ВОзвращает список болезней. Можно фильтр/искать

search, age, gender, parent, symptoms, sort_name, sort_by, rand, branches
GET /disease/?format=api&ordering=icd_name&page=224
HTTP 200 OK
Allow: GET, HEAD, OPTIONS
Content-Type: application/json
Vary: Accept

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    "previous": "http://api.symptomd.ru/disease/?format=api&ordering=icd_name&page=223",
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                {
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                            "name": "Нарушение устойчивости"
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                        {
                            "name": "Падение"
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                        {
                            "name": "Потрея равновесия"
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                        {
                            "name": "Спотыкание"
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            },
            "code": "N28.0",
            "name": "Ишемия или инфаркт почки",
            "icd_name": "Ишемия или инфаркт почки",
            "gender": 0,
            "age_min": 30,
            "age_max": 100,
            "cause": [
                "0"
            ],
            "periodicity": 1,
            "slug": "n28.0_ishemiya_ili_infarkt_pochki",
            "lead": "нефрологическое заболевание, обусловленное эмболией артериальных сосудов органа с последующим некрозом его тканей и нарушением функциональной активности",
            "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;\">В подавляющем большинстве случаев состояние имеет ишемический характер и вызывается эмболией магистральных почечных сосудов. Чаще всего эмбол представлен тромботическим сгустком, реже в таком качестве могут выступать фрагменты атеросклеротических бляшек, жировые массы. Картину, схожую с эмболией ветвей почечной артерии, иногда провоцируют артериовенозные фистулы или кровотечения. Таким образом, основной причиной заболевания является наличие в артериальной части большого круга кровообращения эмболов, которые могут образовываться при следующих патологиях:</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;\">Эндокардит. Воспаление внутренней оболочки левого желудочка или предсердия часто осложняется формированием пристеночного тромба. Его фрагменты периодически попадают в большой круг кровообращения и могут закупоривать просвет артерий 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;\">Аритмии и пороки сердца. Различные нарушения сердечного ритма сопровождаются нарушениями гемодинамики внутри полостей сердца, что иногда приводит к тромбообразованию. Схожий механизм возникновения тромбов отмечается при недостаточности митрального клапана или пролапсе его створок.</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;\">Атеросклеротическое поражение. Выраженный атеросклероз аорты или венечных артерий являются одной из наиболее частых причин инфаркта почки. Закупорка сосуда может быть обусловлена как фрагментом собственно атеросклеротической бляшки, так и тромбом, который образовался на ее поверхности. Атеросклероз почечных сосудов может приводить к расслоению их стенок, что также провоцирует закупорку просвета и острую ишемию.</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;\">Узелковый периартериит. Данное состояние неясной этиологии в случае вовлечения в патологический процесс сосудистой сети почек может становиться причиной инфарктов.</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;\">Медицинские манипуляции. Различные диагностические и лечебные манипуляции на органах мочевыделительной системы могут осложняться стенозом сосудов с развитием острой ишемии почечной ткани.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p>&nbsp;</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;\">Косвенной причиной патологии иногда является наркотическая зависимость, связанная с частыми внутривенными вливаниями (опиоидная или эфедриновая наркомания). В случае использования нестерильного инструментария развивается специфический эндокардит с образованием многочисленных тромбов. Различные формы инфаркта почки обнаруживаются у 20-30% инъекционных наркоманов. Множественные очаги инфарктов в почечной ткани возникают и при диссеминированном внутрисосудистом свертывании крови (ДВС-синдроме).</span></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;\">Основополагающим звеном патогенеза более чем в 90% случаев инфаркта почки считается образование эмболов, которые вызывают закупорку сосудов органа. В результате нарушается снабжение участка почечной ткани кислородом и питательными веществами. По своей кислородной потребности почки уступают только нервной ткани и миокарду, из-за чего в результате ишемии довольно быстро возникают дистрофические изменения в клетках нефронов. Размер поражения зависит от калибра артериального сосуда, перекрытого эмболом &ndash; чем он больше, тем распространеннее зона инфаркта. Характерная форма зоны ишемии &ndash; клиновидная или треугольная с вершиной у ворот почки и обращенным к корковому веществу основанием. Это обусловлено особенностями распределения кровеносных сосудов в органе.