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},
"code": "I83",
"name": "Варикозное расширение вен ног",
"icd_name": "Варикозное расширение вен нижних конечностей",
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"age_min": 20,
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3
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"lead": "неравномерное расширение вен нижних конечностей, которое сопровождается нарушением кровотока и несостоятельностью клапанов пораженных вен",
"description": "По причине возникновения заболевание подразделяется на первичное и вторичное варикозное расширение вен.",
"etiology": "<p>Первичное варикозное расширение связано со слабостью или функциональными нарушениями венозной стенки. Предрасполагающими факторами являются беременность, <a href=\"/symptom/ozhirenie/\" title=\"Перейти на страницу симптома Ожирение\">ожирение</a>, длительное пребывание в положении стоя, врожденная <a href=\"/symptom/slabost/\" title=\"Перейти на страницу симптома Слабость\">слабость</a> соединительной ткани, ношение чулок с тугими резинками. Развитие вторичного варикозного расширения связано с нарушением венозного оттока, например при посттромбофлебитическом синдроме, несостоятельности клапанов глубоких вен, опухолях, травмах.</p>",
"pathogenesis": "",
"diagnostics": "<p>Диагноз ставится на основании жалоб больного, данных осмотра и пальпации. Функциональное состояние вен нижних конечностей оценивают с помощью различных проб.</p>\r\n<p>Для уточнения проходимости глубоких вен применяют флебографию.</p>",
"treatment": "<p>При начальной стадии заболевания – склерозирующая терапия, при прогрессировании болезни – хирургическое лечение.</p>",
"prevention": "<p>Кто любит долго сидеть, тот должен отказаться от этой пагубной привычки. Долгое сидение способствует варикозному расширению вен, так как в согнутых, неподвижных ногах замедляется кровообращение. Постойте немного в транспорте, во время рабочего дня разомните немножко ноги - в общем, больше двигайтесь.</p>\r\n<p>Если в течение дня вам приходится долго сидеть на стуле, например при работе за компьютером, время от времени выполняйте простые упражнения.</p>\r\n<ol>\r\n<li>Сидя на стуле, приподнимите носки и колени 10 раз. Это немного поможет восстановить приток крови к сердцу.</li>\r\n<li>Встаньте на носки, потянитесь, проделайте это 10 раз.</li>\r\n<li>Сидя на стуле, согнув колени, двигайте пятками вперед и назад 15 раз.</li>\r\n</ol>\r\n<p>Тем людям, кто весь день проводит \"на ногах\", также следует опасаться варикоза. Когда ваши ноги испытывают сильную нагрузку, кровь застаивается в венах, вызывая варикозное расширение.</p>\r\n<p>Особенно подвержены такому заболеванию люди, которые страдают избыточным весом. В кровеносных сосудах полного человека находится больше крови, чем у человека с нормальным весом, поэтому на такие сосуды приходится слишком большая нагрузка. Людям с избыточным весом в такой ситуации можно дать только один совет - похудеть и держать свой вес постоянно в норме. Употреблять чаще белки и витамины С и Е, которые являются составляющими коллагена - соединительной ткани вен и венозных клапанов. Но сбалансированное питание не поможет вылечить варикоз, а только улучшит ваше самочувствие.</p>\r\n<p>Двигаться по возможности чаще. Движение - это жизнь, аксиома всем известна. Движение не допускает застоя в крови, заставляет сокращаться мышцы в ногах, что помогает интенсивному движению крови к сердцу. Сделать свою жизнь более динамичной можно при помощи различных средств, таких как спортивная ходьба, бег, катание на велосипеде, аэробика, шейпинг, плавание, занятия на тренажерах. Физические упражнения не дадут крови застаиваться в венах, ткани ног станут упругими и не позволят венам растягиваться на ногах.</p>\r\n<p>Тем, у кого только начинает развиваться заболевание, врачи рекомендуют носить специальные антиварикозные колготки, которые должен выписать врач. Они продаются в аптеках по рецепту. Такие колготки предотвращают <a href=\"/symptom/meteorizm/\" title=\"Перейти на страницу симптома Метеоризм\">вздутие</a> вен, так как сдавливают икроножные мышцы сильнее, чем мышцы бедра. Потоку крови быстрее и легче подниматься вверх, к сердцу.</p>\r\n<p> </p>\r\n<p> </p>\r\n<p> </p>\r\n<p>Конечно, антиварикозные колготки могут только замедлить течение болезни, но не предотвратить ее. Если у вас нет возможности носить эластичные чулки, то бинтуйте ноги эластичным бинтом. Это следует делать по утрам, но перед бинтованием необходимо полежать с поднятыми вверх ногами около 15 мин. В этом случае сила притяжения способствует обратному притоку крови - от ног к сердцу. Уменьшаются отекание и нагрузка на вены. Выполняйте это упражнение по 5-6 мин каждый день, по возможности 2-3 раза в день.</p>",
