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"etiology": "<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;\">Фиброзная дисплазия относится к категории опухолеподобных заболеваний, но не является истинной опухолью костей. Возникает вследствие неправильного развития остеогенной мезенхимы (ткани, из которой в последующем образуется кость). Причины развития не ясны, не исключена генетическая предрасположенность.</span></p>",
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"treatment": "<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;\">Лечение преимущественно хирургическое – полная сегментарная резекция пораженного участка кости в пределах здоровых тканей и замещение дефекта костным трансплантатом. При патологическом переломе накладывают аппарат Илизарова. При множественных поражениях проводят профилактические мероприятия, направленные на предотвращение деформаций и патологических переломов.</span></p>",
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},
"code": "B74",
"name": "Филяриатоз",
"icd_name": "Филяриатоз",
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"age_min": 0,
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"cause": [
3,
2,
6
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"slug": "b74_filyariatoz",
"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": "I80",
"name": "Флебит и тромбофлебит",
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"lead": "Нарушение здоровья, относящееся к группе болезни вен, лимфатических сосудов и лимфатических узлов, не классифицированные в других рубриках",
"description": "Флебит – это заболевание вен, при котором происходит воспаление их сосудистых стенок. Преимущественно актуально это заболевание для области нижних конечностей. \r\nТромбофлебит же собой представляет воспаление вены в таком варианте, течение которого сопровождается появлением тромбов. ",
"etiology": "<p>Чаще всего в качестве причин, провоцирующей развитие флебита и тромбофлебита, выделяют: </p>\r\n<ul>\r\n<li>варикозное расширение вен; </li>\r\n<li> избыточный вес; </li>\r\n<li>гиподинамия (состояние, провоцируемое нехваткой двигательной активности); </li>\r\n<li>длительность пребывания в стоячем положении; </li>\r\n<li>запоры в хронической форме течения этого заболевания. </li>\r\n</ul>\r\n<p>Развитие тромбофлебита также возможно и в результате воздействия аллергической реакции, что определяет такую его разновидность, как аллергический флебит, помимо этого возможно развитие заболевания и в качестве осложнения, возникающего после родов – в этом случае речь идет уже о болевом флебите. Не исключаются и такие случаи, при которых тромбофлебит возникает при инфекционном поражении вены или при ее травмировании, что подразумевает под собой нарушение целостности в ее сосудистой стенке. </p>",
"pathogenesis": "<p>Для возникновения тромбофлебита нужно присутствие одного или нескольких факторов из трех (т.н. триада Вирхова): </p>\r\n<ol>\r\n<li>Повреждение стенки вены (может быть как механическим, вследствие травмы, так и химическим – ожог при введении концентрированных препаратов, наркотических веществ) </li>\r\n<li>Нарушение реологических свойств крови (повышение свертываемости, вязкости и т.п.). Это бывает при обезвоживании, некоторых заболеваниях, гормональных, генетических нарушениях. </li>\r\n<li>Замедление кровотока в вене (при сдавлении вены, ограничении движений (например, при ношении гипсовой повязки)). </li>\r\n</ol>\r\n<p>Под действием одного или нескольких факторов происходит образование тромба в просвете сосуда и воспаление его стенки. Пример: при серьезной травме ноги присутствуют все три фактора – механическое повреждение (надрывы стенки вены вследствие удара), повышение свертываемости (вследствие кровопотери), замедление кровотока (отек тканей, наложение гипса). </p>\r\n<p>Обычно при тромбофлебите поверхностных вен поражается одна вена, воспаление также может распространяться и на ее притоки. Известен мигрирующий тромбофлебит – при нем происходит последовательное воспаление нескольких вен на разных участках конечностей. Такой тромбофлебит требует дополнительной диагностики для исключения онкологических процессов или генетических нарушений свертываемости. </p>",
"diagnostics": "<p>Физикальное обследование: </p>\r\n<ul>\r\n<li>Болезненный плотный инфильтрат в виде шнура по ходу подкожной вены. </li>\r\n<li>Над инфильтратом возможна гиперемия кожи с уплотнением подкожной клетчатки. </li>\r\n<li>При ходьбе - умеренная болезненность. </li>\r\n<li> Температура тела субфебрильная. </li>\r\n</ul>\r\n<p>Лабораторные исследования: признаки воспаления (лейкоцитоз, ускоренное СОЭ). </p>\r\n<p>Инструментальные исследования Дуплексное сканирование вен - позволяет определить истинную границу тромба, так как она может не совпадать с границей, определяемой пальпаторно. Тромбированный участок вены становится ригидным, просвет его неоднороден, кровоток не регистрируется. </p>",
