ВОзвращает список болезней. Можно фильтр/искать

search, age, gender, parent, symptoms, sort_name, sort_by, rand, branches
GET /disease/?format=api&ordering=slug&page=2
HTTP 200 OK
Allow: GET, HEAD, OPTIONS
Content-Type: application/json
Vary: Accept

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            },
            "code": "A03",
            "name": "Шигеллез",
            "icd_name": "Шигеллез",
            "gender": 0,
            "age_min": 0,
            "age_max": 100,
            "cause": [
                "2",
                "7"
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            "slug": "a03_shigellez",
            "lead": "инфекционное кишечное заболевание. Встречается по всему миру у людей всех возрастов, но особенное распространение получает в жаркий сезон",
            "description": "<p>Шигеллез -&nbsp;<span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">инфекционное заболевание человека, которое вызывается бактериями, относящимися к роду шигелл и протекающее с преимущественным вовлечением в воспалительный процесс нижнего отдела толстого кишечника и признаками общей интоксикации.</span></p>\r\n<p><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">&nbsp;</span></p>",
            "etiology": "<p>Шигелла &ndash; неподвижная бактерия, напоминающая по форме палочку размером 2-3 мкм. Она не образует спор, поэтому не очень устойчива в окружающей среде, хотя некоторые виды бактерий могут длительно сохранять свою жизнеспособность в воде и молочных продуктах.<br /> <br /> Шигеллы разделены на группы (Григорьева&mdash;Шига, Штуцера&mdash; Шмитца, Ларджа &mdash; Сакса, Флекснера и Зонне), а те в свою очередь на серовары, которых насчитывается около 50. Их отличают по территории обитания, свойствам токсинов и, выделяемых ими, ферментов.</p>\r\n<p>Шигеллы живут только в организме человека. Попав из кишечника больного или носителя в окружающую среду они остаются жизнеспособными на протяжении 5-14 дней. Прямой солнечный свет убивает бактерии на протяжении 30-40 минут, на фруктах и молочных продуктах они могут сохраняться до 2-х недель.<br /> <br /> Мухи могут быть переносчиком болезни. На лапках насекомых бактерии остаются жизнеспособны до 3-х дней. Сев на пищевые продукты, мухи инфицируют их. Даже небольшого количества шигелл достаточно, чтобы вызвать болезнь.</p>",
            "pathogenesis": "<p>Первая фаза. Попав в организм с пищей или водой, шигеллы преодолевают ротовую полость и желудок. Бактерии спускаются в тонкий кишечник и прикрепляются к его клеткам &ndash; энтероцитам. Здесь они размножаются и выделяют токсины, вызывающие интоксикацию организма.<br /> <br /> Вторая фаза включает несколько этапов.</p>\r\n<ul>\r\n<li>Количество шигелл увеличивается, и они заселяют нижние отделы толстого кишечника. На поверхности бактерий есть особые белки, которые обеспечивают прикрепление к клеткам эпителия. Они воздействуют на рецепторы и побуждают клетку захватить бактерию. Таким образом, возбудитель проникает внутрь эпителия.</li>\r\n<li>Шигеллы выделяют фермент муцин. С его помощью они растворяют клеточные мембраны и заселяют глубокие слои кишечной стенки. Начинается <a title=\"Перейти на страницу симптома воспаление\" href=\"/symptom/vospalenie/\">воспаление</a> подслизистого слоя.</li>\r\n<li>Бактерии нарушают связи между клетками кишечника, что способствует их распространению по здоровым участкам. Кишечная стенка разрыхляется, процесс всасывания нарушается, в просвет кишечника выделяется большое количество жидкости.</li>\r\n<li>Развивается язвенный колит. На слизистой кишечника образуются кровоточащие <a title=\"Перейти на страницу симптома Изменения структуры кожи\" href=\"/symptom/izmeneniya_struktury_kozhi/\">эрозии</a> и язвы. На этом этапе бактерии активно выделяют токсины.</li>\r\n</ul>",
            "diagnostics": "<p>Диагноз дизентерии ставится врачом-инфекционистом по&nbsp;совокупности симптомов. Дополнительно назначают исследования, позволяющие уточнить возбудителя и&nbsp;применить антибиотики&nbsp;направленного действия,&nbsp;&mdash; посевы кала.</p>",
