{"id":29557,"date":"-0001-11-30T00:00:00","date_gmt":"-0001-11-29T22:18:44","guid":{"rendered":""},"modified":"-0001-11-30T00:00:00","modified_gmt":"-0001-11-29T21:00:00","slug":"smegenu-abscesas-arba-epidurinis-abscesas","status":"publish","type":"catalog_entry","link":"https:\/\/www.pasveik.lt\/lt\/irasas\/smegenu-abscesas-arba-epidurinis-abscesas\/","title":{"rendered":"Smegen\u0173 abscesas, arba epidurinis abscesas"},"content":{"rendered":"<p style=\"text-align:justify\"><strong>Smegen\u0173 abscesas, arba epidurinis abscesas<\/strong><\/p>\n<p style=\"text-align:justify\"><strong><\/strong><\/p>\n<p style=\"text-align:justify\"><strong>APIBR\u0116\u017dIMAS<\/strong><\/p>\n<p style=\"text-align:justify\">Galvos<br \/>\n smegen\u0173 abscesas \u2013 tai lokalus p\u016blingas darinys, susiformav\u0119s vienoje<br \/>\nar keliose smegen\u0173 srityse. Morfologin\u012f absceso substrat\u0105 sudaro<br \/>\nimunin\u0117s l\u0105stel\u0117s, p\u016bliai, mikroorganizmai bei j\u0173 i\u0161skiriami toksinai.<\/p>\n<p style=\"text-align:justify\"><\/p>\n<p style=\"text-align:justify\"><strong>EPIDEMIOLOGIJA<\/strong><\/p>\n<p style=\"text-align:justify\">Galvos<br \/>\n smegen\u0173 abscesas yra reta liga. JAV per metus u\u017eregistruojama 1500 \u2013<br \/>\n2500 atvej\u0173. Vyrai \u0161ia liga serga 2 kartus da\u017eniau nei moterys. Apie 25<br \/>\nproc. atvej\u0173 smegen\u0173 absceso prie\u017easties nustatyti nepavyksta.<\/p>\n<p style=\"text-align:justify\"><\/p>\n<p style=\"text-align:justify\"><strong>LIGOS PRIE\u017dASTYS IR EIGA<\/strong><\/p>\n<p style=\"text-align:justify\">Galvos<br \/>\n smegen\u0173 abscesas formuodamasis praeina kelias stadijas. U\u017edegiminis<br \/>\nsmegen\u0173 audinys vadinamas ankstyvuoju cerebritu. V\u0117liau formuojasi<br \/>\naudini\u0173 nekroz\u0117, pripildyta p\u016bli\u0173 ir apsupta gerai vaskuliarizuotos<br \/>\nkapsul\u0117s. V\u0117liau susiformuoja demarkacin\u0117 zona, per 2 savaites pilnai<br \/>\nsusiformuoja kapsul\u0117.<\/p>\n<p style=\"text-align:justify\">Suk\u0117l\u0117jai \u012f galvos smegenis patenka trimis keliais:<br \/>\n &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 1.Tiesiogiai: i\u0161 orini\u0173 an\u010di\u0173, vidurin\u0117s ausies,<br \/>\nsmilkinkaulio ar spenin\u0117s ataugos orini\u0173 l\u0105steli\u0173, patologini\u0173 \u017eidini\u0173<br \/>\ndantyse;<br \/> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 2.Hematogeniu \u2013 da\u017eniausias kelias; b\u016bdingi daugybini\u0173 abscesai;<br \/> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 3.Pa\u017eeistas kaukol\u0117s vientisumas (trauma, chirurgin\u0117 intervencija ir pan.)<\/p>\n<p style=\"text-align:justify\"><\/p>\n<p style=\"text-align:justify\"><strong>KLINIKA<\/strong><\/p>\n<p style=\"text-align:justify\">Klinikiniai<br \/>\n simptomai kinta priklausomai nuo vyraujan\u010dio patogenetinio mechanizmo<br \/>\nir ne visada atspindi ligonio b\u016bkl\u0117s sunkum\u0105. Esant padid\u0117jusiam<br \/>\nvidiniam kaukol\u0117s sl\u0117giui, ligon\u012f vargina galvos skausmas, kur\u012f neretai<br \/>\nlydi pykinimas ir v\u0117mimas. D\u0117l prastos savijautos padid\u0117ja dirglumas,<br \/>\nsuma\u017e\u0117ja d\u0117mesingumas, atsiranda sumi\u0161imas, mieguistumas. Neretai<br \/>\nsutrinka rega, atsiranda raumen\u0173 silpnumas, sutrinka judesi\u0173<br \/>\nkoordinacija. Priklausomai nuo absceso lokalizacijos ir pa\u017eeist\u0173 smegen\u0173<br \/>\n sri\u010di\u0173 i\u0161ry\u0161k\u0117ja b\u016bdingi neurologiniai po\u017eymiai: parez\u0117s, afazija,<br \/>\nkartais s\u0105mon\u0117s sutrikimai. Galvos skausmas pasitaiko 50 \u2013 90 proc.