xirurgicheskie zabolevaniya novorojdennix:rannyaya diagnostika i lechenie

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naujagimių chirurginiai susirgimai: ankstyvoji diagnostika ir gydymas xirurgicheskie zabolevaniya novorojdennix: rannyaya diagnostika i lechenie arunas lyubshis xirurgicheskie zabolevaniya u novorojdennix vrojdennie anomalii kishechnika; anomalii legkix i diafragmi; defekti bryushnoy stenki; opuxoli; drugie vrojdennie anomalii i zabolevaniya; vrojdennie anomalii i drugie zabolevaniya kishechnika atrezii kishechnika: atreziya pishevoda; atreziya/membrana dvenadtsatiperstnoy kishki; atreziya tonkoy kishki; atreziya tolstoy kishki i/ili vixodnogo otverstiya; narusheniya rotatsii kishechnika: sindrom lada; kisti i duplikaturi brijeyki kishechnika; zavorot kishki; invaginatsiya; perforatsiya jeludka i/ili kishki; atreziya pishevoda chastota 1:3000 rodivshixsya; 30-50 % - sochetannie anomalii (serdechno-sosudistie, urogenitalnie, anorektalnie) atreziya pishevoda v anamneze beremenosti – poligidramnion; zond ne proxodit v jeludok; virajennaya slyunotochivost – ne mojet proglotit slyunu; opasnost aspirasii pishi, esli rebenok vskarmlivaetsya; dixatelnaya nedostatochnost iz-za progresiruyushey aspiratsionnoy pnevmonii; mojet bit mekoniy; ne menee u 1/3 novorojdennix - sochetannie vrojdennie poroki (drugie atrezii kishechnika, vrojdenniy porok serdtsa, poroki razvitiya pochek i dr.); peredniy i bokovoy rentgenovskiy snimok grudnoy kletki i …

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odivshixsya; vozmojnie varianti: atreziya dvenadtsatiperstnoy kishki – 40-60%; membrana dvenadtsatiperstnoy kishki – 35-45%; koltsevidnaya podjeludochnaya jeleza – 10-30%; stenoz dvenadtsatiperstnoy kishki – 7-20%; ½ novorojdennix – nedonoshennie; 20-40% sluchaev – trisomiya 21 pari xromosom (bolezn dauna); do 50-70% sluchaev - sochetannie anomalii (nezavershenniy povorot kishechnika, atreziya pishevoda, atreziya vixodnogo otverstiya, koltsevidnaya podjeludochnaya jeleza, anomalii razvitiya pozvonochnika i dr.); atreziya dvenadtsatiperstnoy kishki v anamneze beremennosti v 40% sluchaev -poligidramnion; mojno ustanovit (podozrevat) prenatalno vo vremya uzi; znachitelnoe kolichestvo jeludochnogo soderjimogo s primesyu jelchi ili bez nee (etogo mojet i ne bit); chastaya rvota s primesyu jelchi (ee mojet i ne bit) posle kajdogo kormleniya, cherez 6-12 chasov; mojet otoyti mekoniy! peredniy rentgenovskiy snimok grudnoy kletki i jivota: dve ili odna poverxnost jidkosti i vozduxa, “nemaya” nijnyaya chast jivota; atreziya dvenadtsatiperstnoy kishki prenatalnaya diagnostika atreziya dvenadtsatiperstnoy kishkii atreziya dvenadtsatiperstnoy kishki atreziya dvenadtsatiperstnoy kishki atreziya dvenadtsatiperstnoy kishki atreziya dvenadtsatiperstnoy kishki atreziya dvenadtsatiperstnoy kishki …

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m 12-24 chasa posle rojdeniya (v zavisimosti ot visoti atrezii); ne otxodit mekoniy, vo vremya klizmi mojno poluchit nebolshoe kolichestvo serovatoy slizi (ee mojet i ne bit); na perednem rentgenovskom snimke grudnoy kletki i jivota vidni vzdutie petli tonkoy kishki i mnojestvennie poverxnosti jidkosti-vozduxa; atreziya tonkoy kishki atreziya tonkoy kishki atreziya tonkoy kishki atreziya tonkoy kishki atreziya tonkoy kishki: lechenie ne kormit! zond v jeludok (8fr ili 10fr), otsasivat soderjimoe jeludka (profilaktika aspiratsii pishi); polnoe parenteralnoe pitanie; vozmeshat patologicheskie poteri jidkosti (oni ravni otsasivaemomu soderjimomu iz jeludka); perevezti novorojdennogo rebenka dlya operatsionnogo lecheniya; operatsiya; atreziya tolstoy kishki chastota – 1:20000-60000; mojet bit sochetannaya atreziya tonkoy kishki; mnojestvennie atrezii bivayut redko; atreziya tolstoy kishki v akusherskom anamneze – poligidramnion; mojet bit ustanovlena prenatalno vo vremya uzi; proyavlyaetsya na 36-72 chas posle rojdeniya, nachav vskarmlivanie rebenka; rezko vzduvaetsya jivot, cherez stenku jivota konturiruyutsya kishki, vidna peristaltika kishechnika; obilnaya rvota kishechnim soderjimim; ne …