            "treatment": "<p>Лечение шигеллеза можно проводить на дому, если состояние больного удовлетворительное. Для госпитализации существует перечень показаний:</p>\r\n<ul>\r\n<li>среднетяжелое и тяжелое течение болезни</li>\r\n<li>тяжелые сопутствующие заболевания</li>\r\n<li>лица декретированных групп, работающие с детьми или на предприятиях питания</li>\r\n<li>дети до года</li>\r\n</ul>\r\n<p><br /> Режим. При легком течении болезни нет необходимости соблюдать строгий постельный режим. Больной может вставать и ходить по палате (квартире). Однако стоит избегать физических нагрузок и соблюдать правила гигиены.<br /> <br /> Диета при шигеллезе помогает нормализовать стул и избежать истощения. В остром периоде болезни необходимо придерживаться диеты №4, а после прекращения поноса диета №4А.<br /> <br /> В дни, когда в кале присутствуют кровь и слизь, блюда должны быть максимально щадящими, чтобы не раздражать пищеварительный тракт. Это: рисовый отвар, протертый манный суп, кисели, нежирные бульоны, сухари.<br /> <br /> По мере улучшения состояния рацион можно расширить. В меню включают: протертый творог, супы на бульонах, вареное перетертое мясо, рисовую кашу, черствый белый хлеб.<br /> <br /> Через 3 дня после прекращения поноса можно постепенно возвращаться к нормальному питанию.</p>",
            "prevention": "<ul>\r\n<li>использовать для питья только кипяченую воду или бутилированную</li>\r\n<li>не пить воду из водопровода, непроверенных колодцев или родников</li>\r\n<li>тщательно мыть овощи и фрукты перед едой</li>\r\n<li>не потреблять подпорченные фрукты, в которых бактерии размножаются в мякоти</li>\r\n<li>не покупать разрезанные арбузы и дыни</li>\r\n<li>тщательно мыть руки после посещения туалета</li>\r\n<li>не допускать мух к пищевым продуктам</li>\r\n<li>не потреблять продукты с истекшим сроком хранения</li>\r\n<li>в странах с повышенным риском заражения шигеллами не покупать блюда, не подвергшиеся термической обработке</li>\r\n<li>вакцинация дизентерийным бактериофагом троекратно с интервалом в 3 дня</li>\r\n</ul>",
            "clinical_picture": "<p>Инкубационный период. С момента заражения до появления первых симптомов шигеллеза (бактериальной дизентерии) может пройти 1-7 дней. Чаще 2-3 дня.</p>\r\n<ul>\r\n<ul>\r\n<li><a title=\"Перейти на страницу симптома Высокая температура 38-42&deg; \" href=\"/symptom/vysokaya_temperatura_38-42/\">Повышение температуры</a>. Начало заболевания острое. Резкое <a title=\"Перейти на страницу симптома Высокая температура 38-42&deg; \" href=\"/symptom/vysokaya_temperatura_38-42/\">повышение температуры</a> до 38-39 градусов &ndash; реакция иммунитета на появление в крови токсинов шигелл. Больные жалуются на <a title=\"Перейти на страницу симптома Озноб\" href=\"/symptom/oznob/\">озноб</a> и чувство жара.<br /> &nbsp;</li>\r\n<li>Интоксикация. Признаки отравления головного и спинного мозга токсинами: <a title=\"Перейти на страницу симптома Снижение аппетита\" href=\"/symptom/snizhenie_appetita/\">потеря аппетита</a>, <a title=\"Перейти на страницу симптома Слабость\" href=\"/symptom/slabost/\">слабость</a>, <a title=\"Перейти на страницу симптома Боль в мышцах\" href=\"/symptom/bol_v_myshcah/\">ломота</a> в теле, <a title=\"Перейти на страницу симптома Головная боль\" href=\"/symptom/golovnaya_bol/\">головная боль</a>, <a title=\"Перейти на страницу симптома Апатия\" href=\"/symptom/apatiya/\">апатия</a>. Развивается в первые часы болезни.<br /> &nbsp;</li>\r\n<li>Учащение стула (<a title=\"Перейти на страницу симптома Диарея\" href=\"/symptom/diareya/\">понос</a>). <a title=\"Перейти на страницу симптома Диарея\" href=\"/symptom/diareya/\">Диарея</a> развивается на 2-3 день болезни. Сначала выделения имеют каловый характер. Со временем становятся более скудными, жидкими, с большим количеством слизи. При развитии эрозий в кишечнике, в кале появляются прожилки крови и гноя. Больной опорожняется 10-30 раз в сутки. Дефекация сопровождается мучительной болью при напряжении воспаленной прямой кишки.<br /> &nbsp;</li>\r\n<li><a title=\"Перейти на страницу симптома Боль в животе\" href=\"/symptom/bol_v_zhivote/\">Боли в животе</a> появляются при внедрении шигелл в слизистую оболочку кишечника и развитии воспаления. Это происходит через 2 дня после начала заболевания. Первые часы боль носит разлитый характер. Когда повреждается нижний отдел кишечника, боль становится резкой, режущей схваткообразной. Преимущественно ощущается в левой половине живота. Неприятные ощущения усиливаются непосредственно перед дефекацией и ослабевают после опорожнения кишечника.<br /> &nbsp;</li>\r\n<li><a title=\"Перейти на страницу симптома Тошнота\" href=\"/symptom/toshnota/\">Тошнота</a>, иногда повторная <a title=\"Перейти на страницу симптома Рвота\" href=\"/symptom/rvota/\">рвота</a> &ndash; результат воздействия токсина на рвотный центр в головном мозге.<br /> &nbsp;</li>\r\n<li>Ложные болезненные позывы к дефекации &ndash; тенезмы. Признак раздражения нервных окончаний кишечника.</li>\r\n</ul>\r\n</ul>\r\n<p>&nbsp;</p>\r\n<ul>\r\n<li><a title=\"Перейти на страницу симптома Тахикардия\" href=\"/symptom/tahikardiya/\">Тахикардия</a> и снижение давления &ndash; количество сердечных сокращений более 100 в минуту. Артериальное давление снижено из-за интоксикации и потери жидкости.</li>\r\n</ul>",