</span></p>\r\n<p>&nbsp;</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;\">После прекращения поступления артериальной крови дистрофия клеток нефронов постепенно нарастает, сменяясь их гибелью и формированием участков некроза. Одновременно возникает раздражение юкстагломерулярного аппарата с образованием больших количеств гормона ангиотензина 2, что приводит к развитию вазоренальной гипертензии и каскаду связанных с этим нарушений (повышается риск инфаркта миокарда или инсульта). Продукты распада некротизированных тканей всасываются в системный кровоток и становятся причиной интоксикации организма, проявляющейся повышением температуры, головными болями, тошнотой. Исходом некроза становится разрастание фиброзной ткани и формирование рубца.</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;\">При диагностике важную роль играет сбор анамнеза. Приступ в большинстве случаев развивается на фоне сердечно-сосудистых патологий, поэтому если пациент страдает от ишемической болезни сердца, недавно перенес инфаркт миокарда, то вероятность окклюзии почечных артерий повышается. Если же таких заболеваний в анамнезе нет, нефролог сначала исключает другие возможные причины возникновения болей и прочих симптомов. Пациент проверяется на почечную колику (закупорку мочевыводящего канала), воспалительные процессы (нефриты, пиелонефриты), развитие хронической почечной недостаточности.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</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;\">Больной с симптомами инфаркта почки должен пройти следующие обследования:</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 мочи, в том числе на выявления в ней крови.</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;\">Анализ крови. Внимание уделяется уровню лейкоцитов и параметрам свертываемости (коагулограмма).</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 почек. Быстрый и простой способ подтвердить диагноз.</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;\">Ангиография почечных сосудов. Наиболее показательный метод, но, к сожалению, не всегда доступный.</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;\">КТ и МРТ. Используются для подтверждения диагноза, если предыдущие обследования дают спорный результат.&nbsp;</span></li>\r\n</ul>\r\n<p>&nbsp;</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;\">Основные цели терапии данного заболевания изменяются в зависимости от этапа патологического процесса. На начальных этапах первоочередной задачей является восстановление адекватного кровотока в органах выделения, что позволяет минимизировать негативные последствия ишемии. В дальнейшем на первый план выступает устранение кровотечения (макрогематурии), явлений общей интоксикации и сохранение функциональности оставшейся части органа. Зачастую для этих целей используют препараты с противоположным действием (например, антикоагулянты и гемостатики), поэтому от специалиста требуется особая осторожность при их назначении. Консервативная терапия инфаркта сводится к использованию следующих лекарственных средств:</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;\">Обезболивающие препараты. Боли могут быть очень интенсивными, в ряде случаев болевой синдром устраняется только мощными наркотическими анальгетиками &ndash; морфином, фентанилом и другими.</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;\">Тромболитические средства. К ним относят стрептокиназу и другие препараты данной группы, цель их применения &ndash; устранение тромба в сосуде, восстановления адекватного кровотока. Медикаменты используются только на первых этапах заболевания, до развития выраженной гематурии. После начала выделения крови с мочой назначение этих средств строго запрещено.</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;\">Гемостатические препараты. Применяются при выраженной гематурии и профузном почечном кровотечении. Основным лекарственным средством данной группы является этамзилат натрия, введение которого позволяет минимизировать кровопотерю и улучшить прогноз заболевания.</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;\">Антикоагулянты. На любом этапе патологии рекомендуется принимать меры по нормализации работы свертывающей системы крови, с этой целью назначаются антикоагулянты прямого действия (например, гепарин). Схема, дозировки и длительность применения строго индивидуальны, определяются после изучения коагулограммы больного.</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;\">Антиагрегантные средства. Антиагреганты (например, ацетилсалициловая кислота) редко используются в остром периоде заболевания. Их назначают через 1-2 недели после исчезновения гематурии для снижения риска рецидива и отдаленных осложнений. Дозировка и длительность курса лечения определяется с учетом функциональной активности выделительной системы.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p>&nbsp;</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 тяжелых случаях (например, тотальный инфаркт почки) проводят хирургическое лечение, которое на начальных стадиях болезни сводится к восстановлению проходимости магистральных артерий и почечного кровотока. При поздней диагностике и развитии некротических изменений в почке по показаниям осуществляют оперативное удаление зоны инфаркта вплоть до нефрэктомии (при наличии у больного второго здорового органа). В числе вспомогательных лечебных мероприятий используют гемодиализ (при почечной недостаточности), назначают диуретические, гипотензивные и другие средства по показаниям.</span></p>",
