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},
"code": "S12",
"name": "Перелом шейного отдела позвоночника",
"icd_name": "Перелом шейного отдела позвоночника",
"gender": 0,
"age_min": 0,
"age_max": 100,
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"slug": "s12_perelom_sheynogo_otdela_pozvonochnika",
"lead": "нарушение целостности одного или нескольких шейных позвонков в результате травматического воздействия",
"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 большинстве клинических случаев переломы позвонков шейного отдела возникают вследствие следующих травмоопасных ситуаций:</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;\">сдавливание или прямой удар области шеи</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;\">прыжки вниз головой на мелководье</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;\">падение с высоты</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;\">резкое принудительное сгибание шеи</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;\">повреждение по типу хлыстовых, полученные в ДТП</span></li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Также травмы связаны с дегенеративными изменениями, происходящими под влиянием возраста или патологий, вызывающих несовершенный остеогенез.</span></p>",
"pathogenesis": "",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Диагностика переломов позвоночника, как правило, не составляет для специалиста большого труда, особенно если травме предшествовали определенные события (ДТП, падение и т.д.). Чтобы дифференцировать повреждение шейного отдела от переломов других участков позвоночника, необходимы инструментальные методы диагностики, которые дают возможность поставить точный диагноз. </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;\">Компьютерная томография. Метод, позволяющий получить послойное изображение поврежденного участка, оценить состояние твердых тканей и близлежащих структур. С его помощью можно диагностировать даже мелкие трещины и микропереломы, которые не поддаются диагностике другими способами. С помощью КТ можно выявить самые мелкие повреждения в позвоночном столбе и прилегающих тканях. </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;\">Рентгеновское исследование. Классический способ, которые подразумевает использование рентгеновского аппарата, в результате чего получаются снимки в нескольких проекциях, отображающие состояние костной ткани, в том числе и различные повреждения. </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-резонансная томография. Наиболее информативный и современный метод исследования, позволяющий определить все патологии позвоночного столба, в том числе и травмы, трещины и переломы.</span></li>\r\n</ul>\r\n<p> </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;\">В большинстве случаев при переломах шейных позвонков показано консервативное лечение. Пациентов госпитализируют в травматологическое отделение. При неосложненных переломах без смещения проводят иммобилизацию с использованием воротника по типу Шанца, гипсового корсета или жесткого воротника сроком до 4 месяцев. При наличии смещении и опасности повреждения спинного мозга применяют вытяжение петлей Глиссона в сочетании с корректирующими подушками или валиками.</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;\">При сгибательных переломах подушку под голову не кладут, под плечи подкладывают валик. При разгибательных повреждениях используют две подушки, подложенные под голову пациента, после устранения компрессии подушки убирают. Через 15-30 суток вытяжение снимают и накладывают жесткий воротник или гипсовый полукорсет сроком на 3-4 месяца. Больным назначают обезболивающие, физиотерапевтические процедуры и лечебную гимнастику.</span></p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Хирургические вмешательства проводят при нестабильных переломах и переломовывихах шейных позвонков (особенно в сочетании со сдавлением или повреждением спинного мозга), оскольчатых компрессионных переломах, а также при неэффективности консервативного лечения. Для фиксации позвонков применяют ламинарные контракторы, трансартикулярные фиксаторы или пластины. В послеоперационном периоде назначают антибиотики, анальгетики, ЛФК, массаж и физиопроцедуры, в последующем проводят реабилитационные мероприятия.</span></p>",
"prevention": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В качестве профилактики переломов рекомендуется:</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;\">избегать травмоопасных ситуаций</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;\">соблюдать правила поведения на воде</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;\">вести активный образ жизни</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;\">проходить регулярные обследования для ранней диагностики остеопороза после 40 лет</span></li>\r\n</ul>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В случае обнаружения дефицита кальция необходимо своевременно проконсультироваться у лечащего врача, пройти курс лечения витаминно-минеральными комплексами.</span></p>",
