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"description": " Полиурия — состояние организма, при котором в результате нарушения водного баланса происходит увеличение выработки мочи и частоты мочеиспускания. ",
"etiology": "<p>Все причины возникновения делятся на 2 большие группы: патологическую и физиологическую. </p>\r\n<p>К физиологическим причинам заболевания относят: </p>\r\n<ul>\r\n<li>прием лекарств, способствующих увеличению выработки мочи; </li>\r\n<li>большое количество выпитой воды; </li>\r\n<li>переохлаждение; </li>\r\n<li>добавление в рацион продукции, содержащей глюкозу и ведущей к ухудшению обратного всасывания первично выработанной урины. </li>\r\n</ul>\r\n<p>К патологической группе относят такие факторы, как: </p>\r\n<ul>\r\n<li>наличие камней в почках; </li>\r\n<li>воспалительные процессы в мочевом пузыре; </li>\r\n<li>заболевания простаты; </li>\r\n<li>раковые образования в мочевом пузыре; </li>\r\n<li>почечную кисту; </li>\r\n<li>острой формы пиелонефрита; </li>\r\n<li>хронического типа пиелонефрита у беременных женщин; </li>\r\n<li>сердечной недостаточности; </li>\r\n<li>одного из типов диабета; </li>\r\n<li>неврологические заболевания; </li>\r\n<li>бессимптомного пиелонефрита, появляющегося у женщин, у которых последний триместр беременности. </li>\r\n</ul>",
"pathogenesis": "<p>Механизм возникновения патологии связан с нарушением процесса обратного всасывания воды при прохождении первичной мочи через систему почечных канальцев. В норме из первичной мочи отфильтровываются лишь токсины и вредные вещества, которые в дальнейшем поступают в мочевой пузырь, а нужные компоненты и вода остаются в организме. При полиурии этот процесс нарушается — организм теряет жидкость в повышенных объемах. </p>\r\n<p> </p>",
"diagnostics": "<p>Ведущий метод выявления полиурии — проба Зимницкого — сбор мочи, выделенной за сутки, с определением объема каждой порции и последующим изучением в лабораторных условиях. Исследованию подлежит литраж выведенной мочи и ее удельный вес. </p>\r\n<p>Специальная проба с лишением жидкости позволяет достоверно выявить основное заболевание, ставшее причиной полиурии. Суть метода — в сознательном введении организма в состояние обезвоживания на период от 4 до 18 часов. В течение этого времени у пациента контролируют осмоляльность — особый показатель, характеризующий концентрационную способность почек. Одновременно оценивают баланс жидкости в плазме крови. </p>\r\n<p>Дополнительными методами исследования являются: </p>\r\n<ul>\r\n<li>анализ мочи с микроскопическим исследованием осадка; </li>\r\n<li>биохимия крови; </li>\r\n<li>коагулограмма — исследование на свертываемость; </li>\r\n<li>цитоскопия; </li>\r\n<li>УЗИ почек и органов брюшины; </li>\r\n<li>экскреторная урография почек; </li>\r\n<li>КТ и МРТ. </li>\r\n</ul>\r\n<p>При подозрении на заболевания эндокринного характера назначают: </p>\r\n<ul>\r\n<li>исследование крови на сахар и гормоны; </li>\r\n<li>УЗИ щитовидной железы; </li>\r\n<li>рентген костей; </li>\r\n<li>глюкозотолерантный тест. </li>\r\n</ul>",
"treatment": "<p>Терапия полиурии сводится к лечению основного заболевания. При ярко выраженной дегидратации имеет смысл регидратационная терапия. В зависимости от степени обезвоживания применяют оральную или парентеральную регидратацию. <br class=\"SCXW242796711\" /> <br class=\"SCXW242796711\" />Оральная регидратация применяется при легкой и средней степени обезвоживания и заключается в приеме готовых растворов, содержащих определенную пропорцию углеводов и электролитов: Регидрон, Оралит. <br class=\"SCXW242796711\" /> <br class=\"SCXW242796711\" />Парентеральная регидратация назначается при тяжелых степенях дегидратации. Чаще всего внутривенно вводят физиологический раствор. Необходимое количество рассчитывают исходя из массы тела человека и предполагаемых потерь жидкости. <br class=\"SCXW242796711\" /> </p>",
"prevention": "<p>Профилактические мероприятия полиурии включают в себя: </p>\r\n<ul>\r\n<li>нормализацию режима питания; </li>\r\n<li>употребление в малых количествах продуктов, которые могут повышать выработку организмом мочи — содержащие кофеин напитки, шоколад, приправы; </li>\r\n<li>контроль за суточным употреблением жидкости. Норма должна составлять полтора или два литра; </li>\r\n<li>полный отказ от спиртных напитков; </li>\r\n<li>своевременная диагностика и лечение заболеваний, которые могут вызвать полиурию; </li>\r\n<li>прохождение полного врачебного обследования два раза в год. </li>\r\n</ul>",
