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"lead": "Злокачественное новообразование шейки матки- онкологическое заболевание.",
"description": "Злокачественное новообразование шейки матки- онкологическое заболевание. В структуре онкологической заболеваемости женщин злокачественные опухоли шейки матки составляют почти 15% и среди поражений органов репродуктивной системы стабильно занимают третье место после рака молочной железы и рака эндометрия.",
"etiology": "<p>Ведущую роль в канцерогенезе рака шейки матки отводят вирусу папилломы человека как наиболее частому виду инфекций, передающихся половым путем Возбудитель вируса папилломы человека — группа ДНКсодержащих вирусов, относящихся к семейству Papavaviriade (HPV — human papilloma virus), обладающих способностью инфицировать и трансформировать эпителиальные клетки шейки матки.</p>",
"pathogenesis": "",
"diagnostics": "<p>При выяснении анамнеза необходимо обратить внимание на перенесённые заболевания, нарушения менструальной и репродуктивной функций, изменения в работе кишечника и мочевого пузыря, возраст больной, семейное положение, образ жизни.</p>\r\n<p>Шейка матки доступна для визуальных и инвазивных методов исследования, что способствует выявлению РШМ на ранних стадиях. Ранняя диагностика включает несколько различных исследований.</p>\r\n<p>Расширенная кольпоскопия позволяет изучать состояния эпителия шейки матки под 7,5–40кратным увеличением. Особое внимание уделяют зоне трансформации. Для повышения информативности исследования используют ряд специфических проб. Одна из них состоит в аппликации на шейку матки 3–5% раствора уксусной кислоты, что позволяет оценить состояние терминальной сосудистой сети, питающей эпителий шейки матки.</p>\r\n<p>В качестве опухолевого маркёра плоскоклеточного рака шейки матки в сыворотке крови пациентки определяют уровень специфического Аг — SCC. В норме он не превышает 1,5 нг/мл.</p>\r\n<p>При подозрении на предопухолевую патологию или рака шейки матки необходимо проводить углублённую диагностику (биопсия шейки матки, выскабливание цервикального канала).</p>\r\n<p>Гистологическое исследование считают заключительным и решающим методом диагностики РШМ, позволяющим определить характер морфологических и структурных изменений.</p>\r\n<p>Стадию РШМ определяют с помощью УЗИ, рентгенографии лёгких, цистоскопии, ирригоскопии. По показаниям выполняют КТ и МРТ.</p>",
"treatment": "<p>При раке шейки матки IА1 стадии (без неблагоприятных факторов прогноза) у лиц молодого, репродуктивного возраста, соматически отягощённых больных может быть выполнена высокая конусовидная ампутация шейки матки. После этой операции (в пределах здоровых тканей) показано строгое динамическое наблюдение.</p>\r\n<p>Для сохранения репродуктивной функции можно выполнить высокую конусовидную ампутацию шейки матки с забрюшинной или лапароскопической тазовой лимфодиссекцией.</p>\r\n<p>Стандартное хирургическое лечение РШМ IB1 стадии: расширенная экстирпация матки с придатками.</p>\r\n<p>У больных репродуктивного возраста яичники могут быть сохранены и выведены за пределы таза (возможно проведение послеоперационной лучевой терапии). Транспозиция яичников может быть выполнена при плоскоклеточном раке высокой и умеренной степени дифференцировки и отсутствии опухолевой сосудистой эмболии.</p>\r\n<p>Выбор метода лечения зависит от возраста, соматического статуса, мнения больной. Тактику лечения определяют на консилиуме.</p>",
"prevention": "<p>Риск заболеть раком шейки матки наиболее высок у женщин группы риска (раннее начало половой жизни, частая смена сексуальных партнеров, наличие инфекций, передающихся половым путем, первые роды в очень раннем возрасте, частые аборты). Основным способом профилактики рака шейки матки считают своевременное выявление фоновых, особенно предраковых, процессов и их лечение. Не менее важно использование барьерных средств контрацепции, препятствующих распространению инфекций, передающихся половым путем к которым относят и вирус папилломы человека, считаемый этиологическим фактором развития вируса папилломы человека. </p>",
"clinical_picture": "<p>Рак шейки матки принадлежит к опухолям, которые длительное время протекают бессимптомно. Появление клинических симптомов и жалоб говорит о далеко зашедшем опухолевом процессе. Наиболее часто больные предъявляют жалобы на обильные , кровянистые выделения и боли.</p>\r\n<p>Первые симптомы рака шейки матки. носят жидкий, водянистый характер и обусловлены лимфореей из участка опухоли, подвергшегося некрозу или распаду.</p>\r\n<p>Кровотечения — самый частый клинический симптом. Кровотечения при раке шейки матки носят характер многократно беспорядочно повторяющихся кровянистых выделений, усиливающихся в предменструальном и постменструальном периодах. В начале заболевания кровянистые выделения часто носят характер контактных, возникают после полового акта, натуживания или пальцевого исследования шейки матки.</p>\r\n<p>Боли по своему характеру, локализации, интенсивности бывают различны, бывают локализованы в поясничной области, крестце и под лоном.</p>\r\n<p>Поздние симптомы рака шейки матки. Развиваются в результате регионарного метастазирования, прорастания соседних органов, присоединения воспалительного компонента. К ним относят боли, тела, появление отёков конечностей, нарушения работы кишечника, мочевыделительной системы.</p>\r\n<p>Общие симптомы рака шейки матки. К ним относят общую , повышенную \"></a>, .</p>",
