meningiti

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powerpoint presentation meningiti buxara-2016 opredelenie meningit – ostroe infektsionnoe zabolevanie s preimushestvennim porajeniem pautinnoy i myagkoy mozgovix obolochek golovnogo i spinnogo mozga meningiti pervichnie proisxojdenie vtorichnie meningiti bakterii vozbuditeli (chashe vsego) virusi meningiti gribi vozbuditeli (reje) rikketsii prosteyshie mikoplazmi amebi gelminti ● ● ● ● ● ● meningiti polost nosoglotki vxodnie vorota kishechnik meningiti (patogenez) krov (stadiya virusemii ili bakteriemii) vxodnie vorota obolochki golovnogo mozga meningiti seroznie tserebrospinalnaya jidkost gnoynie meningiti gnoynie seroznie bakterialnie seroznie (limfotsitarnie) virusnie tuberkulezniy sifiliticheskiy isklyucheniya: morfologicheskie izmeneniya pautinnaya i myagkaya obolochki ependima i sosudistie spleteniya jeludochkov meningiti techenie: ostrie podostrie xronicheskie molnienosnie patogenez meningitov vospalenie i otek mozgovix obolochek rasstroystva mikrotsirkulyatsii narushenie likvorodinamiki otek golovnogo mozga vnutricherepnaya gipertenziya simptomi meningita obshemozgovie obsheinfektsionnie meningealnie likvornie obshemozgovie simptomi golovnaya bol raspirayushaya, po vsey golove, preimushestvenno – lob, zatilok obuslovlena razdrajeniem mozgovix obolochek, (vetvey v i x cherepnix nervov + simpaticheskix volokon), svyazana s videleniem toksicheskix veshestv + …

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niya (u detey) meningealnie simptomi virajennost meningealnix simtomov mojet bit razlichnoy slabo virajeni pri molnienosnom techenii u pojilix lyudey u detey mojet bit vibuxanie rodnichka obshaya giperesteziya (svet, zvuk, koja) – priznaki razdrajeniya mozgovix obolochek meningealnie simptomi rigidnost mishts zatilka s.brudzinskogo meningealnie simptomi simptom kerniga nevrologicheskie ochagovie simptomi pri meningite otrajayut vovlechenie veshestva mozga (golovnogo i spinnogo) i koreshkov cherepnix i spinnomozgovix nervov, chashe vsego – glazodvigatelnix – protsess na osnovanii (tuberkulez, gribkovie porajeniya, kantseromatoz) sjr mogut bit ↑, zatem ↓ + patologicheskie refleksi boli na spinalnom urovne psixomotornoe vozbujdenie, deliriy (pri tyajelom gnoynom meningite), epilepticheskie pripadki narushenie urovnya soznaniya do komi + psixoorganicheskiy sindrom + tserebralnie sudorogi (epilepsiya) ostrie gnoynie meningiti vozbuditeli: gemofilnaya palochka meningokokk pnevmokokk streptokokk gruppi v listeriya ostrie bakterialnie meningiti zavisimost vozbuditelya ot vozrasta: 1 mesyats- 6 let pnevmokokki hemophillius influenzae meningokokki starshe 6 let meningokokki pnevmokokki ostrie bakterialnie meningiti zavisimost vozbuditelya ot vozrasta: do 1 …

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okk listeriya leykemiya staphyllococcus aureus gramotritsatelnie bakterii limfoma listeriya diagnostika meningitov bolnoy s podozreniem na meningit obyazatelno napravlyaetsya v statsionar tserebrospinalnaya jidkost issledovanie imeet reshayushee znachenie, t.k. pozvolyaet isklyuchit subaraxnoidalnoe krovoizliyanie kantseromatoz bezopasno pri otsutstvii zastoynix diskov zritelnix nervov tserebrospinalnaya jidkost ↑ davleniya vneshniy vid likvora zavisit ot chisla kletochnix elementov serozniy – prozrachniy, slegka opalestsiruet gnoyniy – mutniy, jelto-zeleniy tserebrospinalnaya jidkost xarakteren pleyotsitoz s neznachitelnim uvelicheniem belka (kletochno-belkovaya dissotsiatsiya) gnoyniy – neytrofili serozniy – limfotsiti uroven i xarakter pleyotsitoza zavisyat ot tyajesti meningita i ego dinamiki (neytrofili↓ i ↑limfotsiti→ blagopriyatnoe techenie) tserebrospinalnaya jidkost differentsialnaya diagnostika glyukoza snijaetsya pri tuberkuleznom meningite, pri gribkovix meningitax rezkoe snijenie glyukozi xarakterno dlya tyajelix gnoynix meningitov bakteriologicheskoe i serologicheskoe issledovanie (dlitelnoe vremya, no neobxodimo) immunologicheskie ekspress-metodi bakterialnie meningiti diagnosticheskiy poisk 1 nevrologicheskoe issledovanie 2 issledovanie krovi: a) gemokultura b) rutinnie laboratornie issledovaniya, srp, kreatinin, pechenochnie probi, svertivayushaya sistema krovi 3 kt (isklyuchit abstsess golovnogo …