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"etiology": "<p>Как правило, выделения из уретры свидетельствуют о каком-либо заболевании. Характер этих выделений очень часто указывает на возбудителя. Так, например, слизисто-гнойные выделения в небольших количествах по утрам характерны для хламидиоза и уреамикоплазмоза.</p>\r\n<p> </p>\r\n<p> белого цвета в сочетании с интенсивным зудом бывают, как правило, при трихомониазе.</p>\r\n<p> </p>\r\n<p>Гнойные выделения в большом количестве в сочетании с болевыми ощущениями и резью при мочеиспускании встречаются при гонорее.</p>",
"pathogenesis": "<p>Классифицируются выделения из уретры по нескольким признакам. По количеству они подразделяются на скудные, умеренные и обильные. Затем по цвету они могут быть желтыми, белыми, зелеными, желто-зелеными, красноватыми. По прозрачности: прозрачные и мутные. По консистенции выделения из уретры бывают жидкие и густые.</p>\r\n<p> </p>\r\n<p>Классификация по времени появления такова. Они могут быть постоянными и периодическими, а также возникающими при определенных обстоятельствах, например после полового акта или мочеиспускания.</p>",
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"clinical_picture": "<p>Помимо выделений из уретры, в клинике обращают на себя внимание такие симптомы, как боль и , которые возникают под воздействием мочи и спермы на поврежденную слизистую уретры. Также возможны дискомфорт и ощущение жжения.</p>",
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"name": "Нарушения голоса",
"icd_name": "Нарушения голоса",
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"lead": "Нарушение здоровья, относящееся к группе симптомы и признаки, относящиеся к речи и голосу",
"description": "Нарушения голоса - это отсутствие или расстройство фонации вследствие патологических изменений голосового аппарата. \r\n\r\nАфония - полное отсутствие голоса и дисфония - частичные нарушения высоты, силы и тембра. ",
"etiology": "<p>К нарушениям голоса часто приводят следующие факторы: </p>\r\n<ul>\r\n<li>параличи и парезы голосообразующих органов; </li>\r\n<li>патологические процессы в коре или структуре головного мозга, в проводящих нервных путях; </li>\r\n<li>ДЦП; </li>\r\n<li>наличие воспалительных процессов в голосовых связках; </li>\r\n<li>неправильное строение голосового аппарата; </li>\r\n<li>воспаление гортани хронического характера; </li>\r\n<li>травмы или ожоги верхней части дыхательного горла; </li>\r\n<li>наличие новообразований в горле; </li>\r\n<li>наличие рубцов в гортани после операции; </li>\r\n<li>операция по удалению верхней части дыхательного горла; </li>\r\n<li>психическая травма; </li>\r\n<li>заболевания эндокринной сферы; </li>\r\n<li>вредные привычки; </li>\r\n<li>операции, в ходе которых удаляются гортань и голосовые связки; </li>\r\n<li>принадлежность к женскому полу. </li>\r\n</ul>",
"pathogenesis": "<p>В патогенезе функциональных нарушений голоса выделяют 3 основных момента: </p>\r\n<ol>\r\n<li>наличие невротического фона </li>\r\n<li>наличие пускового момента (различные невротические реакции - страх, горе, предшествующие воспалительные заболевания, перенапряжение голоса) </li>\r\n<li>фиксации нервной системой механизмов неправильного голосообразования по типу патологических условных рефлексов </li>\r\n</ol>\r\n<p>Для возникновения центральных функциональных нарушений голоса необходимо сочетание всех трех компонентов. </p>\r\n<p>Периферические функциональные нарушения голоса: чаще всего это результат перенапряжения голосовой функции. Невротический фон отсутствует. </p>\r\n<p>Для функциональных нарушений голоса характерно: </p>\r\n<ul>\r\n<li>часто резко возрастает двигательная функция гортани, может наблюдаться дискоординация между речевым дыханием, голосообразованием и артикуляцией </li>\r\n<li>могут быть нарушения сенсорной функции (чувствительности в голосовом аппарате), возникать неприятные ощущения в гортани (першение и т. п.) </li>\r\n<li>возможны нарушения секреторных функций, которые иногда сопровождаются ощущением инородного тела в области гортани. </li>\r\n<li>(нарушения моторных, сенсорных, секреторных функций) </li>\r\n<li>неврологическая симптоматика (высокие сухожильные рефлексы, неустойчивый фон настроения, депрессии, нарушения сна). </li>\r\n</ul>\r\n<p> </p>",