"treatment": "<p>Необходимо применять эластические компрессионные бинты, чулки, колготки как дополнение к медикаментозному лечению больных. Все пациенты с ТГВ должны носить эластические компрессионные чулки для снижения риска развития посттромботического синдрома. </p>\r\n<p>Системная консервативная терапия осуществляется с применением нестероидных противовоспалительных фармпрепаратов в комбинации со средствами, уменьшающими проницаемость венозной стенки. </p>\r\n<p>Антикоагулянтную терапию рекомендуется проводить при симультантном тромбозе глубоких вен или при развитии восходящего тромбофлебита у пациентов с ограничением показаний для оперативного лечения, при возникновении посттромбофлебитического синдрома. </p>\r\n<p>В первоначальные несколько дней заболевания рекомендуется локальное применение холода, эластичная компрессия больной конечности (эластичное бинтование), нанесение мазей, в составе которых содержатся нестероидное противовоспалительное средство и гепарин (категорически недопустимо применение мазевых компрессов, которые ограничивают теплоотдачу и могут способствовать прогрессированию заболевания). </p>\r\n<p> </p>",
"prevention": "<p>Чтобы избежать появления тромбофлебита нужно вести здоровый образ жизни. Необходимо своевременное лечение варикозной болезни. Следует избегать травм, обезвоживания. Несколько повышает риск развития тромбофлебита прием гормональных контрацептивов. При появлении первых симптомов нужно срочно обратиться к врачу – это позволит эффективно лечить заболевание и избежать осложнений. <br class=\"SCXW95579271\" /> <br class=\"SCXW95579271\" /> <br class=\"SCXW95579271\" /> <br class=\"SCXW95579271\" /> </p>",
"clinical_picture": "<p>Тромбофлебит поверхностных вен нижних конечностей </p>\r\n<ul>\r\n<li>Начинается с варикоза, отчего симптоматику патологии невозможно спутать с каким-либо другим заболеванием. </li>\r\n<li>Помимо болевых ощущений, которые зачастую возникают именно в том месте, где произошло уплотнение стенок с образованием кровяных сгустков, у больного отмечается повышенная температура тела. К числу сопутствующей симптоматики относят увеличение лимфоузлов. </li>\r\n<li>Пораженные вены можно обнаружить при пальпации. Как правило, кожные покровы в этих местах приобретают красный оттенок, а при ощупывании места можно обнаружить характерное уплотнение, причем при визуальном рассмотрении нередко отмечается припухлость. При пальпации больного мучают сильные боли. </li>\r\n</ul>\r\n<p>Флебит и тромбофлебит глубоких сосудов нижних конечностей </p>\r\n<ul>\r\n<li>Характеризуются болевыми ощущениями, в особенности при опускании ноги. В этот же момент больной часто ощущает распирание, что может сопровождаться повышением температуры кожных покровов в месте поражения. </li>\r\n<li>Вследствие развития патологии человек замечает у себя набухание и изменение оттенка кожных покровов на синий. Уже на вторые сутки от начала заболевания ноги больного «покрываются» соответствующей венозной и сосудистой сеткой, которая не только портит внешний вид, но и доставляет дискомфорт. </li>\r\n<li>Так, при ходьбе и в статичном положении человек страдает от болевого синдрома, в то время, когда при сжимании с передней и задней стороны наступает нестерпимая боль. При этом также отмечается, что сжимания со сторон не доставляет неудобств. </li>\r\n</ul>\r\n<p>Бедренной вены </p>\r\n<ul>\r\n<li>Проявляется набуханием и покраснением поверхности с внутренней стороны бедра; </li>\r\n<li>здесь же отмечается боль и разбухание подкожных вен; </li>\r\n<li>поражения общей бедренной вены сопровождается распуханием венозной системы, набуханием, покраснением, повышением температуры тела, лихорадкой, а также острой болью. </li>\r\n</ul>\r\n<p>Тромбофлебит подвздошно-бедренного участка магистральной вены </p>\r\n<ul>\r\n<li>характеризуется болевыми ощущениями в области поясницы и крестца, нередко присутствует боль с одной стороны живота; </li>\r\n<li>причем болевой синдром может быть ярко выраженным при полном перекрытии сосуда, и слабо выражен в случае частичного перекрытия. </li>\r\n</ul>\r\n<p>Глубоких вен </p>\r\n<ul>\r\n<li>Также проявляется в зависимости от локализации и расположения тромба. Более того, представленные поражения проявляются лишь незначительными болевыми ощущениями и малой отечностью, что затрудняет диагностирование заболевания. </li>\r\n<li>При отсутствии своевременного лечения глубокие тромбозы открываются, что провоцирует развитие тромбоэмболии легочных артерий. </li>\r\n<li>Опасность тромбоэмболии заключена в ее стремительном течении и размером тромба. Если отрывается тромб больших размеров, смертельный исход наступает в течение получаса. </li>\r\n</ul>",
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}
]
}