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                    "branch_medicine_code": "003",
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                    "lead": "Область медицины, включающая в себя лечение 1066 заболеваний. В 376 клиниках России оказывается помощь по этому направлению медицины.",
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                    "branch_medicine_code": "031",
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                    "lead": "Область медицины, включающая в себя лечение 647 заболеваний. В 2328 клиниках России оказывается помощь по этому направлению медицины.",
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                    "lead": "Область медицины, включающая в себя лечение 685 заболеваний. В 631 клинике России оказывается помощь по этому направлению медицины.",
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                    "lead": "Область медицины, включающая в себя лечение 851 заболевания. В 696 клиниках России оказывается помощь по этому направлению медицины.",
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                    "lead": "Область медицины, включающая в себя лечение 743 заболеваний. В 1561 клинике России оказывается помощь по этому направлению медицины.",
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                    "lead": "Область медицины, включающая в себя лечение 739 заболеваний. В 1042 клиниках России оказывается помощь по этому направлению медицины.",
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                    "lead": "Область медицины, включающая в себя лечение 486 заболеваний. В 491 клинике России оказывается помощь по этому направлению медицины.",
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                    "slug": "terapiya",
                    "lead": "Область медицины, включающая в себя лечение 908 заболеваний. В 1399 клиниках России оказывается помощь по этому направлению медицины.",
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                {
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                    "branch_medicine_code": "036",
                    "slug": "psihiatriya_narkologiya",
                    "lead": "Область медицины, включающая в себя лечение 149 заболеваний. В 377 клиниках России оказывается помощь по этому направлению медицины.",
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                    "branch_medicine_code": "034",
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                    "lead": "Область медицины, включающая в себя лечение 335 заболеваний. В 180 клиниках России оказывается помощь по этому направлению медицины.",
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                    "disease_count": null,
                    "name": "общая врачебная практика (семейная медицина)",
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                    "branch_medicine_code": "026",
                    "slug": "obschaya_vrachebnaya_praktika_semeynaya_medicina",
                    "lead": "Область медицины, включающая в себя лечение 151 заболевания. В 203 клиниках России оказывается помощь по этому направлению медицины.",
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            "code": "A04",
            "name": "Бактериальные кишечные инфекции",
            "icd_name": "Другие бактериальные кишечные инфекции",
            "gender": 0,
            "age_min": 0,
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            "cause": [
                2,
                5,
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            "periodicity": 1,
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            "lead": "к бактериальным инфекциям относится огромная группа заболеваний, причиной которых являются микроорганизмы – бактерии. Это небольшие одноклеточные микроорганизмы",
            "description": "",