            "prevention": "<p>&nbsp;</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;\">Поскольку заболевание часто является осложнением болезней сердечно-сосудистой системы, его профилактика заключается в правильном лечении основной патологии &ndash; использовании антиагрегантных средств, антибиотиков при эндокардитах, антихолестеринемических средств в случае атеросклероза.</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;\">Одним из главных признаков приступа является боль в пояснице разной интенсивности. Так, при незначительном некрозе боль тупая, непостоянная, а вот при обширном поражении по интенсивности она сопоставима с коликой. Кроме этого, болевые ощущения усугубляются, если пациенту вовремя не оказана медицинская помощь. В этом случае поврежденная почка не справляется с очищением крови, повышается интоксикация организма, в результате от этого страдает и второй орган.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</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;\">Другие симптомы инфаркта:</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;\">Уменьшение количества мочи (снижение суточного диуреза).</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;\">Наличие крови в моче (гематурия). Иногда ее хорошо видно невооруженным глазом, а иногда, при незначительном количестве, определяется она только в анализах. Насторожить должно окрашивание мочи в коричневый цвет.</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;\">Слабость, быстрая утомляемость.</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;\">Повышение артериального давления.</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.</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;\">Тошнота, иногда рвота.</span></li>\r\n</ul>\r\n<p>&nbsp;</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;\">Если приступ не лечить, симптомы инфаркта нарастают с каждым днем. Поскольку почка не справляется со своими функциями, организм будет страдать от нарастающей интоксикации. У пациентов появляются головные боли и головокружения, становится более выраженной тошнота и слабость, На 2-3 сутки температура тела повышается до субфебрильных показателей.</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;\">&nbsp;</span></p>",
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                    "lead": "Дизартрия (из др.-греч. δυσ- — приставка, означающая затруднённость, расстройство + ἀρθρόω — «сочленяю, соединяю») — нарушение произносительной стороны речи, обусловленное недостаточностью иннервации речевого аппарата. При дизартрии, в отличие от афазии, ограничена подвижность органов речи (мягкого нёба, языка, губ), из-за чего затруднена артикуляция. У взрослых дизартрия не сопровождается распадом речевой системы: нарушением восприятия речи на слух, чтения, письма. В детском же возрасте дизартрия нередко приводит к нарушению произнесения слов и, как следствие, к нарушению чтения и письма, а иногда к общему недоразвитию речи. Выявление дизартрии требует неврологического обследования, по результатам которого назначаются лечение и логопедическая коррекция.Дизартрия не является самостоятельным заболеванием, хотя у некоторых больных может быть наиболее заметным проявлением поражения нервной системы. Наблюдается при травмах и опухолях нервной системы, нарушениях мозгового кровообращения, нейроинфекциях, демиелинизирующих заболеваниях и др. У детей дизартрия часто сочетается с другими проявлениями дизонтогенеза, вызванного действием пре- и перинатальных факторов, входит в структуру нарушений при детских церебральных параличах.Значительное нарушение звукопроизношения легко распознаётся, поскольку речь смазанная, глухая, часто с носовым оттенком («Говорит, как с кашей во рту»). Лёгкие нарушения артикуляции выявляются при специальном логопедическом обследовании.