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},
"code": "R64",
"name": "Кахексия",
"icd_name": "Кахексия",
"gender": 0,
"age_min": 0,
"age_max": 100,
"cause": [
3
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"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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