Добавил:
kiopkiopkiop18@yandex.ru Вовсе не секретарь, но почту проверяю Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз: Предмет: Файл:

4 курс / Дерматовенерология / Dermatologia_i_venerologia_KGMU_g_Simferopol_2012_g

.pdf
Скачиваний:
1
Добавлен:
23.03.2024
Размер:
9.49 Mб
Скачать

2.Oxapaicrepmylh'e:meMeHT.

3.Tip11:ae,u,wre KJ111HWiec:irn:e Cl1'.TJaI\1'lli, rrp11: KaropMx g aI-!HbUl: 3JieMerrr Mo- lKeT IIORBt1TbO!: Ha KOlKe.

11.Ha npweM K Bpaqy o6paTJ1JIOI 6oJILHOJ1: H. 35 JieT, pa6o'll1H,c )f(aJI0-

6aMl1 Ha B b lCbIIlaHHR B o6JiaCTl1 TflIOBHm;a, KOHe'lHOCTeJ1:,Bblp(l)l(eHHbJH 3yp; KO)f(l1. 3a6oJieBaHl1e Ha'laJIOCbBHe3aIIHO c qyBCTBa 3yp;a, a 3aTeM IIORBl1Jll1Cb .HpKo-po30Bbie IIRTHa, KOTOphre qepe3 HeCKOJibKO qacon l1C'le3aJIH,no.ii:BJl.HJittCL HOBbie. Ilpep;nonaraeT, <rro 3TO nocnep;- CTBHe yKyc:on KOMapon. CTpap;aeT xpoHwiecKHM racTpHTOM, xpoHH'leCKttM TOH311JIJil1TOM, xpOHH'leCKHMKOJil1TOM. Ilptt o6cnep;oBaHHJ1: Ha K.O)f(e TflIOBttm;a, KOHe'lHOCTeH BH)J;Hbl MHOrO'J:ffCJleHH:r.Ie3JJeMeHTbl CbIIIH pa3MepoM OT 1 CM )J;O 60JJhllH1X CJIHBHLIX O'laro:Bc ¢ecrOH'J:a- TbIMl1 Kpa.ii:M11. Ha oT,a;enLHLIX yqacrKax CLirrL perpeccttpyeT.

l.0 KaKl1'.X3JieMeHI-ax Cbilll1 MOJKHO rrop;yMaTb?

2.Oxapaicrep113yK!' 3JieMeHT.

3.TipHBegwre KJil1HK'feCKl1'.Cl1:TJaI~l1'e .l1, rrp11: KCYI'OpbX naHnbl11: 3JieMeHT MO-

lKeT IIORBITTbOI Ha'KOlKe?

12. Ha rrptteM r< npaqy o6paTHJICH MY:>K'lttHa42 neT, crpottTenL, c )KaJlo6a Mtt Ha HeBbJHOCHMbIW 3y,a; IIO nceMy Teny, KOTOpbltt B03Hl1KaeT BHe3aIIHO, o6LI'lHOneq.epoM. 3y.o; rrpop;OJI)l{HTeneH, JIHlllaeT cHa. I>oneH OKOJJO .o;nyx Mec.ii:u,en, 3a Me,11;Hll,HHCKOM IIOMOIIJ;blO He o6pam;ancH. IlpH o5cne,a;onaHHl1: KO:>Ka cyxa.H, Ha CIIHHe, KOHe'J:HOCT.R:X, )l(HBOTe, 6ep,pax Mil:O.lKeCTBeHHb ie 3KCK0pttall,J1J.f, IIOKpbITbie reMopparn'leCKHMH I<OpO'lKaMH.

1.0 KaKHX :meMeI-ITaX Cblfil1 MQ)f(HQ p,yMaTb?

2.OxapaKTep113yT1:Te :meMeHT.

3.ITp1-i.Be)J.11Te KJil1HW{eCKl1e Cl1Tyau11T1, rrpM KOTOpbIX )J.aHHbrM 3rre-

Me1n MO)!'.<eTIJOSIBl1TbCSl Ha KO)f(e.

