных воздухом.</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;\">Иммунодефицитные состояния, гиповитаминозы. Петрозит осложняет течение отитов, мастоидитов при нарушении функций факторов общей и локальной иммунной защиты. У детей данную патологию часто провоцирует снижение местного иммунитета на фоне ветряной оспы, краснухи или кори. Основным предрасполагающим фактором у взрослых служит сахарный диабет. Развитию болезни способствует общее истощение больного, недостаток витаминов в рационе.</span></p>\r\n<p> </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;\">Ячейки височной кости, окружающие лабиринт, сообщаются со средним ухом посредством узких извилистых клеточных ходов. При значительном снижении сопротивляемости организма инфекция распространяется по этим ходам или гематогенным путём. Развивается остеомиелит. Отток гноя затруднён, еще больше ухудшается при формировании грануляций. Происходит гнойное расплавление костной ткани. В зависимости от варианта пневматизации воспаление охватывает всю пирамиду или ее отдельные участки. При изолированном поражении верхушки формируется петроапицит.</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 гнойно-воспалительный процесс вовлекается головной мозг и его оболочки. Апицит приводит к возникновению ограниченного верхушечного лептоменингита либо, распространяясь дальше по верхней части пирамиды, вызывает воспаление оболочек мозга в области средней и задней черепных ямок. В результате могут развиваться тромбозы кавернозного синуса, нейропатии черепно-мозговых нервов. Петрозит с поражением нижней поверхности костной структуры провоцирует прорыв гноя в носоглотку.</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;\">Диагностический поиск при подозрении на петрозит осуществляет врач-оториноларинголог. При сборе анамнеза уточняются предшествующие операции на ЛОР-органах, длительность течения отита, учитывается наличие сопутствующей патологии. Осмотр выявляет отёчность мягких тканей заушной области, признаки отореи. При пальпации ушной раковины и соответствующей половины головы наблюдается резкая болезненность. Визуально определяются симптомы парезов черепных нервов, нистагм. Окончательный диагноз устанавливается на основании результатов следующих процедур:</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;\">Эндоскопия. Отоскопия позволяет выявить достоверные признаки воспаления в области наружного слухового прохода, среднего уха. Определяется отёк и помутнение барабанных перепонок, в большинстве случаев присутствуют перфорации, слуховые проходы заполнены гноем. Осуществляется забор гнойного отделяемого.</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 исследования. Лейкоцитоз, нейтрофильный сдвиг формулы периферической крови отражают наличие воспаления в организме. Исследование спинномозговой жидкости позволяет подтвердить или исключить гнойный менингит. С помощью культурального метода выявляется возбудитель заболевания, определяется его чувствительность к антибиотикам.</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;\">Визуализационные методики. Рентгенография височных костей по Стенверсу визуализирует зоны воспаления и расплавления костной ткани. КТ, МРТ дают возможность более точно локализовать патологический процесс, выявить внутримозговые осложнения. С помощью этих методик осуществляется дифференциальная диагностика петрозита с новообразованиями височной кости. С этой же целью иногда выполняется радиоизотопное сканирование костей черепа.</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;\">Вспомогательными методами диагностики являются аудиометрия, камертональное исследование, которые используются для определения степени снижения слуха.</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>",
"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;\">Основу фармакологического лечения остеомиелита височной кости составляет антибактериальная терапия. Оптимально назначение медикаментов с учетом результатов определения чувствительности микрофлоры к антибиотикам. При отсутствии такого исследования лечение назначается эмпирически. Обычно применяются защищённые аминопенициллины, цефалоспорины 3-4 поколения, линкозамиды. Препараты вводятся в высоких дозах, парентерально. Одновременно осуществляется коррекция уровня глюкозы крови, проводится общеукрепляющая терапия.</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;\">Согласно публикациям некоторых зарубежных авторов, неосложнённый петрозит можно полностью излечить консервативными методами. Описано несколько случаев выздоровления пациентов с полным восстановлением функции отводящего нерва. Такие больные нуждаются в постоянном медицинском наблюдении, регулярном динамическом рентгеновском контроле. Однако чаще консервативное лечение применяется перед оперативным вмешательством и после него.</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;\">Хирургическое лечение.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Оперативное вмешательство показано при отсутствии положительного эффекта от проводимой антибактериальной терапии. В целях профилактики жизнеугрожающих состояний многие специалисты рекомендуют сразу после постановки диагноза активно наладить отток гноя из поражённого участка кости. Для этого выполняется антромастоидотомия или общеполостная операция. При вторичном послеоперационном нагноении для улучшения оттока гноя рекомендуется тщательно прочистить и расширить свищевые каналы. При неэффективности такого лечения височная кость подвергается частичной резекции.</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>",