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kt - mrt - rentgenografiya legkix - osmotr vracha lor - osmotr kardiologa - osmotr terapevta meningokokkoviy meningit vozbuditel - gramotritsatelniy diplokokk (palochka veykselbauma) mazok spinnomozgovoy jidkosti (okraska po gramu) obnarujivaetsya v leykotsitax ili vnekletochno meningokokkoviy meningit peredaetsya kapelnim putem istochnik bolnoy chelovek zdoroviy nositel vo vneshney srede neustoychiv (t˚↑↓ , nedostatochnaya vlajnost, vliyanie solnechnogo sveta), otsyuda – nizkaya kontagioznost zabolevaemost sporadicheskie sluchai nebolshie epidemii (chashe zimoy, vesnoy) boleyut lyudi vsex vozrastov, no chashe - deti meningokokkoviy meningit patogenez verxnie dixatelnie puti (vegetiruet), mojet bit nazofaringit krov (pri nizkoy rezistentnosti) (mojet bit meningokokkemiya s gemorragicheskoy sipyu) endotoksin zapuskaet dvs-sindrom i endotoksicheskiy shok meningokokkoviy meningit patomorfologiya podpautinnoe prostranstvo gnoyniy eksudat (konveksitalnaya poverxnost kori, osnovanie, spinnoy mozg) po perivaskulyarnim prostranstvam gnoy mojet perexodit na veshestvo mozga veni rasshireni, otek, nebolshie gnoynie ochagi, melkie krovoizliyaniya, trombi v obolochkax mozga –vospalitelnaya infiltratsiya jidkost – mutnaya, snachala – neytrofilnaya, zatem + limfotsiti + plazmaticheskie kletki …

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diplopiya, ptoz, anizokoriya) do epoxi penitsillina – chasto porajalsya viii nerv glaznoe dno obichno ne izmeneno, mojet bit rasshirenie ven krov: ↑ leykotsitoz (neytrofili), – ↑ soe likvor: v pervie chasi mojet bit normalnim 1-2 den – davlenie ↑ do 200-500 mm vod.st., mutniy – kletki – sotni, tisyachi (2-10 tis) v 1 mm – v kletkax mojet bit meningokokk – belok mojet povishatsya ↑ do 10-15 g/l – glyukoza mojet snijatsya ↓ meningokokkoviy meningit klinika osobennosti proyavleniya u detey obshee bespokoystvo pronzitelniy (meningealniy) krik vibuxanie rodnichka sudorogi (toniko-klonicheskie), perexodyashie v epilepticheskiy status meningokokkoviy meningit oslojneniya pnevmonii mio- i perikardit otek mozga (narushenie soznaniya, epilepticheskie pripadki, rasstroystvo dixaniya i serdechnoy deyatelnosti) vklinenie v tentorialnoe ili bolshoe zatilochnoe otverstie gemorragicheskaya sip - zvezdochki, vistupayushie nad urovnem koji, plotnie, v oblasti yagodits, beder, goleney (v 20% meningokokkemii mojet bit bez meningita) bakterialniy shok (endotoksicheskiy) ↑ t º, oznob, sip (melkaya, zatem krupnaya, …

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powerpoint presentation meningiti buxara-2016 opredelenie meningit – ostroe infektsionnoe zabolevanie s preimushestvennim porajeniem pautinnoy i myagkoy mozgovix obolochek golovnogo i spinnogo mozga meningiti pervichnie proisxojdenie vtorichnie meningiti bakterii vozbuditeli (chashe vsego) virusi meningiti gribi vozbuditeli (reje) rikketsii prosteyshie mikoplazmi amebi gelminti ● ● ● ● ● ● meningiti polost nosoglotki vxodnie vorota kishechnik meningiti (patogenez) krov (stadiya virusemii ili bakteriemii) vxodnie vorota obolochki golovnogo mozga meningiti seroznie tserebrospinalnaya jidkost gnoynie meningiti gnoynie seroznie bakterialnie seroznie (limfotsitarnie) virusnie tuberkulezniy sifiliticheskiy isklyucheniya: morfologicheskie izmeneniya pautinnaya i myagkaya obolochki ependima i sosu...

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