Co,LJ,ep)f(aTeJlbHblH MOAYJlb 2

napa3HTapHble 6one3Hl1 KO>KM

'llecoTKa(scabies) - 3apa3Hoe rrapa3HTepHoe 3a60AeBaHHe,

BbI3LIBaeMoe qecoTO"!HbIM Kt>em;oM po,n:a Sarcoptes scabiei.

'lecomo~H&Lu 3yoeH& - KAem; -

HMeeT BH,n: "!eperraxn, 6eAo-

:>KeAToro UBeTa, ,ll,J\HHa caMKH Kt>eru:a -

OKOAO 0,5 MM, ,ll,J\HHa caMu.a

-- OKOAO 0,2 MM. IJ;HKi\ :lKH3HH "leCOTO'!HOroKt>em;a rro,n:pa3,n:eASieTCH Ha p errpO.nyKTHBHbIH H MeTaMopcpuqecKHH. PenpO,n:yKTHBHbJH LI.HK!> Ha'fHHaeTCH c norra,n:aHHH Ha KO~ 0!1AO,n:OTBOpeHHOM caMKH, KOTOpaH rrpOHHKaeT B porOBOH CAOH, H, rrpo,n:BHrruJCb B ero rAy6HHe rra-

31

4-6·
7-10

paAAeA:&HO noBepXHOCTH K02KH, cpopMHpyeT irecOTO'lHhlHXOA, B KOTO- p oM OTKAal(bIBaeT SI.HU.a. CKopOCTh npol(BH2KCHiffi CaMKH 1 MM B cy-

TKH. IlepHO.ZJ:H'leCKHc a MKa OCTaHaBAHBaeTCSl, 'lT06bI npo6y paBHTb B

poroBOM CAOC OTBepCTHe, Heo6XOAHMOe AASl fIOCTynACHH.H B03,ayxa, 6e3 KOT oporo KACW: nortt6aeT. MeTaMopcpw-recKirn U:HKA 2KH3HH KAern,a

3a:KAIO'Iae T C.H B npeBpar.u:eHHH .HHU: 13 t\H'IHHKH, a 3;:tTeM B HHMql bI -

MOAO)I:h ie o co6n, KOTOpble qepe3 npo6ypaBAeHHbie caMKOM XO.ZJ:bl BbI-

XOJi:SIT ua noBepxHoCTb K02KH. Ha noBepxHOCTH K02KH rrponcxo.n:HT OTIAOAOTBOpeHHe HOBhIX CaMOK, IlOCAe qero caMU:bI rH6HyT, H BCCb U:HKA IlOBTOpsteTC.H. IlpO_lI:Ol\.2KHTCAbHOCTb 2KH3HH caMKH B K02Ke OKOAO

2 MCC.Hl\eB. 3a 3TO BpeMSI OHa OTKAa)J.bIBaeT AO ~;o SIHU:.

l::feAOBeK 3apIDKaeTCSI qar.u:e BCCI'O npH npstMOM KOHTaKTC c 60AbHbIM 'ICCOTKOH(B T OM "lHCAe H IlOAOBOM), a TalOKe rrpH orrocpe.n.o-

BaHHOM KOHTaKTe ('Ie pe3 HaTeAbHOe, IIOCTeAf,HOe 6eAhe H )l.pyrue

rrpe.n:Me T:&I 6:&1Ta). Huey6au:noHHhIH rrepuo,11. 3a6oAeBaHHSl •mr.u:e Bcero

c ocTaBAfieT ,D.He li, HO M02KeT u YAAHHstTbC.H ,11.0 He,11.eAb. H an-

6oAee "laCTO BbICbIIlaHHSl rrpH qecoTKC AOKaAH3YIOTCR B Me2KilaAbl~e­

BblX CKA a,11.Kax KHCTCH, H a 6oKOBbIX IlOBepxHOCTS'!XIlMbT.I.eB, H a CI'H- 6aTeAbHOi,i ITOBepXHOCTH Ayqe3arrs:rCTHbIX cyCTaBOB, Ha K02Ke rrpe,n:- IlAC'IHHH Ilt\e"l, Ha K O:>Ke 2KHBOTa, 6e,11.ep H 51TOAHU:. y rpy;:i:Hh!X ):\CTeH BbICbffiaHHSl AOKaAH3yK>TCR Ha KO:>Ke Aal(OHeli, no,n:OllIB, si:ro,n:HU., He-