Форма дизартрии зависит от места поражения нервной системы. Предложены разные классификации дизартрий, однако основной и наиболее распространённой в мире является клинико-неврологическая классификация, предполагающая выделение 6 форм (и одной смешанной):\r\n\r\nвялая — обусловлена периферическим парезом или параличом мышц, принимающих участие в артикуляции, вследствие поражения языкоглоточного, блуждающего и подъязычного нервов и/или их ядер, а также нарушения нервно-мышечной передачи. Часто сочетается с расстройствами глотания. Является одной из составляющих бульбарного синдрома;\r\nспастическая — обусловлена двусторонним центральным парезом или параличом мышц, иннервируемых языкоглоточным, блуждающим и подъязычным нервами, вследствие двустороннего поражения передних центральных извилин и/или корково-ядерных путей. Является одной из составляющих псевдобульбарного синдрома;\r\nодносторонняя верхнемотонейронная — обусловлена преимущественно односторонним центральным парезом или параличом мышц, иннервируемых языкоглоточным, блуждающим и подъязычным нервами, вследствие одностороннего поражения передних центральных извилин и/или корково-ядерных путей;\r\nатактическая — обусловлена поражением мозжечка или его проводящих путей; характеризуется растянутой, скандированной речью с нарушением модуляции и меняющейся громкостью;\r\nгиперкинетическая — вид экстрапирамидной дизартрии, возникающий при поражении подкорковых узлов и их нервных связей. Является одним из вариантов гиперкинезов, часто сочетается с гиперкинезами другой локализации. Речь смазанная, невнятная с носовым оттенком, резко нарушена просодика, интонационно-мелодическая структура речи, её темп;\r\nгипокинетическая — вид экстрапирамидной дизартрии, возникающий при поражении подкорковых узлов и их нервных связей. Чаще всего наблюдается при паркинсонизме, характеризуется замедленной невыразительной речью, нарушениями модуляции голоса;\r\nсмешанная — часто наблюдается при травмах нервной системы, диффузном и многоочаговом её поражении, когда имеет место сочетание разных механизмов дизартрии.Диагноз дизартрии (МКБ-10: R47.1) устанавливается врачом (как правило, невропатологом). При этом учитывается заключение логопеда. Логопед, в свою очередь, исследует не только особенности и характеристики нарушения звукопроизношения, но и все другие стороны речи.Поскольку дизартрия не является самостоятельным заболеванием и может наблюдаться при многих расстройствах нервной системы, содержание и очерёдность лечебных мероприятий определяются врачом после установления клинического диагноза, с учётом возраста и состояния больного. Во многих случаях требуется комплексное (лечебное и логопедическое) воздействие.\r\n\r\nВ детской логопедической практике важная роль отводится общему развитию всех сторон речи: словаря, грамматического строя, фонематического слуха, поскольку дети, страдающие дизартрией, испытывают в школьные годы трудности в усвоении письменной речи. В некоторых случаях целесообразно обучение таких детей в дошкольном периоде в логопедических группах детского сада.",
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            },
            "code": "M75.3",
            "name": "Кальцифицирующий тендинит плеча",
            "icd_name": "Кальцифицирующий тендинит плеча",
            "gender": 0,
            "age_min": 30,
            "age_max": 100,
            "cause": [
                "0"
            ],
            "periodicity": 1,
            "slug": "m75.3_kalcificiruyuschiy_tendinit_plecha",
            "lead": "воспаление сухожилий, расположенных в области головки плеча, с их последующей дегенерацией",
            "description": "<p>&nbsp;</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;\">Кальцифицирующий тендинит плечевого сустава возникает при отложении солей кальция на сухожилиях мышц, окружающих плечевой сустав. При этом возникает реактивное воспаление тканей вокруг кальциевых отложений (депозитов), что может сопровождаться болью.&nbsp;</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;\">Врачи выделяют факторы, увеличивающие риск развития воспалительного процесса:</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;\">профессиональная деятельность, которая подразумевает интенсивные физические нагрузки на плечевой сустав;</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;\">частые микроповреждения связок;</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 сухожилий, характеризующаяся уменьшением упругости;</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;\">нарушения осанки;</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;\">заболевания инфекционного характера, болезнетворные микроорганизмы быстро распространяются по телу через кровеносную систему;</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;\">частые стрессовые ситуации, депрессивные синдромы;</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;\">аллергическая реакция на лекарства;</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;\">дисплазия суставных тканей;</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;\">ослабление иммунной системы;</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;\">повышенная концентрация сахара в организме;</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;\">поражение щитовидной железы;</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;\">длительное использование тугой повязки;</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;\">операция в области плеча;</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;\">аномальное строение суставной ткани плеча;</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;\">остеохондроз шейного отдела;</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;\">употребление спиртных напитков;</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;\">курение;</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;\">прием наркотических препаратов;</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;\">частые и длительные переохлаждения;</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;\">артрит и артроз;</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;\">подагра.</span></li>\r\n</ul>\r\n<p>&nbsp;</p>",