            "etiology": "<p>Обычно заражение происходит при употреблении: сырой воды или молока; тех продуктов, которые не могут быть термически обработанными (торты с кремом, кисломолочные продукты); необработанного термически мясо; птичьих яиц, выпитых сырыми или неполностью проваренных/прожаренных; пользования общими полотенцами, посудой, контакт с сиденьями унитаза, дверными ручками, игрушками в том доме, где живет или работает больной, после чего здоровый ранее человек не помыл руки; купание с заглатыванием воды в открытых водоемах.</p>\r\n<p>Учитывая, что бактерии очень большая группа микроорганизмов, они разделены на несколько групп по определенным критериям.</p>\r\n<full></full>\r\n<p>По способу питания:</p>\r\n<ul>\r\n<li>сапрофиты – свободно живущие бактерии, которые питаются не живыми органическими веществами, не болезнетворные (единственным исключением являются легионеллы – микробы, обитающие в жидкости кондиционеров, при попадании в организм человека вызывают пневмонию);</li>\r\n<li>паразиты – питаются за счет других, в эту группу относятся все болезнетворные бактерии, а также необходимые микроорганизмы, которые живут в «содружестве» с человеком (нормальная микрофлора кишечника состоит из полезных бактерий, которые в процессе жизнедеятельности синтезируют витамины группы В, необходимые организму человека).</li>\r\n</ul>\r\n<p>По форме клетки:</p>\r\n<ul>\r\n<li>кокки – шаровидные бактерии. К ним относятся: менингококк (менингит), стафилококк (большинство гнойничковых заболеваний), пневмококк (пневмония), стрептококк (ангина, , стрептодермии).</li>\r\n<li>палочковидные бактерии – форма клетки в виде прямой или изогнутой палочки. Возбудителями заболеваний являются: кишечная палочка (острые кишечные инфекции, воспалительные заболевания внутренних органов), шигелла (дизентерия), микобактерия туберкулеза, дифтерийная палочка (дифтерия), возбудитель столбняка.</li>\r\n<li>извитые бактерии – по форме напоминают спираль штопора: бледная трепонема – возбудитель сифилиса, лептоспиры – заболевание лептоспироз (интересно, что форма штопора помогает спирохетам буквально «вбуравливаться» через кожу человека и таким способом проникать в организм).</li>\r\n<li>бактерии, меняющие форму – особая группа бактерий без клеточной стенки, являются внутриклеточными паразитами: микоплазмы (хронические заболевания мочеполовых органов, трудно поддающихся лечению).</li>\r\n<li>жгутиковые формы – бактерии на клетке имеют жгутики, активно двигаются во внешней среде, что позволяет им увеличивать возможность заражения (холерный вибрион – возбудитель холеры).</li>\r\n</ul>",
            "pathogenesis": "<p>Самым важным в развитии заболеваний, вызванных бактериальной инфекцией является выделение бактериями токсинов (ядов), которые обладают воспалительным действием, вызывают интоксикацию организма и повреждают внутренние органы:</p>\r\n<ul>\r\n<li>эндотоксины – выделятся после гибели бактерии и разрушения ее клетки (кишечные инфекции). Наиболее опасным является эндотоксин менингококка при менингококковой инфекции. В случае гибели значительного количества бактерий, выделившийся эндотоксин может привести к развитию инфекционно-токсического шока и привести к смерти.</li>\r\n<li>экзотоксины – яды, выделяемые живыми бактериями в процессе их жизнедеятельности (дифтерия).</li>\r\n</ul>",
            "diagnostics": "<p>Основным методом в диагностики бактериальных инфекций является бактериологическое исследование. При этом от больного берется материал, содержащий бактерии, и засевается на специальные питательные среды. После роста колоний на питательных средах (около 48 часов), бактерии идентифицируют. Огромным плюсом данного метода является возможность проводить исследование чувствительности выделенной бактерии к антибиотикам, для назначения рационального лечения. Также используются:</p>\r\n<ul>\r\n<li>микроскопическое исследование материала – позволяет поставить ориентировочный диагноз при выявлении бактерий с помощью микроскопа.</li>\r\n<li>серологическое исследование – определяется наличие антител в крови к определенным бактериям, увеличение титра антител свидетельствует о наличии в организме бактерий.</li>\r\n</ul>",
            "treatment": "<p>Лечение бактериальных инфекций, как и любого другого заболевания, является комплексным и включает:</p>\r\n<ul>\r\n<li>этиотропная терапия – лечение, направленное на уничтожение причины заболевания – бактерии. Для этого используется арсенал антибиотиков. На данный момент есть несколько групп антибиотиков, но самым важным является их разделение на бактерицидные антибиотики (убивают бактерии) и бактериостатические (подавляют рост и размножение бактериальных клеток). Это очень важно знать, особенно в случае менингококковой инфекции назначение бактерицидных антибиотиков приведет к массовой гибели менингококков и выходу эндотоксинов в кровь.</li>\r\n<li>патогенетическая терапия – направлена на выведение из организма бактериальных токсинов, которые накапливаются в процессе инфекционного заболевания (дезинтоксикация). Также проводится лечение, направленное на восстановление поврежденных органов.</li>\r\n<li>симптоматическая терапия – необходима для облегчения состояния человека при бактериальной инфекции и снижения выраженности симптомов.</li>\r\n</ul>\r\n<p>В нынешнее время, благодаря антибиотикам удается излечивать большинство бактериальных инфекций, однако стоит помнить, что неправильный прием антибиотиков может привести к развитию у бактерий резистентности (нечувствительности) и даже зависимости от антибиотиков.</p>",
