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"lead": "злокачественное опухолевое поражение отделов тонкого кишечника: двенадцатиперстной, тощей или подвздошной кишки.",
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"etiology": "<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;\">Точные причины возникновения онкологических образований в тонком отделе кишечника до сих пор не выяснены. Однако достоверными данными подтверждено, что это заболевание у большинства пациентов развивается на фоне хронических патологий органов желудочно-кишечного тракта, а также при воспалительных процессах, протекающих в различных отделах кишечника. Специалисты предполагают, что возникнуть рак тонкого кишечника может вследствие следующих недугов:</span></p>\r\n<ul>\r\n<li><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;\">дуоденит;</span></li>\r\n<li><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;\">колит;</span></li>\r\n<li><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;\">энтерит;</span></li>\r\n<li><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;\">язвенная болезнь;</span></li>\r\n<li><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;\">болезнь Крона;</span></li>\r\n<li><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;\">целиакия;</span></li>\r\n<li><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;\">синдром Пейтца-Егерса;</span></li>\r\n<li><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;\">доброкачественные образования в кишечнике;</span></li>\r\n<li><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;\">генетические патологии;</span></li>\r\n<li><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;\">злокачественные новообразования других внутренних органов.</span></li>\r\n</ul>\r\n<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;\">Риск получить диагноз возрастает при наличии вредных привычек, неправильном питании (при употреблении в пищу красного мяса, острых, жирных и копченых блюд и отсутствии в меню достаточного количества овощей и фруктов – источников пищевых волокон). Спровоцировать преобразование клеток в раковые может и радиоактивное излучение.</span></p>",
"pathogenesis": "",
"diagnostics": "<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;\">Диагностика с применением специального оборудования помогает достоверно установить местонахождение злокачественного образования, определить его тип и строение, степень развития и многое другое.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">Наиболее информативными методами являются:</span></p>\r\n<ul>\r\n<li><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;\">скрининг тест на рак кишечника (кал на скрытую кровь - иммунохимический тест Colon View) помогает обнаружить онкологию на ранней стадии, так как при раке тонкого кишечника явно выраженная кровь в кале появляется только при сильном кровотечении, но чаще всего кровотечения бывают в небольшом количестве, невидимые глазом, поэтому анализ на скрытую кровь в кале, позволяет заподозрить заболевание;</span></li>\r\n<li><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;\">фиброгастродуоденоскопия;</span></li>\r\n<li><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;\">контрастная рентгеноскопия;</span></li>\r\n<li><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;\">ирригоскопия;</span></li>\r\n<li><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;\">колоноскопия;</span></li>\r\n<li><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;\">гистологическое исследование образцов опухоли;</span></li>\r\n<li><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;\">УЗИ брюшной полости;</span></li>\r\n<li><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;\">МКТ брюшной полости и другие (лучше написать просто КТ брюшной полости)</span></li>\r\n</ul>\r\n<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;\">Также проводят ряд дополнительных лабораторных исследований крови и мочи для определения в организме специфических антигенов, индикана и онкомаркеров.</span></p>\r\n<p><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;\"> </span></p>",
"treatment": "<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;\">При операбельности рака тонкого кишечника наиболее эффективно проведение широкой резекции пораженного участка кишки и лимфоузлов, иссечение брыжейки. Протяженность тонкого кишечника позволяет выполнять радикальное удаление опухоли в границах здоровых тканей. Целостность ЖКТ восстанавливается путем наложения энтероэнтероанастомоза (тонкой кишки в тонкую) или энтероколоанастомоза (тонкой кишки в толстую).</span></p>\r\n<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;\">При раке 12-перстной кишки показана дуоденэктомия, иногда с дистальной резекцией желудка или резекцией поджелудочной железы (панкреатодуоденальная резекция). При запущенном раке тонкого кишечника, не позволяющем осуществить радикальную резекцию, производится наложение обходного анастомоза между непораженными петлями кишки. Хирургический этап лечения рака тонкого кишечника дополняется химиотерапией; этот же метод может являться единственным способом лечения неоперабельных опухолей.</span></p>",