pe,n:Ko Ha KO)KC AHlJa, I'OAOBbl. KmKHhIM 3YA - rrepBbIH H OCHOBHOH

CHMf!TOM 3a6oACB8-HH.H, OH HaH60Aee Bblpa2KeH B BC'Iepttee H HO''IHOe

speNLH. 0.n:HOBp eMeHHO Ha K O)Ke IlO.HBAfIIOTCSI qecOTO'lHbIC XOlJ:bl B

BH,11.e CACriffi B03BbIWaror.u:elic.H Ha.n: K02KeH A H HHH rpR3HO-ceporo U:BC -

Ta )l/\.HHOH OT

1 MM A O

1-2 CM. H a

MeCTe BXO,ZI;a H BbIXOAa

KAe1u;a

cpopMHPYlOT CR

n a pHbIC

MOpcpOAOI'H'lCCKlle3ACMeHTbl Cblf!H,

qa11.1.e

Bcero 3 TO MHKj)OBe3HKYAbI, nanyAhI, BOA,n:blpH HAM

nycTyAhI,

TaKJKe

H M e IOTCR MH02KCCTJ3CHH bIC p ac<l:eCbI

(3KCKOpHaIJ;I-Hi)

H MCAKHe

r eMop ··

p arH'le CKHe K OpKH. '{ecOTKa qacTO

OCAO)KHHCTCR

rrpHco e,n:HHeH HeM

BTOj)H'iHOHCTacpHAOCTpenTOKOKKOBOH HHcpeKII.HH c RBACHrn:IMH 3K3e-

MaTH3a:IJ.HH.

 

 

 

 

 

LlHaI'H03'ICCOTKH ycraHaBAHBaeTCR KAHHH'leCKH, rrpH

Heo6-

xo,n:HMOCTH rrpOBOMT Aa6opaTopHyK> ,n:HarHOCTHKY ITYTeM MHKpOCKOIlH'leCKOI'OHCCAe,n:oBaHHR (onHCaHHe CMOTpHTe B rrpaKTH'leCKOI{qacTH yqe6Horo noco6HJ'I).

XapaKmepttbte cU.MnmoMbL npu ttecomrce:

• CHMIITOM App;r1-ro p'IaKOBa - ttam1:'lv.::e c y x MX 'lelllyeK, I'HOHHOreMoppan1qecKMX KOpOK Ha J10KTeBoIX cycTaBax;

32

CHMTITOM <<'rpeyrorrbHll!Ka » (poM6 Mwxa3n111ca) - pacrrorrmKeHHe BbICbmaHHM - se3111ryrr, nycryn, KopoK - TPeyroJibHHKOM, sepmMHa KOToporo cnycKaeTC.$1 K Me)KbfilO)J;H"'IHOMCKJia;:t;Ke, a OCHOB3Hl1e rre-

)l(li!T tta KpeCTD;e.

Ae11.eMue qecom11:u. 0)1.e:>K,Zzy, HaTeAbHOe 6eA:&e, rrocTeAbH:&Ie rrpHHa)J.Ae:>KHOCTH 60AbHOro o6pa6aTbIBaIOT B Ae3KaMepe HAH KI1II.HT.HT npH TeMrrepazype 1000 °C c IIOCAe,IJYIOIIl,HM nporAruKHBaHHeM yrroroM

c rrapoM.

