ВОзвращает список болезней. Можно фильтр/искать

search, age, gender, parent, symptoms, sort_name, sort_by, rand, branches
GET /disease/?format=api&ordering=-who&page=21
HTTP 200 OK
Allow: GET, HEAD, OPTIONS
Content-Type: application/json
Vary: Accept

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            },
            "code": "O06",
            "name": "Аборт неуточненный",
            "icd_name": "Аборт неуточненный",
            "gender": 2,
            "age_min": 15,
            "age_max": 69,
            "cause": [
                3
            ],
            "periodicity": 1,
            "slug": "o06_abort_neutochnennyy",
            "lead": "Нарушение здоровья, относящееся к группе беременность с абортивным исходом",
            "description": "Аборт (или выкидыш) – это спонтанное прерывание беременности и изгнание нежизнеспособного плода из полости матки. ",
            "etiology": "<p>Ранние аборты чаще всего обусловлены хромосомной патологией, несколько реже – нарушением процесса имплантации оплодотворённой яйцеклетки в слизистую оболочку матки. Причинами данной патологии могут становиться следующие нарушения: </p>\r\n<ul>\r\n<li>генетические аномалии развития плода (хромосомные аномалии, несовместимые с жизнью); </li>\r\n<li>эндокринная патология матери (сахарный диабет, дефицит прогестерона, заболевания щитовидной железы, гиперандрогения, дисфункция яичников); </li>\r\n<li>острые инфекционно-воспалительные процессы (ангина, ОРВИ, токсоплазмоз, микоплазмоз, краснуха, хламидиоз, аппендицит, аднексит, эндометрит и т.п.); </li>\r\n<li>чрезмерная физическая нагрузка, падения и травмы; </li>\r\n<li>истмико-цервикальная недостаточность; </li>\r\n<li>нарушения формирования плаценты; </li>\r\n<li>синдром гиперкоагуляции (усиленной свертываемости крови); </li>\r\n<li>аномалии формирования матки (гипоплазия матки, седловидная или двурогая матка); </li>\r\n<li>аутоиммунная патология (антифосфолипидный синдром, дисплазии соединительной ткани); </li>\r\n<li>выскабливания полости матки, аборты в анамнезе; </li>\r\n<li>деформации матки (спайки, синехии, полипы, миома, внутриматочная перегородка); </li>\r\n<li>резус-конфликт. </li>\r\n</ul>\r\n<p>Кроме того, риск самопроизвольного аборта повышает наличие соматической патологии у матери (почечной недостаточности, артериальной гипертензии и т.п.), дефицит некоторых витаминов (главным образом, фолиевой кислоты), многоплодная беременность, вредные привычки матери, психоэмоциональные нагрузки, зачатие методом экстракорпорального оплодотворения, инвазивные методики пренатальной диагностики (кордоцентез, биопсия хориона, амниоцентез), а также плохая экологическая обстановка, приём некоторых лекарств и несбалансированное питание. </p>",
            "pathogenesis": "<p>Механизм аборта различен. В ряде случаев сначала возникают сокращения матки, вызывающие отслойку плодного яйца. В других случаях сокращениям матки предшествует гибель плодного яйца (при токсикозах, острых и хронических инфекционных болезнях беременной и др.). Иногда отслойка и гибель плодного яйца и сокращения матки происходят одновременно. </p>\r\n<p>Частичное отделение плодного яйца вследствие технических ошибок или недостаточной сократительной активности миометрия под участком имплантации зародыша, задержка его частей в матке из-за наличия механических препятствий (миоматозный узел, закрытый шеечный канал и др.) делает невозможным адекватное сокращение стенки органа. В результате продолжается кровотечение из зияющих сосудов, возникает характерная боль и формируется питательный субстрат для возможного инфицирования. </p>",
            "diagnostics": "<p>Диагноз аборт ставится на основании клинической симптоматики, результатов влагалищного, бимануального осмотра, ультразвукового исследования.  </p>\r\n<p>Гинекологический осмотр позволяет оценить состояние шейки матки, обнаружить выделения или кровотечение из канала шейки матки, изгнание плодного яйца и его остатков.  </p>\r\n<p>Бимануальное исследование способствует определению размеров матки, ее консистенции и тонуса. </p>\r\n<p>УЗИ помогает установить признаки самопроизвольного прерывания беременности: отсутствие эмбриона в плодном яйце, отслойку плодного яйца (плаценты), несоответствие размеров эмбриона (плода) сроку гестации, отсутствие сердцебиения у плода. </p>\r\n<p>При диагностике производится общий анализ крови, определение уровня ХГЧ и прогестерона в крови, резус-фактора, количества тромбоцитов, уровня фибриногена.  </p>\r\n<p>При подозрении на инфицированный аборт исследуются бакпосевы крови, мочи и материала, полученного после выскабливания.  </p>\r\n<p>При привычном самопроизвольном прерывании беременности проводится цитогенетическое исследование остатков плодного яйца. </p>",