"prevention": "<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;\">Снизить до абсолютного минимума риск возникновения рака тонкого кишечника невозможно, однако существует ряд профилактических мер, которые помогают избежать формирования опухолей в кишечнике:</span></p>\r\n<ul>\r\n<li><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;\">Регулярно проходить профилактические осмотры в профильной клинике.</span></li>\r\n<li><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;\">Придерживаться принципов здорового образа жизни и питания.</span></li>\r\n<li><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;\">Вовремя и до конца лечить заболевания желудочно-кишечного тракта.</span></li>\r\n<li><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;\">Ежегодный анализ кала на срытую кровь (тест Colon View, с помощью которого можно достоверно определить скрытую кровь в кале и выявить рак кишечника на ранней стадии).</span></li>\r\n<li><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;\">Обращаться к врачу при появлении любых тревожных симптомов со стороны системы пищеварения.</span></li>\r\n</ul>\r\n<p> </p>",
"clinical_picture": "<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;\">Распознать рак тонкого кишечника, симптомы которого меняются в зависимости от стадии заболевания, поначалу очень нелегко, ведь эта разновидность заболевания отличается полным отсутствием симптоматики на начальных этапах развития патологического процесса. Заметные признаки появляются лишь тогда, когда опухоль приводит к появлению язв или сужает просвет кишки.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">Симптомы ранней стадии рака:</span></p>\r\n<ul>\r\n<li><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;\">тошнота и отрыжка;</span></li>\r\n<li><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;\">диарея или запор;</span></li>\r\n<li><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;\">тяжесть в желудке;</span></li>\r\n<li><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;\">вздутие живота;</span></li>\r\n<li><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;\">боли в животе спастического характера.</span></li>\r\n</ul>\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;\">По мере роста опухоли клиническая картина расширяется, и к озвученным симптомам добавляются сложности с опорожнением из-за ложных позывов к дефекации и/или частичной или полной непроходимостью кишечника, кишечные кровотечения и сильные боли в животе.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">Наряду с этим у больных возникает ряд общих симптомов:</span></p>\r\n<ul>\r\n<li><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;\">нарастающая слабость;</span></li>\r\n<li><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;\">утомляемость и общие недомогания;</span></li>\r\n<li><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;\">потеря аппетита или появление отвращения к пище;</span></li>\r\n<li><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;\">резкая потеря в весе;</span></li>\r\n<li><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;\">анемия и возникшая вследствие нее бледность кожных покровов и слизистых;</span></li>\r\n<li><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;\">головокружение;</span></li>\r\n<li><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;\">стойкое повышение температуры тела до субфебрильных значений.</span></li>\r\n</ul>\r\n<p> </p>",
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},
"code": "C25",
"name": "Рак поджелудочной железы",
"icd_name": "Рак поджелудочной железы",
"gender": 0,
"age_min": 55,
"age_max": 100,
"cause": [
3,
0
],
"periodicity": 1,
"slug": "c25_rak_podzheludochnoy_zhelezy",
"lead": " злокачественное новообразование, исходящее из эпителия железистой ткани или протоков поджелудочной железы.",
"description": "Рак поджелудочной железы является одним из самых агрессивных типов онкологии. Наиболее распространенной формой рака поджелудочной железы является аденокарцинома.\r\n\r\n",
"etiology": "<p>Факторами риска рака поджелудочной железы являются:</p>\r\n<ul>\r\n<li>употребление спиртных напитков</li>\r\n<li>курение</li>\r\n<li>обилие жирной и острой пищи</li>\r\n<li>сахарный диабет</li>\r\n<li>цирроз печени<full></full></li>\r\n</ul>\r\n<p>К предраковым заболеваниям относятся:</p>\r\n<ul>\r\n<li>Аденома поджелудочной железы</li>\r\n<li>Хронический панкреатит</li>\r\n<li>Киста поджелудочной железы</li>\r\n</ul>",