BoAbHOH rrpHHHMaeT ,zzyw, a JaTeM Ha sec:& Ko:lKHbIH noKpOB,

B TOM 'lHCAeH Ha Henopa.JKeHHbie yqaCTKH KO:>KH, HaHOCHT H BTHpaIOT O)J.HO H3 CAe,IJYl{)l.IJ.HX cpe)J.CTB: 33 % cepHa.H Ma3b, 2 0 % 3MY.ll.bCHSI 6eH3HA-6eH30aTa (rrpHMeH.HIOT )J.A.H B3pOC.ll.blX), 1() % 3M)'AbCH.H6eH3HA-

6eH30aTa ()J.A.H J1.CTei1), cnpei1 •CrrperaAb», nepMeTpHHOBa.H Ma3:&. Ilpo-

,ll:OA:>KHTeAbHOCTb eypca TepaIIHH COCTaBAAeT OT 2 )J.0 7 )J.HeH B 3aBHCHMOCTH OT rrpHMeIDieMoro cpe,ll.CTBa. no OKOH'laHHli.11.e"leHH.H o6H3aTe.ll.bHbl )J.YIII, CMeHa HaTeAbHOro H ITOCTeAbHOro 6eA.b.H.

De..a;HKyAe3 (smHHOCTL). Ha KO)Ke '-!eAOBeKanap a3HTHpyroT

ZOJtOEIH& Le, nJtarnstHbLe H Jt061C06bLe ewu.

J\OKaAH3aI..J;H.H r0.11.0BHbIX BllICH - npeHM)'m;eCTBeHHO BOAOCH-

CTa.H '-laCTh r'OAOBhI , '-lam;e BHCO"lHbie H 3aTbl1\0"lHbie o6AaCTH, a TalOKe 6 poBH, peCHHI.I,bl. IT.11.aTSIHbie BllIH A0KaAH3YIOTC.H B 0611.l:tCTH ITAe'!eH:, aepxHeH 'laCTHCIIHHbl , B IIO,ll.Mbillie"lHbIX Bna,n:HHax, Ha )KHBOTe, no5TCHlU.I,e , B n:axoBo-6e,n:peHHblX CKAaAKax. THIIH"lHblMH MeCTaMH AOKa-

.ll.H3aU:t1H A06KOBblX Brne:H .HBAACTCSI A060K, IIO,AMbillie'IHbie.HMKH, 06-

AaCTb rpy,ll.H, :JKFIBOTa, auyca.

IIyTH nepe,n:a"lH ITCJ1.HKJAe3a - 3TO TeCHbIH 6bITOBOH KOHTaKT

c 6oA b HblM <IeAOBeKOM, OJ1.e)K,Aa 60AhIIOro 'leAOBeKa,TIOAb30BaHHe 06- l.l.l,HM IIOCTeAJ,HblM 6eAbeM, IIOAOBOH KOHTaKT.

IIepuo,n:aMH )Kli3HeHHoro I.I,HKAa y ameli .SIBAAIOTCH: 3apOJ1.bIrneBhI H (OTKAMbIBaHHe .HlfI.I,-rHHJl. H HX C03peBaHHe) -- OT 4 Jl.O 7 ,n:HeH H MeTaMopcpo.11.oni"leCKHH (TpoeKpaTHa.H AHHbKa AH'IHHKH, BbIAy mrn-

weikH H3 .HHl.I,) - 3-5 ,ll.Heli )J.ASI Ka)K,ll;OH AHHbKH, 3aTeM Hac1ynaeT

n e pHOJl. B3p0CAOH oco6H.

BbI:>KJrnaeMOCTb BIIIH B OKp~al{):w;eM: cpe.u.e OT 27 Jl.O 46

J1.HCH. B CyTKH caMKa OTKAa)J.bIBaeT OT 5 Jl.O 14 .HHI.I,, a 3a BeCb JK113HeHHblH 1.1,HKA - Jl.O 300 .HHl.I,.

