sil kasalligida bemorlarda kuzatiladigan yurak qon tomir sistemasi òzgarishlari

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xronicheskoe legochnoe serdtse pri tuberkuleze mavzu: sil kasalligida bemorlarda kuzatiladigan yurak qon tomir sistemasi òzgarishlari reja: sil kasalligida yurakning umumiy kasalliklari sil kasalligida yurak körinishlari davolash usullari. xronicheskoe legochnoe serdtse (xls) eto gipertrofiya i/ili dilatatsiya pravogo jeludochka, razvivayushiesya vsledstvie zabolevaniy, porajayushix strukturu ili tolko funktsiyu legkix. klassifikatsiya voz(1961g.) 1-ya gruppa — zabolevaniya, pervichno porajayushie vozduxonosnie puti i alveoli ( xozl, tuberkuleza i sistemnix disseminirovannix zabolevaniy legkix, professionalnie bolezni) 2-ya gruppa — zabolevaniya, pervichno narushayushie dvijeniya grudnoy kletki 3-ya gruppa — zabolevaniya, pervichno porajayushie sosudistuyu sistemu legkix. patogenez v patogeneze legochnogo serdtsa u bolnix tuberkulezom legkix imeyut znachenie anatomicheskie i funktsionalnie izmeneniya, kotorie privodyat k povisheniyu sosudistogo soprotivleniya v malom kruge krovoobrasheniya. anatomicheskie izmeneniya sostoyat v umenshenii emkosti sosudistogo rusla, v pervuyu ochered za schet sujeniya i obliteratsii melkix sosudov — prekapillyarov i kapillyarov. vsledstvie bolshoy emkosti sosudov malogo kruga virajennaya gipertenziya voznikaet pri umenshenii sosudistogo rusla bolee chem na 2/3 …

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i dostoveren, esli davlenie krovi v legochnoy arterii previshaet 25 mm rt. st. v pokoe i vishe 30 mm rt. st. pri fizicheskoy nagruzke. morfologicheskim priznakom xls yavlyaetsya utolshenie stenki pravogo jeludochka bolee 5 mm. stepen gipertrofii miokarda pravogo jeludochka opredelyayut v zavisimosti ot tolshini stenok kak slabuyu (5–6 mm), umerennuyu (6–8 mm) i virajennuyu (bolee 8 mm). simptomi xronicheskogo legochnogo serdtsa pri tuberkuleze klinicheskaya kartina zabolevaniya vklyuchaet simptomi osnovnogo protsessa i priznaki lyogochno-serdechnoy nedostatochnosti. na rannix stadiyax dominiruyut simptomi intoksikatsii ili dixatelnoy nedostatochnosti: kashel, odishka, povishenie temperaturi tela. vajniy simptom - «tyopliy» tsianoz (sledstvie arterialnoy gipoksemii), intensivnost tsianoza sootvetstvuet stepeni virajennosti respiratornix rasstroystv i stepeni dixatelnoy nedostatochnosti. golovokrujenie, golovnie boli, sonlivost i sjimayushie pristupoobraznie boli v oblasti serdtsa. po mere uvelicheniya pravix otdelov serdtsa vozmojno vozniknovenie «anginoznix boley» vsledstvie sdavleniya levoy koronarnoy arterii uvelichennim lyogochnim stvolom. bolnie s lyogochno-serdechnoy nedostatochnostyu i stadii mogut dlitelnoe vremya ostavatsya v sostoyanii polnoy …