            "pathogenesis": "",
            "diagnostics": "<p><span id=\"docs-internal-guid-f14c87ba-7fff-61de-cff4-0dcd066df965\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">После обращения в клинику врач осматривает пациента, определяет локализацию болезненных ощущений. При постановке диагноза доктор учитывает отёчность и скованность движений. Симптоматика схожа с артритом. Главное отличие &mdash; воспалительный процесс сухожилия сопровождается уменьшением активных движений, пассивные сохраняются. Для постановки точного диагноза пациента направляют на магнитно-резонансную томографию. Используют инъекцию обезболивающего препарата в область вращательной манжеты плеча, при ослаблении дискомфорта диагностируют тендинит. Если МРТ недостаточно используют рентгенографию, артроскопию, рентген с использованием контраста. </span></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;\">Консервативное лечение</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;\">Основная задача консервативного лечения это уменьшить воспаление и боль. Поэтому, на первом этапе консервативное лечение включает в себя покой и прием НПВС (ибупрофен). Противовоспалительные препараты позволяют уменьшить воспалительный процесс и снизить болевые прояления. При наличии сильной боли могут быть назначены инъекции кортикостероидов. Применение стероидов позволяет на некоторое время эффективно снять отек и воспаление.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</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 тот период времени, когда отложения кальция начинают реабсорбироваться, боль может быть особенно сильной. В таких случаях возможно удаление части депозитов кальция с использованием промывания физ. раствором через два прокола в области депозитов кальция. Эта процедура называется лаважем. Иногда при этой процедуре удается разбить кальцинаты на кусочки (их удаляют с помощью иглы). Удаление депозитов позволяет быстрее уменьшить болевой синдром и добиться более быстрого восстановления сухожилия. Даже тогда, когда промывание не удаляет отложения кальция, это может уменьшить давление в сухожилиях, что приводит к уменьшению боли.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</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;\">Физиотерапия. Физиопроцедуры являются одной из основных составляющих консервативного лечения кальцинирующего тендинита. Применение такой методики, как ультразвук, помогает уменьшить болевой синдром и воспаление. Но эффект при применение ультразвука достигается только при курсовом лечении (до 24 процедур в течение 6 недель). Ударно-волновая терапия в настоящее время является наиболее современным методом консервативного лечения таких заболеваний. Ударная волна разрушает крупные депозиты кальция, что позволяет организму быстрее абсорбировать их.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</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;\">ЛФК показано в стадии завершения реабсорбции и позволяет восстановить мышечный тонус и улучшить кровоснабжение структур плеча. Как правило, проводится индивидуальный подбор упражнений и ЛФК проводится в течение 4-6 недель. Проведение физических упражнений очень важно для укрепления мышц вращающей манжеты плеча, так как эти мышцы помогают контролировать стабильность плечевого сустава. Укрепление этих мышц может фактически уменьшить давление на депозиты кальция в сухожилии.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</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: 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 неэффективности консервативного лечения и ухудшение функций плеча или наличие стойкого болевого синдром рекомендуется оперативное лечение. Как правило, хирургическое лечение проводится малоинвазивным атроскопическим методом, что позволяет пациенту не оставаться на ночь в хирургическом отделении. Хирург при атроскопической операции визуально определяет локализацию депозитов кальция в сухожилиях вращательной манжеты, удаляет их и промывает эту область, удаляются также свободные кристаллы кальция, которые могут раздражать окружающие ткани.</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;\">В редких случаях, бывает, необходима открытая операция. При такой операции до депозитов кальция доступ идет через разрез мышц связок с удалением части сухожилий. После удаления депозитов проводится сшивание мышц и сухожилий.