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"code": "P23",
"name": "Врожденная пневмония",
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"description": " \r\nВрожденная пневмония — это остро протекающее инфекционно-воспалительное заболевание легких, которое проявляется в первые 72 часа жизни. ",
"etiology": "<p>Воспаление легких у новорожденных вызывают различного рода болезнетворные микроорганизмы, грибы, вирусы, простейшие. К ним относятся возбудители: стафилококк, стрептококк, пневмококк, вирус простого герпеса, цитомегаловирус, микоплазмы, хламидии, грибы рода Кандида и множество других. Пути попадания инфекции различны. </p>\r\n<p>Классифицируют бронхогенный (заражение происходит через легкие во время прохождения по родовым путям) и гематогенный (инфицирование ребенка матерью через кровь во время вынашивания плода) способ ее проникновения в детский организм. </p>\r\n<p>К группе риска относятся младенцы, период дородового развития которых происходил с такими осложнениями, как: </p>\r\n<ul>\r\n<li>внутриутробная гипоксия (недостаток получения кислорода плодом); </li>\r\n<li>застойные явления в легких при гипотрофии, то есть недоразвитие дыхательных путей; </li>\r\n<li>пороки сердца, легких; </li>\r\n<li>нарушение иммунитета, передающееся по наследству; </li>\r\n<li>недостаток или избыток витаминов в организме плода; </li>\r\n<li>хронические болезни матери и перенесенные инфекции в период созревания ребенка; </li>\r\n<li>патологические кровотечения во время беременности; </li>\r\n<li>слишком раннее отхождение околоплодных вод; </li>\r\n<li>повреждения головного мозга и верхних дыхательных путей при родах. </li>\r\n</ul>",
"pathogenesis": "<p>Возбудитель, проникнув в легкие через кровь или дыхательные пути, вызывает здесь воспалительный процесс (как правило, двусторонний). Это сопровождается отеком тканей, патологической продукцией секрета, очаговым спаданием альвеол. В результате — легкие не в состоянии качественно исполнять свою функцию, а организм новорожденных страдает от недостаточности кислорода, избытка углекислого газа, нарушения обменных процессов. При отсутствии адекватного лечения возможны опасные последствия: тяжелые дыхательные расстройства, отек легких, нарушение сердечной деятельности, полиорганная недостаточность. </p>",
"diagnostics": "<p>В общем анализе крови выявляют повышение (или снижение) числа лейкоцитов, сдвиг формулы влево, появление незрелых форм. </p>\r\n<p>Исследование мочи поможет определить кетоацидоз, поражение почек. </p>\r\n<p>На рентгенографии грудной клетки выявляют характерные воспалительные инфильтраты, усиление легочного рисунка, расширение прикорневой зоны. </p>\r\n<p>Бактериологические и серологические исследования крови (ликвора) дают возможность определить возбудителя и его чувствительность к лекарственным средствам. </p>",
"treatment": "<p>Уход. Необходимо поддерживать оптимальную температуру окружающей среды, недопустимо переохлаждение и перегревание ребенка. Правильный уход предусматривает свободное пеленание, частые перемены положения ребенка, регулярную обработку кожи и слизистых оболочек. </p>\r\n<p>Оксигенотерапия применяется для борьбы с дыхательной недостаточностью и в зависимости от ее степени тяжести осуществляется путем ингаляций, помещения ребенка в кислородную палатку, </p>\r\n<p>Вскармливание. Способ кормления (грудь, соска, зонд) и количество пищи определяется возрастом ребенка и его состоянием. </p>\r\n<p>В качестве этиотропной (направленной на возбудителя) терапии назначаются антибактериальные препараты с учетом чувствительности к ним возбудителя. </p>\r\n<p>Инфузионная терапия с целью детоксикации. </p>\r\n<p>Кислородотерапия. </p>\r\n<p>Пассивная иммунотерапия. При тяжелом течении пневмонии показаны специфические иммуноглобулины. </p>\r\n<p>Местная терапия: - СВЧ на грудную клетку 5-7 сеансов, далее электрофорез с эуфиллином, новокаином, препаратами кальция 7-10 сеансов; - отвлекающая терапия - горчичное обертывание грудной клетки; - регулярные санации трахеобронхиального дерева или бронхоскопии с промыванием бронхов антисептическими растворами. </p>",
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"code": "B48",
"name": "Другие микозы, не классифицированные в других рубриках",
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"block_rubric": 15,
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}
]
}