            "treatment": "<p>Основными задачами являются удаление из полости матки погибшего плода и его частей, остановка кровотечения и предупреждение возможных инфекционных осложнений.  </p>\r\n<p>Очищение полости матки. Для удаления оставшегося плодного яйца применяют абортцанг, после чего с учетом гестационного срока выполняют вакуум-аспирацию (до 12 недели беременности) или классический кюретаж маточных стенок (с 12 недели и далее). Эффективное ведение пациентки без полной чистки маточной полости невозможно. Для оптического контроля качества вмешательства может использоваться гистероскопия. </p>\r\n<p>Остановка маточного кровотечения. При сочетании неполного прерывания беременности с коагулопатическими и гемодинамическими расстройствами в зависимости от результатов лабораторных анализов капельно вводят гормон окситоцин на растворе Рингера или физрастворе. В исключительных случаях при значительной кровопотере рекомендованы гемостатики, переливание крови или ее компонентов. </p>\r\n<p>Антибактериальная терапия. Применение антибиотиков широкого спектра действия прямо показано при клинических и лабораторных признаках инфекционного процесса. С профилактической целью препараты с антимикробным действием вводят при поздней диагностике неполного отхождения плодного яйца. Курс антибиотикотерапии длится от 7 до 10 дней.  </p>",
            "prevention": "<p>В целях профилактики аборта рекомендуется вести здоровый образ жизни, своевременно лечить как соматическую, так и гинекологическую патологию, а также регулярно посещать гинеколога и становиться на учёт при беременности. В качестве вторичной профилактики рекомендуется планировать очередную беременность не ранее, чем через 3-4 месяца после самопроизвольного аборта. </p>",
            "clinical_picture": "<p>Клиническая картина неполного аборта является продолжением симптоматики самопроизвольного выкидыша в ходу или постепенно развивается в течение нескольких часов после хирургического аборта. При лекарственном прерывании гестации патологические признаки могут появиться спустя несколько суток и даже недель после приема медикаментов.</p>\r\n<p>Незавершенный аборт проявляется интенсивными схваткообразными болями внизу живота, зачастую иррадиирующими в поясницу и крестец, а также обильным маточным кровотечением с возможным присутствием в выделениях фрагментов абортивного материала. Реже болезненные ощущения имеют тянущий характер. О присоединении инфекции свидетельствует появление резкого гнилостного запаха вагинальных выделений, повышение температуры тела до 37,5-38,0° С и выше. При утяжелении патологии пациентки жалуются на слабость, головокружение, обморочные состояния. </p>\r\n<p>При полном прерывании беременности плодное яйцо изгоняется из матки полностью, матка сокращается и кровотечение останавливается. </p>",
            "image": null,
            "image_alt": null,
            "standard_type": 3,
            "danger": 1,
            "published": 2,
            "parent": null,
            "block_rubric": 158,
            "standards": [
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            },
            "code": "O03",
            "name": "Самопроизвольный аборт",
            "icd_name": "Самопроизвольный аборт",
            "gender": 2,
            "age_min": 10,
            "age_max": 79,
            "cause": [
                3
            ],
            "periodicity": 1,
            "slug": "o03_samoproizvolnyy_abort",
            "lead": "Нарушение здоровья, относящееся к группе беременность с абортивным исходом",
            "description": "Самопроизвольный аборт (или выкидыш) – это спонтанное прерывание беременности на сроке до 22 недель и изгнание нежизнеспособного плода из полости матки. ",
            "etiology": "<p>Ранние самопроизвольные аборты чаще всего обусловлены хромосомной патологией, несколько реже – нарушением процесса имплантации оплодотворённой яйцеклетки в слизистую оболочку матки. Причинами данной патологии могут становиться следующие нарушения: </p>\r\n<ul>\r\n<li>генетические аномалии развития плода (хромосомные аномалии, несовместимые с жизнью); </li>\r\n<li>эндокринная патология матери (сахарный диабет, дефицит прогестерона, заболевания щитовидной железы, гиперандрогения, дисфункция яичников); </li>\r\n<li>острые инфекционно-воспалительные процессы (ангина, ОРВИ, токсоплазмоз, микоплазмоз, краснуха, хламидиоз, аппендицит, аднексит, эндометрит и т.п.); </li>\r\n<li>чрезмерная физическая нагрузка, падения и травмы; </li>\r\n<li>истмико-цервикальная недостаточность; </li>\r\n<li>нарушения формирования плаценты; </li>\r\n<li>синдром гиперкоагуляции (усиленной свертываемости крови); </li>\r\n<li>аномалии формирования матки (гипоплазия матки, седловидная или двурогая матка); </li>\r\n<li>аутоиммунная патология (антифосфолипидный синдром, дисплазии соединительной ткани); </li>\r\n<li>выскабливания полости матки, аборты в анамнезе; </li>\r\n<li>деформации матки (спайки, синехии, полипы, миома, внутриматочная перегородка); </li>\r\n<li>резус-конфликт. </li>\r\n</ul>\r\n<p>Кроме того, риск самопроизвольного аборта повышает наличие соматической патологии у матери (почечной недостаточности, артериальной гипертензии и т.