            "prevention": "<p>Специфической профилактики (то есть вакцин или анатоксинов) ни для одной из этих инфекций нет.</p>\r\n<p>Применяются только неспецифические профилактические мероприятия:</p>\r\n<ol>\r\n<li>соблюдение индивидуальных гигиенических мероприятий;</li>\r\n<li>кипячение воды и молока перед употреблением; мытье рук после туалета;</li>\r\n<li>отказ от употребления сырых яиц (даже собранных от собственных же птиц);</li>\r\n<li>достаточная термическая обработка мяса;</li>\r\n<li>скрупулезный просмотр сроков годности тех продуктов, которые вы собираетесь покупать;</li>\r\n<li>мытье овощей, ягод, зелени, фруктов перед употреблением;</li>\r\n<li>хранение готовой продукции в холодильнике;</li>\r\n<li>отказ от кормления грудничков неразведенным коровьим или козьим молоком;</li>\r\n<li>поддержка достаточных санитарных условий в доме/квартире;</li>\r\n<li>если в семье кто-то заболел – кипячение всей его посуды, отказ от употребления еды из одной посуды, обеззараживание испражнений хлорсодержащими препаратами.</li>\r\n</ol>",
            "clinical_picture": "<p>Инкубационный период – 6-48 часов. Чем раньше у взрослых появляются какие-либо симптомы с момента употребления инфицированной пищи, тем тяжелее будет протекать кишечная инфекция. Затем развиваются такие синдромы:</p>\r\n<p>Интоксикационный, который проявляется такими симптомами: ; \"></a>;  в теле; \"></a>; \"></a>.</p>\r\n<p>Повышается температура тела до разных цифр.</p>\r\n<p>Гастритический синдром: ; \"></a>; после приема пищи или воды – \">Рвота</a>\">\">рвота</a></a>, после нее становится легче.</p>\r\n<p>Энтеритный синдром: тошноты и рвоты почти нет, только в самом начале, но появляется частый жидкий стул.</p>\r\n<p>Колитический синдром: боли внизу живота, болезненные позывы на дефекацию, при этом сам поход «по-большому» – тоже болезнен. Стул скудный, со слизью и кровью. После дефекации легче в животе не становится.</p>\r\n<p>Сочетание трех вышеуказанных симптомов в различных комбинациях. Для каждой из инфекций характерно свое сочетание этих симптомов, но оно не обязательно наблюдается каждый раз. </p>",
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            "code": "A05.1",
            "name": "Ботулизм",
            "icd_name": "Ботулизм",
            "gender": 0,
            "age_min": 1,
            "age_max": 100,
            "cause": [
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            "periodicity": 1,
            "slug": "a05.1_botulizm",
            "lead": "острое инфекционное заболевание, вызываемое токсином Clostridium botulini, который поражает нервную систему организма, нарушая нервно-мышечную передачу",
            "description": "<p>Ботулизм -&nbsp;<span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">острая инфекционная болезнь преимущественно с фекально-оральным механизмом передачи, развивающаяся в результате употребления пищевых продуктов, в которых произошло накопление токсина возбудителя, блокирующего передачу нервных импульсов.</span></p>\r\n<p><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">&nbsp;</span></p>",
            "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;\">Главная причина кроется в попадании токсина в человеческий организм вместе с пищей.</span></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;\">Так как возбудитель предпочитает бескислородную среду, то консервы с грибами, мясом, овощами или рыбой, произведенные с нарушением термической обработки, &ndash; основные источники ботулинического токсина.</span></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;\">&nbsp;</span></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;\">Ядовитые продукты не отличаются по вкусу и запаху. Заподозрить присутствие микроорганизма можно при вздутии крышки у банок или консервов.