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"code": "B74",
"name": "Филяриатоз",
"icd_name": "Филяриатоз",
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3,
2,
6
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"lead": "Паразитарное заболевание человека и животных, вызываемые филяриями (нитчатками) — нематодами семейства Onchocercidae",
"description": "",
"etiology": "<p>Болезнь передается от человека к человеку через укус комара. Когда комар кусает человека, который имеет лимфатический филяриатоз, микроскопические черви, циркулирующие в крови человека, заражают насекомое. Здоровые люди получают лимфатический филяриатоз путем укуса зараженного комара. Микроскопические черви проникают вместе со слюной комара под кожу жертвы, а затем попадают в лимфатические сосуды. В лимфатических сосудах они растут. Взрослый червь живет около 5-7 лет. Когда взрослые особи спариваются, они выпускают в кровь человека миллионы микроскопических червей, которые называются микрофиляриями. Таким образом, болезнь передается от зараженного человека к насекомому, а затем от насекомого к здоровому человеку.</p>",
"pathogenesis": "<p>В зависимости от области, которая повреждена червями, филяриоз может проявляться в трех различных формах.</p>\r\n<ol>\r\n<li>Лимфатический филяриатоз (слоновость конечности). Поражает лимфатическую систему и лимфатические узлы. Возбудители - Нитчатка Банкрофта, Brugia malayi и Brugia timori.</li>\r\n<li>Подкожный филяриатоз (страдает подкожная клетчатка и ближайшие к ней ткани). Этот вид инфекции вызывает Лоа Лоа (глазной червь).</li>\r\n<li>Серозный полостной филяриатоз (заболевание локализуется в полости живота). Его возбудителями являются паразиты Mansonella perstans и Mansonella ozzardi.</li>\r\n</ol>\r\n<p>Филяриоз не представляет угрозы для жизни человека, однако он наносит существенный вред лимфатической системе. Болезнь не вызывает никаких симптомов на начальном этапе. Таким образом, большинство людей не знают, что больны. Лимфедема с утолщением кожи и ближайших тканей - это классический симптом филяриоза.</p>\r\n<p>Филяриоз обычно диагностируется путем прямого обнаружения паразита в образцах кожи или крови. Основные симптомы начинают появляться после гибели червей в организме.</p>",
"diagnostics": "<p>Несмотря на серьезность заболевания, оно мало изучено, что вызывает определенные трудности с диагностикой. Из-за отсутствия характерных симптомов врачи часто приступают к лечению аллергии или других болезней по своему профилю, не догадываясь о паразитарной природе болезни.</p>",
"treatment": "<p>Консервативное лечение направлено на дегельминтизацию посредством химических препаратов, однако, их нельзя принимать длительно (из-за возникновения тяжелых побочных эффектов), поэтому подобный подход зачастую не способен вывести личинки филярий, «прячущиеся» в верхних слоях кожи. Сертифицированный и клинически апробированный Антипаразитарный комплекс «Оптисалт», в состав которого входят только натуральные ингредиенты растительного происхождения, показан для приема длительными курсами, достаточными для дегельминтизации. Помимо этого, препараты «Оптисалт» снимают симптомы аллергии (устраняют <a href=\"/symptom/zud/\" title=\"Перейти на страницу симптома Зуд\">зуд</a>), выводят токсины гельминтов, нормализуют обмен веществ, позволяя человеку быстро восстановиться после инвазии.</p>",
"prevention": "<p>Предотвратить укусы комаров можно такими способами:</p>\r\n<ul>\r\n<li>использовать аэрозоли; кремы от комаров, антимоскитные сетки;</li>\r\n<li>не создавать привлекающих комаров источников воды или отходов;</li>\r\n<li>носить одежду из плотной ткани с рукавами и длинными штанинами;</li>\r\n<li>использовать в помещении эфирные масла и реппеленты.</li>\r\n<li>спать под москитной сеткой в период пребывания в эндемичном по филяриатозу месте;</li>\r\n<li>в период после заката солнца особенное внимание уделить равномерному нанесению мази или крема от насекомых.</li>\r\n</ul>",