п.), дефицит некоторых витаминов (главным образом, фолиевой кислоты), многоплодная беременность, вредные привычки матери, психоэмоциональные нагрузки, зачатие методом экстракорпорального оплодотворения, инвазивные методики пренатальной диагностики (кордоцентез, биопсия хориона, амниоцентез), а также плохая экологическая обстановка, приём некоторых лекарств и несбалансированное питание. </p>",
            "pathogenesis": "<p>Механизм самопроизвольного аборта различен. В ряде случаев сначала возникают сокращения матки, вызывающие отслойку плодного яйца. В других случаях сокращениям матки предшествует гибель плодного яйца (при токсикозах, острых и хронических инфекционных болезнях беременной и др.). Иногда отслойка и гибель плодного яйца и сокращения матки происходят одновременно. </p>",
            "diagnostics": "<p>Диагноз самопроизвольного прерывания беременности ставится на основании клинической симптоматики, результатов влагалищного, бимануального осмотра, ультразвукового исследования.  </p>\r\n<p>Гинекологический осмотр позволяет оценить состояние шейки матки, обнаружить выделения или кровотечение из канала шейки матки, изгнание плодного яйца и его остатков.  </p>\r\n<p>Бимануальное исследование способствует определению размеров матки, ее консистенции и тонуса. </p>\r\n<p>УЗИ помогает установить признаки самопроизвольного прерывания беременности: отсутствие эмбриона в плодном яйце, отслойку плодного яйца (плаценты), несоответствие размеров эмбриона (плода) сроку гестации, отсутствие сердцебиения у плода. </p>\r\n<p>При диагностике производится общий анализ крови, определение уровня ХГЧ и прогестерона в крови, резус-фактора, количества тромбоцитов, уровня фибриногена.  </p>\r\n<p>При подозрении на инфицированный аборт исследуются бакпосевы крови, мочи и материала, полученного после выскабливания.  </p>\r\n<p>При привычном самопроизвольном прерывании беременности проводится цитогенетическое исследование остатков плодного яйца.</p>",
            "treatment": "<p>Лечение угрожающего прерывания беременности должно быть комплексным и включать постельный режим, седативные, спазмолитические средства, в I триместре показана патогенетически обоснованная гормональная терапия в зависимости от причин угрозы прерывания, гормональных показателей крови и (или) мочи, срока беременности. Дозы эстроген- и гестагенсодержащих гормональных препаратов подбирают под контролем клинических и лабораторных данных. С целью снижения лекарственной нагрузки целесообразно использовать физические методы лечения: иглорефлексотерапию, эндоназальную гальванизацию, электроаналгезию и др. </p>\r\n<p>При угрожающем самопроизвольном аборте во II и III триместрах беременности женщину следует госпитализировать, т.к. необходимы постоянный контроль за состоянием шейки матки, оценка состояния плода. Для лечения используют токолитические средства: b-адреномиметики, индометацин, сульфат магния. Одновременно можно использовать спазмолитические средства, физиотерапию: электрорелаксацию матки, электрофорез магния и др. </p>\r\n<p>При начавшемся самопроизвольном А. показана срочная госпитализация при любом сроке беременности. Лечение в основном такое же, как и при угрожающем выкидыше. Для прекращения кровянистых выделений при начавшемся А. в I триместре беременности применяют эстрогенсодержащие препараты. Производные стильбенов не рекомендуются. Чаще всего используется таблетированный этинилэстрадиол (микрофоллин) в постепенно снижающейся дозе. После прекращения кровянистых выделений или одновременно с микрофоллином назначают прогестерон или его синтетический аналог туринал. При обильных кровянистых выделениях гормональная терапия начавшегося А. не эффективна. Показаны также аминокапроновая кислота, дицинон, аскорутин. </p>\r\n<p>При аборте в ходу, неполном, полном и шеечном А. проводят инструментальное удаление остатков плодного яйца и сгустков крови методами выскабливания или вакуум-экскохлеации, что позволяет остановить кровотечение и предотвратить инфицирование. </p>\r\n<p>При неосложненном инфицированном А. удаление остатков плодного яйца проводится на фоне антибактериальной терапии. Принцип лечения при осложненном инфицированном и септическом аборте такой же, как и при послеродовой септической инфекции. </p>\r\n<p>При несостоявшемся А. длительное выжидание нецелесообразно. В I триместре беременности погибшее яйцо удаляют инструментально. В более поздние сроки беременности проводят родовозбуждение. Перед родовозбуждением необходимо произвести исследование свертывающей системы крови. После удаления плодного яйца назначают антибактериальную терапию и средства, сокращающие матку. </p>",