</span></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;\">Основные продукты питания, которые могут вызвать ботулизм:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">грибная консервация;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">консервы с бобовыми;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">вяленая или копченая рыба;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">мясная или колбасная продукция;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">домашние консервы;</span></p>\r\n</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;\">Также палочка ботулизма может попасть в организм через органы дыхания или через большие раневые поверхности. Во втором случае размножение анаэробов происходит в омертвевших тканях.</span></p>\r\n<p>&nbsp;</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;\">Сначала ботулотоксин попадает в желудок и кишечник, затем всасывается в кровь, а далее поражает отделы нервной системы.</span></p>",
            "pathogenesis": "<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;\">Входные ворота инфекции &mdash; слизистая выстилка желудочно-кишечного тракта и повреждённые кожные покровы.</span></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;\">Главенствующая роль в патогенезе принадлежит ботулотоксину. При алиментарном заражении (через пищу) ботулотоксин совместно с активной формой бактерии попадает в организм человека. Ботулотоксин активно всасывается сначала через слизистую оболочку полости рта, затем через слизистую ЖКТ. После его поступления из желудка и тонкой кишки он проникает в лимфатическую и кровеносную систему и далее с током лимфы и крови попадает во все органы и ткани.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</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;\">Ботулотоксин обладает способностью крепко объединяться с рецепторами нервных клеток, блокируя высвобождение ацетилхолина (нейромедиатора нервной системы) в щель синапса (места соединения с нейроном). Из-за этого нарушается нервно-мышечная передача в холинергических нервных волокнах, в результате чего возникают парезы и параличи.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</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;\">Нарушение вентиляции усугубляет парез мышц глотки и гортани, скопление вязкой слизи в над- и подсвязочном пространстве, вдыхание рвотных масс, пищи и воды. Влияние ботулотоксина обратимо, так как органы при этом не повреждаются, поэтому со временем (при устранении токсина) двигательная активность полностью восстанавливается.</span></p>\r\n<p>&nbsp;</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;\">Из-за функционального нарушения вегетативной иннервации пищеварительные железы выделяют недостаточно слюны и желудочного сока, развивается выраженный парез желудочно-кишечной системы, на фоне сниженной выработки слюны воспаляется слизистая оболочка полости рта (гнойный паротит). Активные формы бактерии ботулизма, поступившие в организм человека с едой, продолжают вырабатывать токсин, и его постоянное поступление в кровь усугубляет токсический эффект.</span></p>",
            "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;\">Для диагностики ботулизма выполняются следующие исследования:</span></p>\r\n<p>&nbsp;</p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">Анализ газового состава крови, т. е. определение процентного содержания кислорода и углекислого газа, а также исследование pH крови. Для выполнения анализа берут артериальную кровь.</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">Обнаружение ботулотоксина в сыворотке крови больного с помощью реакции нейтрализации антитоксическими сыворотками путём биопробы на белых мышах.</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">Бактериальный посев содержимого желудка, рвотных масс, испражнений, раневого отделяемого, продуктов на анаэробные питательные среды (Китта-Тароцци, бульон Хоттингера, казеиново-грибную).</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">Серологические реакции &mdash; реакция непрямой гемагглютинации (РНГА). Исследование позволяет обнаружить антитела в сыворотке крови.</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">Общий анализ мочи и клинический анализ крови неинформативны (изменения только при осложнениях)</span></p>\r\n</li>\r\n</ul>",