<br \/>\nligoni\u0173, \u017eidininiai neurologiniai poky\u010diai \u2013 50 proc. Klasikin\u0117 triada \u2013<br \/>\n galvos skausmas, kar\u0161\u010diavimas ir \u017eidininiai neurologiniai poky\u010diai<br \/>\npasitaiko tik 5 proc. ligoni\u0173.<\/p>\n<p style=\"text-align:justify\"><\/p>\n<p style=\"text-align:justify\"><strong>DIAGNOSTIKA<\/strong><\/p>\n<p style=\"text-align:justify\">Smegen\u0173 abscesas diagnozuojamas atlikus \u0161iuos tyrimus ir radus \u0161iuos kriterijus:<\/p>\n<ul>\n<li>bendra neurologin\u0117 simptomatika;<\/li>\n<li>vystosi nuo absceso lokalizacijos \u017eidinin\u0117 simptomatika;<\/li>\n<li> kar\u0161\u010diavimas (hektinis);<\/li>\n<li>kraujo tyrime leukocitoz\u0117;<\/li>\n<li>KT tyrimas.<\/li>\n<\/ul>\n<p style=\"text-align:justify\"><\/p>\n<p style=\"text-align:justify\"><strong>GYDYMAS<\/strong><\/p>\n<p style=\"text-align:justify\">Gydoma<br \/>\n antibiotikais, kurie praeina hematoencefalin\u012f barjer\u0105 bei chirurginiais<br \/>\n veiksmais. Galimos dvi grup\u0117s: pasistengti absces\u0105 i\u0161punktuoti.<br \/>\nPraplovin\u0117ti absces\u0105 kasdien 3-4 dienas. \u0160is b\u016bdas geras tuo, kad<br \/>\npavyksta i\u0161vengti meningito. Arba vykdoma atvira kraniotomija ir pilnas<br \/>\nabsceso pa\u0161alinimas.<\/p>\n<p style=\"text-align:justify\">Operacinis gydymas taikomas, jei:<br \/> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 1.Blog\u0117ja ligonio b\u016bkl\u0117 d\u0117l smegen\u0173 absceso sukeliamo spaudimo;<br \/> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 2.N\u0117ra ger\u0117jimo gydant antibiotikais 2 savaites;<br \/> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 3.\u012etariama anaerobin\u0117 infekcija;<br \/> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 4.Didel\u0117 absceso ply\u0161imo rizika.<\/p>\n<p style=\"text-align:justify\"><\/p>\n<p style=\"text-align:justify\"><strong>PROFILAKTIKA<\/strong><\/p>\n<p style=\"text-align:justify\">N\u0117ra.<\/p>\n<p style=\"text-align:justify\"><\/p>\n","protected":false},"featured_media":0,"template":"","tags":[27937,27936],"catalog_supplier":[],"catalog":[27445],"class_list":["post-29557","catalog_entry","type-catalog_entry","status-publish","hentry","tag-epidurinis-abscesas","tag-smegenu-abscesas","catalog-nervu-sistemos-ligos"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/catalog_entry\/29557","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/catalog_entry"}],"about":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/types\/catalog_entry"}],"wp:attachment":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/media?parent=29557"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/tags?post=29557"},{"taxonomy":"catalog_supplier","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/catalog_supplier?post=29557"},{"taxonomy":"catalog","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/catalog?post=29557"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}