"pathogenesis": "",
"diagnostics": "<p>При раке поджелудочной железы обследование пациента начинают с расспроса о жалобах и с объективного осмотра. Однако на ранних стадиях рака они малоинформативны. При пальпации органов брюшной полости почти всегда можно обнаружить увеличенные печень, селезенку и желчный пузырь. В запущенных случаях при РПЖ в брюшной полости определяется жидкость — <a href=\"/symptom/ascit/\" title=\"Перейти на страницу симптома Асцит\">асцит</a>. Характерные для РПЖ изменения в биохимическом анализе крови — увеличение билирубина, ферментов (липаза, амилаза и др.), печеночных трансаминаз (АсАт, АлАт), желчных кислот, на поздних стадиях — снижение уровня белков. УЗИ и более достоверные рентгенологические методы (компьютерная и магнитно-резонансная томография, ангиография, холангиография — чреспеченочная и чрескожная) позволяют увидеть место расположения опухоли, оценить ее размеры и степень прорастания в соседние органы. Биопсия и последующее изучение ткани опухоли под микроскопом позволяет подтвердить опухолевое происхождение клеток и определить тип рака.<br /><br /><br /></p>",
"treatment": "<p class=\"bodytext\">На первой стадии онкологии, когда опухоль не превышает 2 см и не выходит за пределы поджелудочной, а метастазы отсутствуют, можно избавиться от новообразования с помощью панкреатикодуоденэктомии (если опухоль в головке) или дистальная панкреатэктомии со спленэктомией (если опухоль в теле или хвосте). После операции необходимо пройти 6 курсов химиотерапии гемзаром или фторурацилом.</p>\r\n<p class=\"bodytext\">Опухоль поджелудочной железы на 2 и 3 стадиях характеризуется выходом новообразования за пределы органа, прорастанием онкологии в сосуды, окружающие ткани и нервов, поражением лимфоузлов. Чаще всего такие опухоли уже нерезектабельны. Лишь в отдельных случаях (когда отсутствует прорастание новообразования в нервы и магистральные сосуды) можно выполнить гастропанкреатодуоденальную резекцию. После нее пациенту показана химиотерапия гемзаром.</p>\r\n<p class=\"bodytext\">Рак поджелудочной железы четвертой стадии предполагает наличие отдельных метастазов. Основным видом лечения в данном случае будет являться химиотерапия. К препаратам первой линии относят гемцитабин, также можно давать пациенту сочетание гемзара с тарцевой. Вторая линия — это схемы лечения, включающие лечение оксалиплатином, иринотеканом, фторурацилом/кселодами, цисплатином. Эффективность препаратов первой линии значительно выше.</p>\r\n<full></full>\r\n<p class=\"bodytext\">Существуют две главные проблемы, которые беспокоят онкобольных с опухолью поджелудочной железы, — это боль и <a href=\"/symptom/zheltuha/\" title=\"Перейти на страницу симптома Желтуха\">желтуха</a>. При желтухе пациентам показана эндоскопическая установка стента. Стнетом называют пористую трубку или металлический проволочный каркас, который вводят в просвет суженого желчного протока. Стент растягивает проток, позволяя выводить желчь без нарушений. Опухоль не может сдавить стент, однако со временем прорастает сквозь его стенки и вновь нарушает отток желчи.</p>\r\n<p class=\"bodytext\">Еще один вариант обеспечения нормального оттока — это установка дренажа. В этом случае проходимость не восстанавливается, а желчь выходить наружу — в специальный мешочек.</p>\r\n<p class=\"bodytext\">Боль при онкологии поджелудочной железы является следствием разрастания опухоли и сдавливания окружающих ее нервов и органов. Чтобы устранить боль, обычно используют стандартные ненаркотические анальгетики, наркотические препараты (омнопон, промедол, морфин), пластыри и иные медикаменты.</p>\r\n<p class=\"bodytext\">Возможно также применение следующей обезболивающей методики: в просвет эпидурального пространства близ спинного мозга вводят катетер, через который поступает анестетик местного действия и блокирует проведение нервного болевого импульса. Катетер необходимо устанавливать выше места опухоли. Его фиксируют на коже. Это является заметным недостатком: катетер, торчащий из спины, вызывает массу неудобств. У этого способа есть и свои плюсы: отсутствует негативное влияние на организм, которое оказывают наркотические препараты.</p>",
"prevention": "",