IIorra,naSI Ha B0.11.0CHCTYIO '!aCTb KO)Kl.f H npHKpeIIMISICb K CTep)l{HJ{) BOAOCa, BOIIIb BOH3aeT CBOH pOTOBOH annapaT B KO:>KY H coceT KpOBb H3 KarrH.11.Aflp OB . B MeCTe yeyca no.n: BAHSIHHeM p a3,ll.pa- )KeHilll KO)JCH ceKpeTOM C.11.J{)HHblX :>KeAe3 IIO.HBASIJOTCH 3yJ1.SI:rn;He II.HTHa

33

52°C.
30-40°C,

H y3eAKH (xapaKTepHbI ,lI,AR rQAOBHOro H IlAaTHHOro ne,n:HK)'Ae3a).IlpH OTCyTCTBHH Ae'IeHHSI H Heco6A10,n:eHHH npaBHA AH'IHOH rHrHeHhI HapacraeT 3y,z:i:, IlOHBMUOTCR pacqecbI, YCHAHBaeTCR H pacnpoCTpaHSieTCR, BOCTiaAeHHe, o6pa 3yroTCR 3p03HH, KOpO'IKH, rneAyrrreHHe , a 3aTeM

Be3HK)'AhI, MOJCHYrHe - pa3BHBaeTCR 3K3eMaT03HLIH npou.ecc, KCYI'O- pbIH MO:>KeT OCJ\O)KlUITCH nuo.n.epMHeH.

Aettettue ne0u.x:yne3a. 0.n.e:>K,Zzy, HaTe A&Hoe 6eA&e , n o<---reAh-

Hhie rrpHHa,ll.Ae.lKHOCT H 60AhHOro o6pa6aThIBaIOT B .n.e3KaMepe HAH KHlliI'ffiT npH TeMnepa:rype 100 ·c c IIPCAeJzyIOIU,HM nporAa:>KI-t:BaHHeM yTIOl'OMc napoM.

IlpH nopa:>KeHHH BOAOCHCTOH '!aCTHro!IOBhI BOAOCbl peKOMeH-

JlYeTCR KOpOTKO OCTpWib, nopa:>KeHHbie BOAOChl IlO,ll.MhllUe'IHblXBna- ,ll.HH H noAOBhix oprauoa Heo6xo,nHMO c6pHTb . BoAhHoi'1 npHHHM aeT

JlYill, a 3aTeM Ha nopa:>KeHHbIH yqaCTOK KO:>KH, a A)"IUie Ha BeCh KO:lKHhlH IlOKpOB HaHOCHT H BTHpaIOT OAHO H3 CAeJzyIOw;mc tpeACTB: 33 % cepHrui: Ma3b, 20 % 3MYAbCHR 6eH3HA6eH30aTa (npHMeHRIOT ,[(AR

B3pocA&IX) , 10 % 3MYAhCHR 6eH3HA-6eH30aTa (AAR AeTeH), pacra op

•HHTTHcpop•. IlpO,[(OA:>KHTeAbHOCTb K)'pcaTepanHH COCTaBMl:eT OT 1 /J..O

3 ,[(HeH B 3aBHCHMOCTU OT IlpHMeHReMOro cpe,[(CTBa. Ilo OKOH'-1.BHHH Ae'!eHHSIo6H3aTeAbHh l .nyrn, CMeHa Ha:reAbHOro H noCTeAhHOro 6ei1.bH.

.ll.eMOAeK03 - rnHpoKo pacnpoCTpaHeHHOe xpoHwiecKoe na-

pa3HTapHoe 3a6011.eaaHHe KO)KH qei1.oseKa. Bo36y,nHTeARMH ero HBAH·· IOTC5I KAern;H - OeMoOuyuO&i (Demodex folliculorum H Demodex brevis). UuKA pa3BHT H5I A eMo,neKca ,noCTaTO'iHO CAo:>KeH H cocraBAReT

B cpe,nHeM 25-30 JI.Heil, Bech MeTaMopcpo3 (siiiu.o - AH'IHHKarrpOTO-

HHMcpa - .n:eliTOHHMcpa - HMaro) IIOAHOCTblO ocym;ecrBASieTCR B BOAOCSIHblX cpOAAHK)'Aaxl:I CaAhHLIX )KeJl.e3ax.