"diagnostics": "<p>Для выявления анатомических или воспалительных изменений голосового аппарата выполняется ларингоскопия; с целью оценки функции голосовых складок — стробоскопия. В диагностике опухолевых поражений незаменимы рентгенография и МСКТ гортани. Для получения сведений о функции мышц гортани проводится электромиография. С помощью электроглоттографии оцениваются изменения голосового аппарата в динамике. </p>\r\n<p>Логопедическое обследование включает оценку анамнеза, жалоб, особенностей голоса, характера голосообразования и голосовой атаки, физиологического и фонационного дыхания, темпо-ритмических и интонационных характеристик речи; определение времени максимальной фонации. </p>",
"treatment": "<p>При функциональных нарушениях голоса решающее значение придается общеукрепляющему лечению, массажу передней поверхности шеи, ЛФК, физиотерапии, соблюдению голосового режима. При органических нарушениях голоса проводится общая и местная медикаментозная терапия (эндоларингеальное введение лекарственных препаратов, ингаляции), по показаниям – хирургическое лечение ЛОР-патологии (удалении избыточной ткани голосовых складок, резекция гортани, ларингэктомия и др.). </p>\r\n<p>Логопедическую работу по восстановлению нарушений голоса следует начинать как можно раньше, чтобы предупредить фиксацию патологической голосоподачи, добиться лучших результатов, предотвратить развитие невротических реакций на дефект. Основные направления коррекционной работы включают психотерапию, коррекцию дыхания, развитие координации фонации и артикуляции, автоматизацию достигнутых навыков и введение голоса в свободное речевое общение. </p>",
"prevention": "<p>С целью предупреждения нарушений голоса необходимо воспитание правильных голосовых привычек (не форсировать голос), профилактика простудных заболеваний, отказ от курения и алкоголя, приема чрезмерно охлажденной и горячей пищи. Лица голосоречевых профессий должны владеть навыками диафрагмального дыхания и правильной голосоподачи. Любую, даже самую малую, простуду недопустимо переносить на ногах; в период болезни следует соблюдать щадящий голосовой режим.</p>",
"clinical_picture": "<p><strong>Симптомы органических нарушений голоса </strong></p>\r\n<p>Нарушения голоса при хронических ларингитах выражается утратой нормального звучания, сильной утомляемостью, иногда - невозможностью выполнения голосовой нагрузки. Характерны неприятные субъективные ощущения в горле – царапанье, першение, саднение, ощущение «комка», боль, давление. </p>\r\n<p>В случае периферических параличей и парезов гортани голос может отсутствовать совсем или иметь хриплое звучание. Нарушение голоса сопровождается сильным речевым утомлением, рефлекторным кашлем, поперхиванием, расстройством дыхания. </p>\r\n<p>Нарушения голоса, связанные с доброкачественными и злокачественными опухолями гортани развиваются постепенно, по мере роста образований. После любого, даже щадящего оперативного вмешательства на гортани возникают преходящие голосовые нарушения. При удалении гортани человек полностью лишается голоса; при этом резко нарушается функция дыхания, поскольку происходит разобщение трахеи и глотки. </p>\r\n<p>При центральных парезах и параличах гортани голос становится слабым, тихим, прерывистым, глухим, монотонным, нередко – с назальным оттенком. </p>\r\n<p>Органические нарушения голоса, возникшие у ребенка раннего возраста, сопровождаются отставанием в речевом развитии, задержкой накопления словаря и развития грамматических структур, нарушением звукопроизношения, трудностями коммуникации и ограничением социальных контактов. Нарушения голоса, развившиеся во взрослом возрасте, могут обусловливать профессиональную непригодность. </p>\r\n<p><strong>Симптомы функциональных нарушений голоса </strong></p>\r\n<p>Будучи периферическим функциональным нарушением голоса, нарушение голоса является профессиональным «заболеванием» лиц голосоречевых профессий. К проявлениям болезни относятся невозможность произвольно регулировать звучание голоса, (усиливать или ослаблять), прерывание (осечки) и быстрая утомляемость голоса, охриплость. В остром периоде голос может пропадать совсем. В большинстве случаев голос восстанавливается самостоятельно после периода отдыха. </p>\r\n<p>При гипотонусной дисфонии вследствие пареза внутренних мышц гортани развивается несмыкание голосовых складок, что проявляется осиплостью голоса, голосовым утомлением, болями в мышцах шеи и затылка; в тяжелых случаях возможна только шепотная речь. При гипертонусной дисфонии, обусловленной тоническим спазмом гортанных мышц, голос искажается, становится глухим, грубым; при афонии – не голос отсутствует совсем. </p>",
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"name": "Кровотечение, не классифицированное в других рубриках",
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}
]
}