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etannie anomalii, osobenno urogenitalnoy sistemi; chem vishe atreziya, tem bolshe veroyatnost anamaliy razvitiya mochevogo puzirya i pochek; atreziya pryamoy kishki i/ili vixodnogo otverstiya v akusherskom anamneze – poligidramnion; net vixodnogo otverstiya v obichnom meste ili ono otkrivaetsya v neobichnom meste; mojet bit svish tolstoy kishki, otkrivayushiysya v promejnost, matku, mochevoy puzir, vlagalishe, mochetochnik – nablyudat, ne poyavitsya li mekoniy!; esli svish otkrivaetsya v mochevivodyashie puti – opasnost infektsii mochevix putey; esli svish otsutstvuet ili on ochen uzkiy (osobenno, esli on otkrivaetsya v uretru malchikam) – klinika nizkoy neproxodimosti kishechnika; peredniy rentgenovskiy snimok grudnoy kletki i jivota i invertogramma pozvolyayut ustanovit visotu atrezii; tsistogramma, fistulogramma pomogaet opredelit lokalizatsiyu svisha; atreziya pryamoy kishki i/ili vixodnogo otverstiya atreziya pryamoy kishki i/ili vixodnogo otverstiya diafragmalnaya grija chastota – 1:2500-3000; raznovidnosti: levostoronnyaya (bodaleka) 90-95% sluchaev; pravostoronnyaya (morgani) 3-5% sluchaev; aplaziya diafragmi 0.5-1%; drugie: paraezofagialnie griji; relaksatsiya diafragmi (povrejdenie n. phrenicus i dr.); diafragmalnaya grija prenatalno …

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.); ochen negomogennaya i neponyatnaya rentgenologicheskaya kartina !!! diafragmalnaya grija jeludok v grudnoy kletke serdtse pechen v grudnoy kletke diafragmalnaya grija diafragmalnaya grija diafragmalnaya grija diafragmalnaya grija relaksatsiya diafragmi vrojdennie anomalii legkix vrojdennaya bronxogennaya kista vrojdennaya adenomatoydnaya kista vrojdennie anomalii legkix vrojdennaya kista legkix vrojdennie anomalii legkix vrojdennaya kista legkix vrojdennie anomalii legkix vrojdennaya lobarnaya emfizema verxney doli pravogo legkogo vrojdennie anomalii legkix vrojdennaya lobarnaya emfizema verxney doli levogo legkogo vrojdennie anomalii legkix vrojdennaya lobarnaya emfizema omfalotsele eto defekt toy chasti bryushnoy stenki, kotoruyu pokrivaet amnioticheskiy meshok; pupochnie sosudi idut po poverxnosti meshka i na ego vershine proxodyat v pupovinu; ona voznikaet na 9-12 ned. beremennosti; chasto vstrechayutsya sochetannie anomalii: poroki serdtsa, trisomii (chashe vsego 13,18 i 21 pari), tsentralnoy nervnoy sistemi i pochek; sindrom bekvita-videmana (omfalotsele, makroglosiya, makrosomiya i organomegaliya, gipoglikemiya(!)); gigantskie omfalotsele neredko sochetayutsya gipopolaziey legkix; omfalotsele prenatalnaya diagnostika omfalotsele omfalotsele omfalotsele omfalotsele: lechenie esli ustanovlena prenatalno – …

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naujagimių chirurginiai susirgimai: ankstyvoji diagnostika ir gydymas xirurgicheskie zabolevaniya novorojdennix: rannyaya diagnostika i lechenie arunas lyubshis xirurgicheskie zabolevaniya u novorojdennix vrojdennie anomalii kishechnika; anomalii legkix i diafragmi; defekti bryushnoy stenki; opuxoli; drugie vrojdennie anomalii i zabolevaniya; vrojdennie anomalii i drugie zabolevaniya kishechnika atrezii kishechnika: atreziya pishevoda; atreziya/membrana dvenadtsatiperstnoy kishki; atreziya tonkoy kishki; atreziya tolstoy kishki i/ili vixodnogo otverstiya; narusheniya rotatsii kishechnika: sindrom lada; kisti i duplikaturi brijeyki kishechnika; zavorot kishki; invaginatsiya; perforatsiya jeludka i/ili kishki; atreziya pishevoda chastota 1:3000 rodivshixsya; 30-50 % - sochetannie anomalii (s...

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