"clinical_picture": "<p>Симптомы лимфатического филяриатоза (слоновости):</p>\r\n<ul>\r\n<li>отек с утолщением кожи и подкожных тканей (классический симптом слоновости). Она обычно поражает нижние конечности. Тем не менее, вульва, грудь у женщин и область промежности у мужчин так же могут страдать от этого симптома.</li>\r\n<li>отек конечностей, груди или половых органов может привести к их увеличению в несколько раз.</li>\r\n</ul>\r\n<p>Происходит это из-за закупорки лимфатических сосудов.</p>\r\n<p>Симптомы подкожного филяриатоза:</p>\r\n<ul>\r\n<li><a href=\"/symptom/syp/\" title=\"Перейти на страницу симптома Сыпь\">сыпь</a>;</li>\r\n<li>гипер или гипопигментированные макулы;</li>\r\n<li>речная <a href=\"/symptom/slepota/\" title=\"Перейти на страницу симптома Слепота \">слепота</a> (симптом онхоцеркоза).</li>\r\n</ul>\r\n<p>Симптомы серозного филяриатоза:</p>\r\n<ul>\r\n<li><a href=\"/symptom/bol_v_zhivote/\" title=\"Перейти на страницу симптома Боль в животе\">боль в животе</a>;</li>\r\n<li><a href=\"/symptom/syp/\" title=\"Перейти на страницу симптома Сыпь\">высыпания</a>;</li>\r\n<li>артрит;</li>\r\n<li>появление пигментированных макул.</li>\r\n</ul>\r\n<p>До 70% инфицированных лиц на начальных этапах заболевания не чувствуют никаких неприятных симптомов. Обычно, при заражении в детском возрасте, признаки заболевания начинают проявляться у человека в подростковый период или в зрелости. Поскольку филяриоз в развитых странах встречается крайне редко, изначально больному может быть поставлен неверный диагноз. Чтобы избежать этого, у пациентов с подозрительными симптомами узнают историю путешествий и пребывания в непривычных местах.</p>\r\n<p>Острая форма заболевания характеризуется внезапным появлением высокой температуры, болезненностью лимфатических узлов, а также ложным бактериальным лимфаденитом. Кожа обычно становится сухой, шелушится. У мужчин воспаляются паховые лимфатические узлы, яички и семенной канатик. У женщин может возникнуть отек промежности, груди.</p>",
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},
"code": "R64",
"name": "Кахексия",
"icd_name": "Кахексия",
"gender": 0,
"age_min": 0,
"age_max": 100,
"cause": [
3
],
"periodicity": 1,
"slug": "r64_kaheksiya",
"lead": "Крайняя степень истощения организма, для которой характерно резкое исхудание, общая слабость, снижение активности физиологических процессов, расстройства психики",
"description": "Выделяют 2 формы кахексии:\r\nПервичную (экзогенная) — при низком поступлении пищи в организм или в том случае, если ее энергетическая и питательная ценность низки;\r\nВторичную (эндогенная) — является осложнением различных заболеваний.\r\n",
"etiology": "<p><a href=\"/symptom/otkaz_ot_pischi/\" title=\"Перейти на страницу симптома Отказ от пищи\">Голодание</a> или длительное <a href=\"/symptom/snizhenie_appetita/\" title=\"Перейти на страницу симптома Снижение аппетита\">недоедание</a>, поражения пищевода, болезни органов желудочно-кишечного тракта, психогенная <a href=\"/symptom/anoreksiya/\" title=\"Перейти на страницу симптома Анорексия\">анорексия</a>, длительная интоксикация при хронических инфекционных болезнях, амилоидоз, истощающие диффузные заболевания соединительной ткани, тяжелая сердечная недостаточность, злокачественные опухоли, эндокринные заболевания с нарушением обмена энергии, болезни щитовидной железы.</p>",