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erdtsa sdvinuta vpravo, toni na verxushke serdtsa gluxie, aktsent ii tona nad lyogochnoy arteriey otchyotliviy. snijeno nasishenie arterialnoy krovi kislorodom do 85%. v klinicheskoy kartine dominiruyut simptomi dlitelno protekayushix lyogochnix narusheniy: kashel, pristupi udushya, subfebrilnaya temperatura. v lyogkix vislushivayut suxie i vlajnie zvonkie xripi raznogo kalibra, pri nalichii ochagovogo protsessa xripi vislushivayut na opredelyonnom uchastke. iii stepen dekompensatsii - totalnaya serdechnaya nedostatochnost. aktsent ii tona nad lyogochnoy arteriey ischezaet, viyavlyayut simptomi otnositelnoy nedostatochnosti tryoxstvorchatogo klapana i venoznogo zastoya v bolshom kruge krovoobrasheniya. u takix bolnix rezko narushaetsya gemodinamika (uvelichivaetsya pechen, stanovyatsya bolee virajennimi otyoki, nabuxayut sheynie veni, umenshaetsya diurez, poyavlyaetsya vipot v bryushnuyu ili v plevralnuyu polost). xotya nekotorie simptomi (tsianoz, odishka i dr.) mogut bit obuslovleni kak lyogochnoy, tak i serdechnoy nedostatochnostyu, u bolnix s xls otmechayut simptomi i sobstvenno pravojeludochkovoy nedostatochnosti («zastoynaya» pechen, astsit, otyoki). v patologicheskiy protsess vovlekaetsya leviy jeludochek v svyazi s uvelicheniem nagruzki na levie …

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i polojeniya serdtsa (rotatsiya po chasovoy strelke, vertikalnoe polojenie eos, sdvig verxushki serdtsa nazad); uvelichenie amplitudi zubtsov r vo ii i iii standartnix otvedeniyax bolee 0.25 mv (2,5 mm); uploshenie, inversiya i dvuxfaznost zubtsov t vo ii i iii standartnix i pravix grudnix otvedeniyax, narastayushie s uvelicheniem stepeni pravoserdechnoy nedostatochnosti, izmeneniya bolee virajeni v iii standartnom otvedenii i v otvedenii v1: polnaya ili nepolnaya blokada pravoy nojki puchka gisa; priznaki gipertrofii pravix otdelov serdtsa (preobladanie r v pravix grudnix otvedeniyax i (ili) s - v levix grudnix, nalichie visokogo ostrokonechnogo r v otvedeniyax ii, iii, avf, v1 i v2. snijenie segmenta st v tex je otvedeniyax, uvelichenie summi r v otvedenii v1 i s v otvedenii v5 do 10 mm lechenie lechebnie meropriyatiya pri ls u bolnix tuberkulezom - eto kompleksnaya terapiya, vklyuchayushaya ryad osnovnix pozitsiy: 1) lechenie osnovnoy patologii (tuberkuleza); 2) snijenie arterialnogo davleniya v mkk i uluchshenie gemodinamiki …

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tkani, slizistoy traxeo-bronxialnogo dereva, snimayut bronxospazm, ventilyatsionnie narusheniya, uluchshayut alveolyarnuyu ventilyatsiyu, umenshayut gipoksemiyu i davlenie v mkk) izmenenie reologicheskix svoystv krovi geparin profilaktika gipoksicheskoy distrofii miokarda anabolicheskie gormoni, pantotenat kaltsiya, tokoferol, aevit, kokarboksilaza, atf, preparati kaliya, insulin s glyukozoy, sulfokamfoklin, vitamin s. image1.jpeg image2.jpeg image3.jpeg image4.jpeg image5.png image6.png image7.jpeg image8.jpeg image9.jpeg image10.jpeg image11.jpeg

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xronicheskoe legochnoe serdtse pri tuberkuleze mavzu: sil kasalligida bemorlarda kuzatiladigan yurak qon tomir sistemasi òzgarishlari reja: sil kasalligida yurakning umumiy kasalliklari sil kasalligida yurak körinishlari davolash usullari. xronicheskoe legochnoe serdtse (xls) eto gipertrofiya i/ili dilatatsiya pravogo jeludochka, razvivayushiesya vsledstvie zabolevaniy, porajayushix strukturu ili tolko funktsiyu legkix. klassifikatsiya voz(1961g.) 1-ya gruppa — zabolevaniya, pervichno porajayushie vozduxonosnie puti i alveoli ( xozl, tuberkuleza i sistemnix disseminirovannix zabolevaniy legkix, professionalnie bolezni) 2-ya gruppa — zabolevaniya, pervichno narushayushie dvijeniya grudnoy kletki 3-ya gruppa — zabolevaniya, pervichno porajayushie sosudistuyu sistemu legkix. patogenez v patog...

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