</span></p>\r\n<p>&nbsp;</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;\">Реабилитация после операции на плече может занять достаточно длительный промежуток времени. В первые 6-8 недель после операции рекомендуется ношение ортеза и ограничение движений, затем необходимо постепенно начинать разработку сустава и сочетать физиопроцедуры с ЛФК. Объем нагрузок на сустав необходимо увеличивать постепенно и очень аккуратно под наблюдением врача ЛФК. Начинают упражнения, как правило, не ранее чем через 6 недель после операции. Упражнения направлены на улучшение мышечной силы плечевого пояса и мышц ротаторной манжеты. Полное восстановление функций плеча после операции может занять от 3 до 4 месяцев. После открытой операции восстановление идет намного медленнее, чем при атроскопической резекции.</span></p>",
            "prevention": "<p>&nbsp;</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;\">Из-за не до конца выясненной этиологии возникновения заболевания целенаправленной профилактики кальцифицирующего тендинита плеча не существует. Есть только общие рекомендации специалистов: избегать травм и резких нагрузок в быту и при занятии спортом, укреплять мышцы плечевого пояса, следить за обменом веществ, избегать переохлаждений.</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;\">Болезнь характеризуется резким появлением симптоматики. Изначально возникают острые болезненные ощущения, которые усиливаются при движении верхней конечности. Выделяют следующие симптомы:</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;\">дискомфорт возрастает в ночное время суток, возможна бессонница;</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;\">прощупывание пораженной области сопровождается усилением боли;</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;\">при движении верхней конечностью возможен скрипящий звук;</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;\">покраснение кожных покровов;</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;\">увеличение температуры пораженной области;</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;\">отложения кальция в суставных тканях, ослабление сухожилия;</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;\">ограничение в движении, рука поднимается только на 90 градусов.</span></li>\r\n</ul>\r\n<p>&nbsp;</p>",
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            },
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            "name": "Камни в мочевом пузыре",
            "icd_name": "Камни в мочевом пузыре",
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            "lead": "проявление мочекаменной болезни, характеризующееся наличием в полости мочевого пузыря солевых или кальцифицированных конкрементов",
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            "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;\">Причины возникновения камней в мочевом пузыре могут быть достаточно разнообразны. В большинстве случаев камнеобразование происходит из-за нарушения оттока мочи. Мочевой пузырь не опорожняется полностью, концентрированные выделения застаиваются, а нерастворимые соли из них начинают кристаллизоваться,&nbsp; и возникают конкременты различного состава и размера.&nbsp;</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</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;\">Образование камней в мочевом пузыре может быть вызвано рядом сопутствующих патологий. Среди них:</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;\">аденома предстательной железы;</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;\">воспалительные процессы в органах мочеполовой системы;</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;\">наличие в мочевыводящих и половых органах инородных тел;</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;\">поражения ЦНС и травмы спинного мозга, сопровождающиеся нарушениями мочеиспускания;</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;\">патологии внутренних мышц;</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;\">миграция камней из почек в мочевой пузырь;</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;\">шистосоматоз (паразитарное 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;\">цистоцеле (опущение мочевого пузыря у женщин);</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;\">врожденные и приобретенные нарушения обмена веществ (медикаментозные, метаболические, воспалительные);</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;\">нарушение физико-химических свойств выделений.