"clinical_picture": "<p>Больные предъявляют жалобы на быструю <a href=\"/symptom/utomlyaemost/\" title=\"Перейти на страницу симптома Утомляемость\">утомляемость</a> конечности, чувство тяжести. Для некоторых больных характерно формирование в течение дня отека голеностопного сустава и голени, который распространяется также и на бедро в виде умеренного расширения вен. Также могут быть жалобы на ощущение тепла в пораженной конечности, а также на кожный <a href=\"/symptom/zud/\" title=\"Перейти на страницу симптома Зуд\">зуд</a>. По мере прогрессирования заболевания присоединяются судороги в икроножных мышцах, как правило, ночью.</p>",
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5082
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"code": "Q65",
"name": "Врожденные деформации бедра",
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"etiology": "<p>В силу врожденного порядка происходят задержка развития ядра, окостенение эпифиза головки бедра и после его появления – медленное развитие эпифиза.</p>",
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"diagnostics": "<p>Рентгенологически определяется почти вертикальное расположение зоны роста. Уменьшение шеечно-диафизарного угла прогрессирует с возрастом. К 5–8 годам укорочение конечности может равняться 4–8 см.</p>",
"treatment": "<p>Ортопедическое, по показаниям – хирургическое.</p>",
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"clinical_picture": "<p>Если в норме шеечно-диафизарный угол у новорожденных является 135°, а в дальнейшем равен 127–130°, то при Coxa vara он уменьшен до 90° или бывает острым. Увеличение угла свыше 135° носит название Coxa valga.</p>\r\n<p> </p>\r\n<p>Основные симптомы: ограничение отведения бедра, смещение большого вертела кверху выше линии Розера-Нелатона, в более старшем возрасте – положительный симптом Тренделенбурга из-за сближения точек прикрепления средней и малой ягодичных мышц, функциональное укорочение конечности, при двусторонней Coxa vara наблюдаются «утиная» походка и образование поясничного лордоза.</p>\r\n<p> </p>\r\n<p>Характерными являются наличие костного бугорка на наружной поверхности бедра в его средней части, укорочение и <a href=\"/symptom/anormalnoe_polozhenie_tela/\" title=\"Перейти на страницу симптома Анормальное положение тела\">искривление</a> диафиза бедра и утолщение бедра в нижней части. С возрастом <a href=\"/symptom/anormalnoe_polozhenie_tela/\" title=\"Перейти на страницу симптома Анормальное положение тела\">искривление</a> диафиза бедра и бугорок на наружной поверхности выравниваются.</p>",
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"diagnostics": "<p>Постановка диагноза основывается на клинических и рентгенологических данных.</p>",
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"clinical_picture": "<p>При врожденной косолапости наблюдаются изменения формы и положения стопы. Внутренняя косолапость (pes varus) характеризуется изменением формы пяточной кости, костей плюсны. При pes equinus стопа находится в положении подошвенного сгибания. При приведении аддукции переднего отдела стопы – pes adductus. Если имеется сумма этих отклонений, стопа носит название pes equino-varus-adductus.</p>\r\n<p> </p>\r\n<p>Врожденная косолапость делится на 2 группы: типичные и нетипичные формы. К нетипичным формам относится косолапость при амниотических перетяжках, врожденных дефектах костей, врожденных спастических параличах.</p>\r\n<p> </p>\r\n<p>Типичная группа врожденной косолапости варусная, контрактуры Остен-Сакена (при этом изменение в костях, связках, мышцах незначительные). При костных формах косолапости наряду с изменениями со стороны связок и мышц отмечаются выраженные изменения таранной кости и ее смещение вперед и кнутри. Наружная лодыжка мешает исправлению деформации, тогда как размеры внутренней лодыжки меньше, чем в норме.</p>\r\n<p> </p>\r\n<p>При врожденной косолапости стопа повернута внутрь, особенно в области пятки и среднего отдела стопы. Имеется приведение переднего отдела стопы, в результате чего на внутренней его поверхности в области I клиновидной кости и ладьевидной кости проходит глубокая складка – борозда Адамса. Стопа находится в положении подошвенного сгибания. Степень деформации колеблется в широких пределах. После того как дети начинают ходить, появляется огрубение кожи по наружному краю стопы. Походка становится своеобразной, «ходульной».</p>",
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