"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 петрозита включает своевременное и адекватное лечение острого и хронического среднего отита.</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;\">Для петрозита характерно 3 типа течения:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li style=\"list-style-type: disc; font-size: 7.5pt; font-family: Verdana; color: #4d4d4d; 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;\">Молниеносный: симптомы петрозита быстро нарастают, температура 39 – 40 градусов, появляются внутричерепные осложнения, от которых большинство больных погибает. Чаще диагностируют такую форму у детей до 1 года.</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7.5pt; font-family: Verdana; color: #4d4d4d; 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;\">Острый: есть признаки интоксикации, температура, боль, обильные выделения из уха гнойного характера, парез отводящего нерва, возможны осложнения. Наблюдается у детей, опасное для жизни состояние требует срочных мер.</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7.5pt; font-family: Verdana; color: #4d4d4d; 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;\">Подострый: все симптомы сглажены, лихорадка до 37,5 – 38 градусов. Процесс имеет склонность к затяжному течению с периодами улучшения и ухудшения. Больше характерен для пожилых людей из-за снижения активности иммунных реакций в организме.</span></p>\r\n</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\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">К симптомам петрозита относятся:</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;\">Боль в ухе, в глубине головы, за глазом, всей половины головы. Иррадиация в затылок, челюсть, лоб.</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Появление или усиление гноетечения из уха, если оно было до этого. Костная ткань расплавляется в результате воспаления, выходом для гноя будет перфорированная барабанная перепонка. Если гной распространяется в сторону черепа, присоединяются поражения черепных нервов с соответствующими симптомами, признаки менингита, нарастает интоксикация и ухудшается состояние.</span></li>\r\n<li><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Парез отводящего нерва: это VI пара черепных нервов, проходит внутри пирамиды, иннервирует мышцы, которые отводят глазное яблоко в сторону. При вовлечении нерва в воспаление у больного развивается сходящееся косоглазие, он не может посмотреть глазом кнаружи на стороне больного уха. Изображение в глазах двоится – диплопия.</span></li>\r\n</ul>\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>",
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"code": "H73.1",
"name": "Хронический мирингит",
"icd_name": "Хронический мирингит",
"gender": 0,
"age_min": 1,
"age_max": 100,
"cause": [
"0"
],
"periodicity": 3,
"slug": "h73.1_hronicheskiy_miringit",
"lead": "хроническое воспаление барабанной перепонки бактериальной, вирусной, грибковой или травматической этиологии",
"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;\">Как правило, заболевание становится осложнением других бактериальных, грибковых или вирусных патологий. К предрасполагающим факторам относится нерациональный прием антибиотиков или кортикостероидов, переохлаждение, частое попадание воды в слуховой проход. В роли самостоятельной нозологии мирингит встречается крайне редко. Наиболее часто в роли пусковых факторов выступают:</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;\">Болезни наружного уха и барабанной полости. Являются основной причиной развития мирингита. Обычно его возникновение обусловлено распространением патологического процесса на барабанную перепонку при внешнем или среднем отите, тубоотите и пр.</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;\">Вирусные, бактериальные, грибковые заболевания. Мирингит может наблюдаться на фоне гриппа, кори, пневмонии или сепсиса. Поражение барабанной перепонки вызвано гематогенным или контактным распространением возбудителя из первичного очага.</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;\">Травматическое повреждение. Воспалительная реакция при травме обусловлена нарушением целостности эпидермиса, покрывающего наружный слой барабанной перепонки. В роли травмирующего фактора могут выступать механические, термические или химические агенты.