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p>&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</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;\">При наличии подозрения на камни в мочевом пузыре специалист обязательно проводит исследование мочи. Этот метод диагностики позволяет определить точное количество солей и других инородных веществ, находящихся в моче при данном заболевании. Для определения состава и величины конкрементов врач применяет специальные исследования, а именно:</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;\">УЗИ мочевого пузыря;</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;\">экскреторная урография (диагностическая процедура, включающая в себя внутривенное введение специального вещества с последующей рентгенографией органов брюшной полости, что позволяет увидеть не только количество конкрементов в мочевом пузыре, но и определить причину нарушения процесса мочеиспускания);</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 (дает возможность оценить место локализации камней и их размеры);</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;\">цистоскопия (при проведении процедуры используется цистоскоп, который врач вводит пациенту сначала в мочеиспускательный канал, а затем в мочевой пузырь, осматривая при помощи оптической системы любые изменения их внутренней 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;\">магнитно-резонансную рентгенотомографию (МРТ).</span></li>\r\n</ul>\r\n<p>&nbsp;</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;\">Курс лечения камней в мочевом пузыре может включать как консервативные, так и оперативные методы. Медикаментозная методика лечения состоит из приема или введения специальных препаратов, способствующих прохождению камня по каналу и выпадению его в мочевой пузырь. Также больному назначают определенную диету в зависимости от вида выявленных конкрементов. Но в данном случае следует отметить, что данный вид лечения может устранить лишь острые приступы, а не основную причину заболевания: сам конкремент. Поэтому, если этот метод терапии не приносит положительных результатов, то врач проводит оперативное лечение. Это может быть:</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;\">Цистолитотомия (хирургический метод камнесечения, проводящийся с помощью эндоскопической техники в полости мочевого пузыря. Врач вводит цистоскоп в мочевой пузырь и дробит конкременты. Если сделать это невозможно, то делается небольшой разрез в надлобковой области живота, после чего конкременты извлекаются);</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;\">цистолитотрипсия (дробление камней в мочевом пузыре проводится с помощью цистолитотриптора, которым захватывается конкремент и фрагментируется в центре полости мочевого пузыря, вымывая при этом его огромным количеством жидкости).</span></li>\r\n</ul>\r\n<p>&nbsp;</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;\">Проведение определенного вида хирургической методики лечения напрямую зависит от результатов диагностического обследования и непосредственно от рекомендаций и назначений специалиста. Независимо от вида все операции проводятся только под анестезией. После оперативного вмешательства больному вставляют катетер для устранения мочи, назначаются антибиотики для приема, курс лечения ими длится обычно пять-семь дней.</span></p>",
            "prevention": "<p>&nbsp;</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 включает своевременную диагностику и лечение заболеваний, провоцирующих образование камней в мочевом пузыре.</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;\">Часто наличие конкрементов, в том числе достаточно больших, не сопровождается какими-либо симптомами и диагностируется случайно в ходе плановых обследований. Признаки камней в мочевом пузыре начинают проявляться при постоянном контакте образования со стенками мочевого пузыря, вызывающем раздражение слизистой, а также тогда, когда камень начинает мешать нормальному оттоку мочи.&nbsp;</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</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;\">Среди характерных симптомов заболевания пациенты часто отмечают следующие:</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;\">болезненные ощущения внизу живота, над лобком;</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;\">резкие позывы к мочеиспусканию, сопровождающиеся болевыми ощущениями, особенно во время активного движения;</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;\">появление в моче кровянистых включений и сгустков;</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;\">ноющие боли в пояснице, бедрах и гениталиях;</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;\">прерывание струи мочи, не позволяющее завершить мочеиспускание без смены положения тела;</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;\">периодическое недержание мочи при застревании конкремента в шейке сфинктера пузыря;</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;\">приапизм, энурез и болезненная эрекция;</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;\">хронический цистит и пиелонефрит (при присоединении инфекции);</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;\">гематурия (в случае травматизации конкрементом расширенных сосудов шейки пузыря).</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>\r\n<p>&nbsp;</p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</p>",
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