"clinical_picture": "<p>Симптомы рака поджелудочной железы связаны с тем, что опухоль сдавливает окружающие органы, приводит к обтурации (закупорке) протоков или вызывает интоксикацию организма в результате распада тканей. Симптомы заболевания обнаруживаются уже на достаточно поздних сроках, когда опухоль достигает значительных размеров. Симптомы сдавления появляются первыми в виде болей. Это означает, что опухоль проросла сквозь нервные окончания. Интенсивность болей у всех пациентов разная — от ощущения сдавления и дискомфорта до острых приступов. При раке головки поджелудочной железы болевые ощущения беспокоят в области правого подреберья, при раке хвоста — слева, при общем поражении — носят опоясывающий характер. Они усиливаются при нарушениях диеты (употреблении жирной, острой пищи или алкоголя), а также в положении лежа на спине. Симптомы закупорки возникают при сдавлении опухолью желчевыводящих путей, кишечника или расположенных поблизости вен. При сдавлении желчного протока прекращается отток желчи из печени в кишечник, что приводит к механической желтухе. Внешне <a href=\"/symptom/zheltuha/\" title=\"Перейти на страницу симптома Желтуха\">желтуха</a> проявляется следующими симптомами: желтое окрашивание кожи, слизистых оболочек и склер; обесцвечивание стула; <a href=\"/symptom/temnaya_mocha/\" title=\"Перейти на страницу симптома Темная моча\">потемнение мочи</a> (моча становится цвета темного пива); увеличение размеров печени и желчного пузыря; появление кожного зуда. <a href=\"/symptom/zheltuha/\" title=\"Перейти на страницу симптома Желтуха\">Желтуха</a> прогрессирует медленно, с течением времени цвет кожи меняется от ярко-желтого до зеленоватого оттенка. Через некоторое время сдавление желчевыводящих путей приводит к печеночно-почечной недостаточности, постоянным кровотечениям и смерти. Прорастание рака поджелудочной железы в желудок и кишечник вызывает желудочную и кишечную непроходимость, при повреждении панкреатических островков самой железы развивается сахарный диабет. Если опухолью поражаются селезеночные вены, то это приводит к увеличению селезенки. Из любых органов, пораженных опухолью, может начаться <a href=\"/symptom/krovotechenie/\" title=\"Перейти на страницу симптома Кровотечение\">кровотечение</a>. Симптомы интоксикации появляются из-за отравления организма токсинами и продуктами распада самой опухоли. Они бывают следующими: резкое снижение веса; <a href=\"/symptom/snizhenie_appetita/\" title=\"Перейти на страницу симптома Снижение аппетита\">снижение аппетита</a> (особенно в отношении мяса, жирной пищи); <a href=\"/symptom/vyalost/\" title=\"Перейти на страницу симптома Вялость\">вялость</a>, <a href=\"/symptom/slabost/\" title=\"Перейти на страницу симптома Слабость\">слабость</a>; <a href=\"/symptom/vysokaya_temperatura_38-42/\" title=\"Перейти на страницу симптома Высокая температура 38-42° \">повышение температуры</a> тела; <a href=\"/symptom/apatiya/\" title=\"Перейти на страницу симптома Апатия\">апатия</a>. За признаками интоксикации часто скрываются сопутствующие признаки нарушения переваривания и усвоения пищи.<br /><br /><br /></p>",
"image": "http://api.symptomd.ru/storage/9b68be57089b1e9e313f2e6ee9412850_qVHAHyN.jpg",
"image_alt": "Поджелудочная железа",
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"parent": null,
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4675,
4683,
5187,
5209,
5212,
5343
]
},
{
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{
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{
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"etiology": "<p>Раку гортани зачастую предшествует хронический многолетний ларингит. Особое значение в возникновении рака гортани относятся предраковые заболевания:</p>\r\n<ul>\r\n<li>длительно существующая папиллома</li>\r\n<li>лейкоплакия слизистой оболочки гортани</li>\r\n<li>дискератозы</li>\r\n<li>пахидермия</li>\r\n<li>фиброма на широком основании</li>\r\n<li>кисты гортанных желудочков</li>\r\n<li>хронические воспалительные процессы</li>\r\n</ul>\r\n<p>Часто наблюдается малигнизация папиллом и лейкоплакии.</p>",
"pathogenesis": "",
"diagnostics": "<p>При диагностике используются следующие процедуры: Непрямая ларингоскопия, внешний осмотр и пальпация. Фиброларингоскопия. Данный метод является одним из основных методов в диагностике рака горла. При проведении этой процедуры есть возможность осмотреть все отделы гортани в большом разрешении и без «слепых зон». Инструмент вводится в гортань легко и безопасно, есть возможность взять биопсию для цитологического исследования. Ко всему прочему, есть возможность визуализации подскладочного отдела и выполнения высококачественной фотосъемки. Морфологическое исследование (гистологическое, цитологическое) материала полученного при биопсии, пункции и соскобах. Компьютерная томография (КТ) гортани. Используется для оценки состояний хрящей гортани, которые нельзя увидеть при ларингоскопии. Также этот метод дает дополнительную информацию о вестибулярном отделе гортани и гортаноглотке. Магнитно-резонансная томография (МРТ). Этот метод позволяет оценить состояние голосовых складок, подскладочного отдела, просвета гортанных желудочков, черпалонадгортанных складок, грушевидных синусов. Рентгенография легких. Используется в случае подозрения на отдаленные метастазы. Ультразвуковое исследование печени и лимфоузлов шеи. Используется в случае подозрения на отдаленные и регионарные метастазы. При наличии увеличенных регионарных лимфоузлов — пункция их для цитологического подтверждения. Все эти методы позволяют однозначно поставить диагноз и назначить подходящее лечение.</p>\r\n<p> </p>",