"pathogenesis": "<p><a href=\"/symptom/kaheksiya/\" title=\"Перейти на страницу симптома Кахексия\">Кахексия</a> приводит не только к упадку сил, она меняет реакцию на лечение и ухудшает переносимость, что фатально сказывается на продолжительности жизни. При потере за полгода не более 5% массы тела, сопровождающейся патологическим отвращением к пище и признаками воспаления, предполагается прекахексия. О системной воспалительной реакции можно говорить при температуре выше 38 °C или ниже 36 °C, тахикардии от 90 ударов, учащённом дыхании, лейкоцитах выше 12 тысяч или ниже 4 тысяч. Только на стадии прекахексии лечением можно остановить потерю мышечной массы, что изменит ближайшую судьбу больного. При потере более 5% массы со всеми указанными признаками говорят о собственно кахексии. Это же состояние возникает у больного с изначально низким весом при утрате только 2% массы тела. Дальнейшее не просто снижение, а форменное <a href=\"/symptom/kaheksiya/\" title=\"Перейти на страницу симптома Кахексия\">истощение</a> с невозможностью встать с постели или из-за слабости проводить в ней более половины дня, безответное применение противоопухолевой терапии — уже рефрактерная <a href=\"/symptom/kaheksiya/\" title=\"Перейти на страницу симптома Кахексия\">кахексия</a>.</p>",
"diagnostics": "<p>Чаще всего диагноз «<a href=\"/symptom/kaheksiya/\" title=\"Перейти на страницу симптома Кахексия\">кахексия</a>» можно установить только по внешнему виду пациента, настолько очевидны проявления кахексии при простом визуальном осмотре. Сбор анамнеза помогает уточнить сроки и стадию заболевания, тяжесть поражения организма. Для более точной оценки степени изменений производят стандартные лабораторные обследования: общий и биохимический анализы крови, общий анализ мочи (при необходимости – бакпосев мочи для исключения сепсиса), лабораторные и инструментальные методы обследования для выявления основного заболевания и его тяжести (рентген, УЗИ, МРТ, КТ, гастроскопия). При необходимости к обследованию могут привлечены и другие специалисты – гастроэнтеролог, кардиолог, гинеколог, невропатолог, психиатр, эндокринолог, онколог.</p>",
"treatment": "<p>Направлено на основное заболевание и должно включать мероприятия по восстановлению питания больного и обеспечению тщательного ухода.</p>\r\n<p> </p>\r\n<p>В рацион вводится пища, богатая белками, жирами, витаминами, предпочтительно употреблять легкоусваиваемые продукты. При нарушениях переваривания и всасывания пищи назначают полиферментные препараты. В тяжелых случаях парентерально вводят растворы глюкозы, электролитов, витамины, белковые гидролизаты, аминокислотные смеси. По показаниям применяют анаболические гормоны.</p>",
"prevention": "<p>Профилактика кахексии сводится к своевременному и адекватному лечению заболеваний, на фоне которых может развиться <a href=\"/symptom/kaheksiya/\" title=\"Перейти на страницу симптома Кахексия\">кахексия</a>. При чрезмерном употреблении алкоголя и приеме наркотиков необходимо лечение от этих зависимостей. </p>",
"clinical_picture": "<p>Резко выраженная <a href=\"/symptom/slabost/\" title=\"Перейти на страницу симптома Слабость\">слабость</a>, утрата трудоспособности, <a href=\"/symptom/anormalnaya_poterya_vesa/\" title=\"Перейти на страницу симптома Анормальная потеря веса\">резкое похудание</a>, признаки обезвоживания, могут наблюдаться безбелковые отеки подкожной клетчатки.</p>\r\n<p> </p>\r\n<p>В тяжелых случаях потеря массы достигает 50 % и более. Кожа бледная или землисто-серая, дряблая, морщинистая. Отмечаются трофические изменения волос и ногтей. Развивается стоматит, нередко выпадают зубы, отмечаются упорные запоры. Понижается половая функция, у женщин наступает аменорея. Уменьшается объем циркулирующей крови, АД обычно снижено.</p>",
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}
]
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