</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> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">Полная программа обследования включает в себя следующие методы диагностики:</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;\">Сбор анамнеза и жалоб. При опросе пациента отоларинголог обращает внимание на дебют заболевания и наличие ранее диагностированных патологий. Врач уточняет динамику и последовательность развития имеющихся симптомов.</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;\">Отоскопия. При остром катаральном варианте присутствует отечность и гиперемия перепонки, сглаженность ее структур, небольшой объем серозного экссудата в полости слухового хода. Хроническая форма характеризуется утолщением стенки, мацерацией эпидермиса, наличием грануляций, большим количеством гнойных пузырьков. При геморрагическом мирингите буллы заполнены серозно-геморрагическим экссудатом. При герпетической этиологии они имеют небольшой диаметр, а крупные гнойники возникают при гриппе или парагриппе.</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;\">Лабораторные анализы. Общий анализ крови позволяет выявить лейкоцитоз со сдвигом лейкоцитарной формулы влево, повышение СОЭ. При вирусной этиологии мирингита на 2-4 сутки от начала заболевания уровень лейкоцитов опускается ниже нормы, возникает относительный лимфоцитоз. При</span></li>\r\n<li>Тональная пороговая аудиометрия. Используется для определения характера развившейся тугоухости и выбора дальнейшей терапевтической тактики. При кондуктивной форме тугоухости наблюдается ухудшение воздушной проводимости при сохранении костного восприятия звука. Сенсоневральная тугоухость характеризуется нарушением работы как звукопроводящей, так и звуковоспринимающих систем.</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;\">Основной метод лечения – медикаментозный, комбинация препаратов определяется отоларингологом. В терапевтическую программу могут входить:</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;\">Антибактериальные или противовирусные средства. В зависимости от этиологического варианта мирингита, результатов бактериологического и вирусологического методов исследования назначаются антибиотики, противогрибковые или противовирусные препараты. Наиболее часто применяют цефалоспорины II-III поколения, макролиды, фторхинолоны, производные амантадина.</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;\">НПВС. Нестероидные противовоспалительные средства угнетают воспалительный процесс в барабанной перепонке. В сочетании с антибактериальной или противовирусной терапией они способны купировать болевой синдром.</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;\">Антисептические препараты. Растворы антисептиков используются для промывания слухового прохода. Это позволяет реализовать местное воздействие на пораженные ткани, способствует эвакуации гнойных или кровянистых масс. Обычно используется фурацилин и борная кислота.</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;\">Дезинтоксикационная терапия. Применяется при развитии выраженного интоксикационного синдрома. Основные препараты – физиологический раствор, 5% глюкоза, низкомолекулярные плазмозаменители.</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;\">Парацентез булл. При образовании крупных гнойников показано хирургическое удаление их геморрагического или гнойного содержимого с последующей обработкой антисептическими препаратами.</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\"> </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 мирингита заключается в предотвращении травматических повреждений уха, соблюдении правил личной гигиены, полноценном своевременном лечении заболеваний, которые потенциально могут привести к поражению барабанной перепонки.</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;\">Хронический мирингит провоцирует хроническая экзема или диффузное воспаление слухового прохода. Поражение касается всей перепонки или отдельных ее участков.</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;\">Нередко выделяется гной с неприятным запахом. Освобожденная от гноя перепонка влажная, шероховатая, грязно-серого цвета. Симптомы хронического мирингита:</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;\">сильный, нестерпимый зуд в ухе;</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;\">выраженное притупление слуха;</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;\">ощущение тяжести в ухе.</span></li>\r\n</ul>",
"image": null,
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"standard_type": 0,
"danger": 30,
"published": 1,
"parent": 6491,
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},
{
"id": 10894,
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{
"id": 86,
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{
"name": "кровь в ухе"
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