"treatment": "<p>Существует консервативное и хирургическое лечение рака гортани. В настоящее время достаточно много внимания уделяется качеству жизни пациентов, поэтому при ранних стадиях рака среднего и надскладочного отдела начинают с консервативного лечения – лучевой и химиотерапии. Оно по эффективности одинаково с хирургическим, однако не нарушает функции гортани, и больные могут продолжать трудовую деятельность.</p>\r\n<full></full>\r\n<p class=\"ramka2\">Комбинированное лечение – сочетание хирургии и лучевой терапии. Проводится пациентам с большими опухолями и распространенностью процесса. Предоперационная лучевая терапия способствует уменьшению размеров опухоли и снижает жизнеспособность раковых клеток. Однако после больших доз ЛТ <a href=\"/symptom/yazva_naruzhnaya/\" title=\"Перейти на страницу симптома Язва наружная\">рана</a> может заживать хуже.</p>\r\n<p>Операция</p>\r\n<p>Объемы операций могут различными. Возможно удаление части гортани (резекция), при этом сохраняется дыхательная функция и голос. При больших опухолях гортань удаляется полностью, после таких операций дыхание осуществляется через трахеостому и человек лишается звучного <a href=\"/symptom/sluhovye_gallyucinacii/\" title=\"Перейти на страницу симптома Слуховые галлюцинации\">голоса</a>. Для восстановления речи проводятся занятия с логопедом, пациенты учатся образовывать звук с помощью заглатываемого в желудок воздуха, такая речь позволяет общаться с окружающими людьми и даже вернутся к труду. Кроме того, применяются специальные силиконовые голосовые протезы.</p>\r\n<p> </p>\r\n<p>Лучевая терапия</p>\r\n<p>Лучевая терапия, облучения рака гортани проводится с боковых полей и включает всю гортань и зону регионарного метастазирования. Общие реакции – <a href=\"/symptom/slabost/\" title=\"Перейти на страницу симптома Слабость\">слабость</a>, головные боли, <a href=\"/symptom/toshnota/\" title=\"Перейти на страницу симптома Тошнота\">тошнота</a>. Местные реакции возникают в гортани и на коже шеи. Больные жалуются на боли при глотании, <a href=\"/symptom/otek_tkaney/\" title=\"Перейти на страницу симптома Отек тканей\">отек тканей</a> шеи. Изменения в гортани характеризуются <a href=\"/symptom/vospalenie/\" title=\"Перейти на страницу симптома воспаление\">воспаление</a> и отеком слизистой и голосовых связок. Это может приводить к усилению охриплости и сужению просвета гортани, поэтому при большом размере опухоли пациенту предлагается наложение трахеостомы (ниже расположения опухоли в трахею вводится трубка, через которую пациент дышит, она после лечения удаляется). При лучевой терапии функция звукообразования не страдает и после лечения восстанавливается звучный голос.</p>\r\n<p>Химиотерапия</p>\r\n<p>Химиотерапия при раке гортани применяется только в сочетании с лучевым и хирургическим лечением. Используются в основном препараты платины – цисплатин. Наблюдение осуществляется в первый год каждый месяц, на второй год – раз в 4 месяца, с 3 до 5 лет – раз в полгода, а после пяти раз в год.</p>",
"prevention": "<p>Рак гортани, как и любое заболевание, легче предупредить, чем вылечить. Поэтому: откажитесь от курения и неумеренного употребления алкоголя; соблюдайте правила индивидуальной профилактики при работе с перечисленными ранее химическими веществами; своевременно лечите хронические заболевания гортани, удаляйте доброкачественные новообразования. В заключение отметим, что при появлении длительно не проходящих охриплости и осиплости не следует месяцами заниматься самолечением или ожидать самоизлечения. Необходимо как можно раньше обратиться к врачу и не отказываться от предложенных обследований и лечения.</p>\r\n<p> </p>",