            "prevention": "<p>В целях профилактики самопроизвольного аборта рекомендуется вести здоровый образ жизни, своевременно лечить как соматическую, так и гинекологическую патологию, а также регулярно посещать гинеколога и становиться на учёт при беременности. В качестве вторичной профилактики рекомендуется планировать очередную беременность не ранее, чем через 3-4 месяца после самопроизвольного аборта. </p>",
            "clinical_picture": "<p>По клинической симптоматике самопроизвольного прерывания беременности различают угрожающий аборт, начавшийся аборт и аборт в ходу. При угрозе самопроизвольного прерывания беременности появляются ноющие боли и тяжесть внизу живота и в крестце; на более поздних сроках боли носят схваткообразный характер. Могут наблюдаться слизисто-сукровичные или кровянистые выделения из влагалища. Тонус матки повышен, ее размер соответствует сроку гестации; шейка матки - закрыта, нормальной длины; рост и развитие плода чаще всего не нарушены. </p>\r\n<p>Начавшийся аборт характеризуется более выраженными приступообразными болями и кровянистыми выделениями из половых путей, слегка приоткрытой шейкой матки, но еще не отторгнутым плодом. При аборте в ходу возникают регулярные схваткообразные боли внизу живота, часто - обильные кровянистые выделения. Внутренний и наружный зев шейки матки открыты, плодное яйцо может находиться в канале шейки матки или во влагалище, величина матки оценивается меньше срока беременности, возможно подтекание околоплодных вод. </p>\r\n<p>При полном самопроизвольном прерывании беременности плодное яйцо изгоняется из матки полностью, матка сокращается и кровотечение останавливается. При неполном аборте некоторые элементы плодного яйца задерживаются в полости матки, матка сокращается не полностью, возможны большая кровопотеря и развитие гиповолемического шока. </p>\r\n<p>Неосложненный инфицированный аборт характеризуется воспалительным процессом в эндометрии (эндометрит) и оболочках плода (хорионит, амнионит), повышением температуры, тахикардией, болезненностью матки, кровянистыми, иногда гнойными выделениями из половых путей. При осложненном инфицированном аборте состояние беременной ухудшается, возникают лихорадка, озноб, боли, диспепсические и дизурические явления, гнойные процессы в малом тазу (сальпингит, параметрит, пельвиоперитонит). Септическая форма самопроизвольного прерывания беременности сопровождается симптомами генерализованной септической инфекции и развитием инфекционно-токсического шока.  </p>\r\n<p>По клинической симптоматике самопроизвольного прерывания беременности различают угрожающий аборт, начавшийся аборт и аборт в ходу. При угрозе самопроизвольного прерывания беременности появляются ноющие боли и тяжесть внизу живота и в крестце; на более поздних сроках боли носят схваткообразный характер. Могут наблюдаться слизисто-сукровичные или кровянистые выделения из влагалища. Тонус матки повышен, ее размер соответствует сроку гестации; шейка матки - закрыта, нормальной длины; рост и развитие плода чаще всего не нарушены. </p>\r\n<p>Начавшийся аборт характеризуется более выраженными приступообразными болями и кровянистыми выделениями из половых путей, слегка приоткрытой шейкой матки, но еще не отторгнутым плодом. При аборте в ходу возникают регулярные схваткообразные боли внизу живота, часто - обильные кровянистые выделения. Внутренний и наружный зев шейки матки открыты, плодное яйцо может находиться в канале шейки матки или во влагалище, величина матки оценивается меньше срока беременности, возможно подтекание околоплодных вод. </p>\r\n<p>При полном самопроизвольном прерывании беременности плодное яйцо изгоняется из матки полностью, матка сокращается и кровотечение останавливается. При неполном аборте некоторые элементы плодного яйца задерживаются в полости матки, матка сокращается не полностью, возможны большая кровопотеря и развитие шока. </p>\r\n<p>Неосложненный инфицированный аборт характеризуется воспалительным процессом в эндометрии (эндометрит) и оболочках плода (хорионит, амнионит), повышением температуры, тахикардией, болезненностью матки, кровянистыми, иногда гнойными выделениями из половых путей. При осложненном инфицированном аборте состояние беременной ухудшается, возникают лихорадка, озноб, боли, диспепсические и дизурические явления, гнойные процессы в малом тазу (сальпингит, параметрит, пельвиоперитонит). Септическая форма самопроизвольного прерывания беременности сопровождается симптомами генерализованной септической инфекции и развитием инфекционно-токсического шока.  </p>",
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