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"code": "C73",
"name": "Рак щитовидной железы",
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"lead": "злокачественная опухоль щитовидной железы, развивающаяся из фолликулярных или из С-клеток.",
"description": "<p>Самый распространенный тип онкологических заболеваний – это папиллярный рак щитовидной железы, встречающийся более чем в 75% случаях. Как правило, такая опухоль возникает из здоровой ткани щитовидной железы и показывает себя, как новообразование в виде кисты или неравномерной, солидной опухоли. Папиллярный рак можно считать одним из самых поддающихся лечению видов злокачественных опухолей. В 85% случаях онкобольные излечиваются полностью от данного вида рака.</p>",
"etiology": "<p>Современная медицина не имеет точных и доказанных причин возникновения опухолей на щитовидной железе, в частности папиллярного рака. Наиболее вероятной причиной считается мутация клеток на уровне ДНК. Причины возникновения мутаций также не известны. Клеточная структура щитовидной железы образует опухоли после мутаций клеток, которые начинают активно расти. Рост злокачественных клеток происходит постепенно, поражая здоровые ткани органа. По мнению медиков, папиллярный рак щитовидной железы может возникать по следующим причинам:</p>\r\n<ul>\r\n<li>Дефицит йода в организме человека;</li>\r\n<li>Врожденный фактор;</li>\r\n<li>Влияние окружающей среды, плохой экологии;</li>\r\n</ul>",
"pathogenesis": "",
"diagnostics": "<p>Первичное диагностирование злокачественной опухоли в щитовидной железе может проводиться врачом путем пальпирования шейной области. При наличии уплотнений и узлов пациента направляют на ультразвуковое исследование. Однако окончательный и точный диагноз может быть поставлен только после проведения гистологического анализа узла, отсеченного из железы или удаленного лимфаузла. Выявление метастазов в костной ткани и легких осуществляется при помощи рентген-исследования.</p>\r\n<p>При возникновении небольших опухолей, которые не прощупываются, могут возникнуть затруднения в диагностировании заболевания, так как увеличение лимфатических узлов в шейном отделе указывает еще на ряд других заболеваний. Чтобы подтвердить или опровергнуть папиллярный рак щитовидной железы проводится гистологический анализ отсеченного лимфатического узла.</p>",
"treatment": "<p>Современная медицина имеет в своем арсенале эффективный метод лечения рака щитовидной железы, который состоит из двух этапов:</p>\r\n<ol type=\"1\" start=\"1\">\r\n<li>Оперативное вмешательство хирургов;</li>\r\n<li>Проведение процедур с радиоактивным йодом.</li>\r\n</ol>\r\n<p>На первом этапе лечения проводится хирургическая операция по отсечению больных клеток органы или полное отсечение щитовидной железы. При поражении рядом находящихся лимфатических узлов выполняется полное или частичное удаление лимфаузлов в шейном отделе. Статистика указывает, что папиллярный рак чаще всего поражает лимфатические узлы, расположенные рядом с гортанью и трахеей.</p>\r\n<p>На втором этапе лечения проводятся процедуры с радиоактивным йодом. Такое лечение показано больным со злокачественной опухолью и наличием метастазов в лимфатических узлах, а так же при прорастании злокачественных образований через оболочку органа. Клетки, вырвавшиеся из железы, являются очень опасными. Терапия с радиоактивным йодом убивает оставшиеся после оперативного вмешательства раковые клетки. Обычно опухолевые клетки могут оставаться в самой щитовидной железе. Кроме этого, радиоактивный йод эффективно борется с метастазами, расположенными в легких, лимфатический системе.</p>",
"prevention": "",
"clinical_picture": "<p>Первый признак – появление на щитовидной железе небольшого узелка. Он заметен под кожей и имеет вид небольшого возвышения с одной стороны. На начальных этапах узелок может быть эластичный и безболезненный, его подвижность ограничена. Он не врос в кожу, а перекатывается под ней. Со временем узел становится более плотным и увеличивается в размерах.</p>\r\n<p>Еще один ранний симптом рака щитовидной железы – увеличение лимфатического узла на шее. Иногда это единственный признак болезни.<br /><br />На поздних этапах, когда опухоль становится более крупная, появляются и другие симптомы:<br /><br /></p>\r\n<ul>\r\n<li>боль в области шеи, которая может отдавать в ухо;</li>\r\n<li>затруднение глотания;</li>\r\n<li>ощущение комка в горле;</li>\r\n<li>осиплость голоса;</li>\r\n<li>кашель, который не связан с простудой или аллергией;</li>\r\n<li>одышка и затрудненное дыхание;</li>\r\n<li>набухание шейных вен.</li>\r\n</ul>\r\n<p><br />Эти симптомы вызваны тем, что опухоль достигла крупных размеров и начала сдавливать окружающие органы: пищевод, трахею. Метастазы в голосовых связках и возвратном гортанном нерве, который проходит рядом с железой – причина изменения <a title=\"Перейти на страницу симптома Слуховые галлюцинации\" href=\"/symptom/sluhovye_gallyucinacii/\">голоса</a>.</p>",
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