"clinical_picture": "<p>Признаки заболевания весьма разнообразны и зависят от формы и места роста опухоли, степени ее распространения. Начальный период заболевания характеризуется незначительными и часто скрыто протекающими симптомами. Должны насторожить следующие симптомы: <a href=\"/symptom/ohriplost/\" title=\"Перейти на страницу симптома Охриплость\">Охриплость</a> или другие изменения <a href=\"/symptom/sluhovye_gallyucinacii/\" title=\"Перейти на страницу симптома Слуховые галлюцинации\">голоса</a>. <a href=\"/symptom/otek_tkaney/\" title=\"Перейти на страницу симптома Отек тканей\">Припухлость</a> в области шеи. <a href=\"/symptom/bol_v_gorle/\" title=\"Перейти на страницу симптома Боль в горле\">Боль в горле</a> и ощущение дискомфорт при глотании, першение. Ощущение инородного тела в гортани при глотании. Постоянный <a href=\"/symptom/kashel/\" title=\"Перейти на страницу симптома Кашель\">кашель</a>. <a href=\"/symptom/vydeleniya_iz_uha/\" title=\"Перейти на страницу симптома Выделения из уха\">Боль в ухе</a>. <a href=\"/symptom/anormalnaya_poterya_vesa/\" title=\"Перейти на страницу симптома Анормальная потеря веса\">Потеря веса</a>.</p>\r\n<p> </p>",
"image": null,
"image_alt": null,
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"published": 1,
"parent": null,
"block_rubric": 23,
"standards": [
4679,
4681,
4947,
5312,
5362
]
},
{
"id": 7936,
"symptoms": [
{
"id": 2600,
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{
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{
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},
{
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}
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"lead": "Человек производит до 1,5 литров мокроты в день, небольшое количество откашливаемой прозрачной слизи считается нормой. Увеличение же объема мокроты и ее цвета может говорить о заболевании. ",
"image": null,
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},
{
"id": 2731,
"synonyms": [
{
"name": "Изменение голоса"
},
{
"name": "Голос пропал"
}
],
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"name": "Нарушение голоса",
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"age_min": 1,
"age_max": 100,
"slug": "narushenie_golosa",
"lead": "Если голос изменился или пропал следует обратиться к врачу",
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},
{
"id": 2732,
"synonyms": [
{
"name": "расстройство голоса"
},
{
"name": "охриплость"
},
{
"name": "слабый голос"
},
{
"name": "фальцет"
},
{
"name": "Дисфония"
},
{
"name": "Осиплость голоса"
},
{
"name": "Сиплый голос"
}
],
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{
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"lead": "онкологическое заболевание дыхательных путей, характеризующееся наличием новообразования, которое произрастает из тканей стенки трахеи",
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"etiology": "<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;\">Одна из основных причин возникновения рака трахеи – отягощенная наследственность. Риск развития злокачественного новообразования значительно увеличивается, если подобный диагноз был поставлен близким родственникам.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">К другим причинам относятся:</span></p>\r\n<ul>\r\n<li><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;\">Активное и пассивное курение.</span></li>\r\n<li><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;\">Вирусная инфекция. Главный инфекционный агент – вирус папилломы человека.</span></li>\r\n<li><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;\">Применение лучевой терапии в борьбе с онкологией смежных с трахеей органов.</span></li>\r\n</ul>\r\n<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;\">Выделяют 4 стадии первичной онкопатологии трахеи. Учитывается степень распространенности опухолевого процесса, вовлеченность лимфатических узлов, наличие отдаленных от опухоли метастатических очагов.</span></p>",
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"diagnostics": "<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;\">При обращении в клинику пациент направляется на комплексное обследование, которое включает:</span></p>\r\n<ul>\r\n<li><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;\">Лабораторные исследования. Диагностика включает биохимическое и развернутое клиническое исследование крови, определение онкомаркеров РЭА, коагулограмму и общий анализ мочи. При проведении исследования крови могут быть определены характерные специфические изменения.</span></li>\r\n<li><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;\">Физикальное обследование. Врач оценивает функциональный статус для определения сопутствующих патологий и вторичных признаков заболевания, оказывающих влияние на выбор лечебной тактики.</span></li>\r\n<li><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;\">Инструментальные методы. Проводится трахео-бронхоскопию, при которой делают биопсия. Данный метод является наиболее информативным, т. к. позволяет не только визуализировать опухоль, но и определить ее размеры, а также область локализации. Бронхоскопия оценивает угрозу осложнений и позволяет получить материал для проведения морфологического исследования.</span></li>\r\n</ul>\r\n<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;\">Среди дополнительных диагностических мер следует выделить УЗИ шейной и надключичной зоны, рентген грудины, компьютерной томографии органов грудной клетки и ЭКГ.</span></p>",
