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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>",
"prevention": "<p>Профилактика врожденной пневмонии заключается в устранении предрасполагающих факторов к развитию пневмонии, соблюдении санэпидрежима в родильном доме, в отделениях больниц для новорожденных. </p>",
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}
]
}