            "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;\">Терапия заболевания включает в себя следующие действия:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">промывание желудка при помощи специального зонда, чтобы удалить остатки зараженной пищи;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">кишечный диализ при помощи специального раствора;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">введение антитоксической сыворотки в соответствии с типом обнаруженных бактерий (А, С или Е);</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">введение препаратов для инфузионной терапии для ускорения дезинтоксикации, восстановления водно-электролитного баланса, устранения белковых нарушений;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">введение антибактериальных препаратов;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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;\">меры по устранению гипоксии и ее последствий;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; 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; margin-left: 36pt;\" dir=\"ltr\">\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 осложнений ботулизма.</span></p>\r\n</li>\r\n</ul>\r\n<p>&nbsp;</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;\">В зависимости от тяжести отравления и общего состояния здоровья лечение ботулизма занимает от нескольких дней до месяца. Однако при своевременном медицинском вмешательстве и соблюдении клинических рекомендаций ботулизм рано или поздно полностью излечивается, а деятельность нервной системы восстанавливается без малейших последствий для ее функционирования.</span></p>",
            "prevention": "<p>&nbsp;</p>\r\n<ol style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li style=\"list-style-type: decimal; 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;\" dir=\"ltr\">\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;\">Правильная очистка и обработка продуктов питания, соблюдение всех норм консервирования.</span></p>\r\n</li>\r\n<li style=\"list-style-type: decimal; 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;\" dir=\"ltr\">\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;\">Не стоит употреблять в пищу консервы и продукты питания из банок с вздутой крышкой. В случае подозрения на то, что консервированный продукт заражен ботулотоксином, следует прокипятить его минимум 30 минут.</span></p>\r\n</li>\r\n<li style=\"list-style-type: decimal; 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;\" dir=\"ltr\">\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;\">Хранить продукты не подлежащие термической обработке (колбасы, солёная и копченная рыба, сало) при температуре не выше 10 С&deg;</span></p>\r\n</li>\r\n<li style=\"list-style-type: decimal; 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;\" dir=\"ltr\">\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;\">Лица, которые употребляли одну и ту же пищу вместе с заболевшими людьми, должны находиться 10-12 дней под медицинским наблюдением.&nbsp;</span></p>\r\n</li>\r\n</ol>",
            "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;\">Первые признаки ботулизма у человека &mdash; симптомы кишечного расстройства (гастроэнтерит) и интоксикация: возникают диффузные головные боли, слабость, адинамия, боли в животе (преимущественно в проекции желудка), тошнотворное состояние, повторная рвота, иногда повышается температура тела. Стул до 5 раз в сутки, жидкий, без явных патологических примесей. К концу первых суток симптомы кишечного расстройства прекращаются и на первый план выходят неврологические расстройства.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\">&nbsp;</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;\">Основной период заболевания характеризуется парезом (снижением двигательной силы) глазных мышц и нарушением зрения. Человек видит туман, сетку, мелькание \"мушек\" перед глазами. Из-за того, что расслабляется ресничная мышца, контуры объектов расплываются, двоится в глазах (диплопия), расширяются зрачки (мидриаз), реакция на свет значительно снижается.</span></p>\r\n<p>&nbsp;</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;\">Нарастает чувство сухости во рту, голос становится гнусавым, появляются нарушения глотания (дисфагия), в горле чувствуется \"комок\". Больной попёрхивается сначала грубой и твёрдой пищей, затем и жидкой, жидкое питание и вода изливаются через нос. Нарастает и прогрессирует слабость мышц, дыхание становиться поверхностным, ощущается сжимание грудной клетки.</span></p>",
            "image": null,
            "image_alt": null,
            "standard_type": 0,
            "danger": 70,
            "published": 1,
            "parent": 6017,
            "block_rubric": 1,
            "standards": [
                4998
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        }
    ]
}