"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;\">Основным методом лечения рака трахеи является хирургическое удаление опухоли. Хирург удаляет пораженный участок трахеи с захватом небольших участков выше и ниже, затем соединяет оставшиеся концы. Такие операции очень сложны из-за особенностей кровоснабжения трахеи. Если сильно повредить кровеносные сосуды, то заживление будет происходить дольше и хуже.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">Некоторым пациентам, которым противопоказано хирургическое лечение, могут быть выполнены эндоскопические вмешательства. Они помогают уменьшить злокачественную опухоль и впоследствии упросить ее удаление:</span></p>\r\n<ul>\r\n<li><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;\">Лазерная хирургия предполагает уничтожение опухолевой ткани с помощью луча лазера высокой интенсивности.</span></li>\r\n<li><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;\">Криохирургия. Во время процедуры на злокачественное новообразование наносят жидкий азот в виде спрея, и низкая температура уничтожает раковые клетки.</span></li>\r\n<li><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;\">Брахитерапия является разновидностью лучевой терапии. Источник излучения находится на конце бронхоскопа, его направляют непосредственно на злокачественную опухоль. Раковые клетки получают максимальную дозу облучения, при этом практически не затрагиваются здоровые ткани.</span></li>\r\n<li><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;\">Фотодинамическая терапия. На поверхность опухоли наносят специальное вещество — фотосенсибилизатор, а затем воздействуют на нее светом определенной длины волны. Под действием света фотосенсибилизатор активируется и разрушает опухолевые клетки.</span></li>\r\n</ul>\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;\">Если неоперабельная опухоль блокирует просвет трахеи, можно выполнить паллиативные хирургические вмешательства. Во время стентирования в заблокированный участок устанавливают короткую трубку с сетчатой стенкой из металла — стент. Это эндоскопическая процедура. Также можно выполнить трахеостомию — сформировать отверстие, которое будет сообщать просвет трахеи с передней поверхностью шеи ниже места сужения. Через эту трахеостому пациент сможет дышать.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">Лучевая терапия</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </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;\">Лучевую терапию зачастую назначают после удаления рака трахеи, чтобы уничтожить опухолевые клетки, которые могли остаться в организме пациента. </span></p>",
"prevention": "<ul>\r\n<li><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;\">Отказ от курения и алкоголя</span></li>\r\n<li><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;\">Своевременное лечение хронических заболеваний</span></li>\r\n<li><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;\">Соблюдение правил работы с токсичными веществами</span></li>\r\n<li><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;\">Ежегодное прохождение профилактических осмотров</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>",
"clinical_picture": "<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;\">Симптомы рака трахеи возникают, когда опухоль достигает определенных размеров:</span></p>\r\n<ul>\r\n<li><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;\">приступообразный кашель (трахеит, бронхит);</span></li>\r\n<li><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;\">выделение небольшого количества густой мокроты;</span></li>\r\n<li><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;\">наличие кровянистых прожилок в отделяемой слизи;</span></li>\r\n<li><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;\">одышка, которая возникает сначала после физической нагрузки, а затем и в состоянии покоя;</span></li>\r\n<li><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;\">изменение голоса (осиплость или полное исчезновение).</span></li>\r\n</ul>\r\n<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;\">На присутствие опухоли в области трахеи могут также указывать такие симптомы, как боли в горле, дискомфорт в области грудины, болезненность при глотании, свист при дыхании, снижение аппетита и повышение температуры тела без видимых на то причин. Проявляться онкологический процесс может частыми фарингитами и ангинами, изменениями в анализах крови и увеличением лимфатических узлов в области шеи и под челюстью.</span></p>",
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