IloKpOBhI .n:.eMOJI.HU.HJI. COC'rDSIT H3 m1yrpeHHero 0)1,HOpR,[(HOro 3IIHAepMaAbHOro CAOR (3 n:u.n:.epMHCa) H BHeUIHero - K)'THK)'.11.,bIKOTO-

pasi, B CBOIO oqepe,nh, TpeXCAOHHa H COC'rDHTH3 3IIH-, 3K30- H 3H,[(O- K)'THK)'Abl.KAew; ,ne Mo,neKca qyacTBHTeAeH K cyxoMY B03eyxy. OH MO)KeT HaxOAHTbCSI np:u O'leHhcyxoM ao3.n:yxe 36 qacoa. B 10 % pac - Taope Kap60AOBOH KHCAOThI MO:>KeT HaxO,n:HThCH .n:.o 1 MHHyTbl, B 96°

CIIHpTe - 3-4 MHHYfhI, B 20 % w;eAO'lH- 4-6 MHHyT. TeMne p azypa

KOMcpOpTa - ry6HTeAhHOH ,[(AH KAew;a ,neMo,neKca SIBA.HeTCH

TeMnepazypa

3apruKeHHe .n:.eMOAeKCOM MO)KeT 1Ip0H30HTH KaK B .l(eTCTBe,

T aK H BO B3p0CAOM nepHOAe. IlpH .n;eHCTBHH KaK 3K30r'CHHbIX, TaK H 3H,ll.OreHHhIX cpaKTOpOB (ce30HH hlH cpaKTOp , B03,n:eliCTBHe B bICOKHX TeMnepazyp, ropR'IaSI IIHW,a, COAHe'!Ha.sI H HCOAHU.HSI, HeAOCTa TO'!Ha.sI

34

O'IHCTKa KOJKH, rHilOBHTaMHH03, ,ll,HCcpJHKI~llil IlHIIJ.eBapwre.11.hHOH H 3HJI.OKpHHHOH CHCTeMhI, 0'-IarH cpOKa.AbHOH HHcpeKIJ.HH, HapymeHHe HMM)'HOAOrH'leCK peaKTHBHOCTH opraHH3Ma 60.11.hHOro) npOHCXO,ll,HT H apyrueHHe CTa6H.11.H3HpOBaHHOro paBHOBeCllil Me:>KJ!Y napa3HTOM H X035IHHOM •

.KJtuH.u'f.ecJCasr.Kapmuna ,n,eMo,n,eKo3a 33.KAIO'laeTCHB rHne-

p e MHH KO:lfrn AHUa H HaAH'IHHBbICblilaHHH. H3AI06AeHHOil AOK aAH3a-

U Heii CbIIlH RB.11.ReTCR AHU.O, a .HMeHHO HOC, m.eKH, rro,n,6opo,n,oK H A06.

Mopcpo.11.orH'lecKHMH 3.11.eMeHTaMH KAl\HHKH ,n,eMo,n,eKo 3a qe.11.oBeKa RBARIOTC.H: 3pHTeMaT0 3Hbie llilTHa, 0'-IaroBaR H.11.H ,ll,Hcpcpy3HaR HHcpH.11.bT pau.m1, MCAKOcpOMHKY.11.RPHOe IllC.11.yuieHHe, cpo.11..11.Hey.11..HpHbie

n any.11.hI po3oBoro H.11.H KpacHoro u.seTa; nany.11.o-Be3HKY.ll.hl; na.ny.11.0- nyCTy.ll.hI H caMOCT051:TC.ll.hHhie MHKpO- H MaKpOnyCTy.11.hI, Te.11.eaHrH3K-

Ta3HH. Co BpeMeHeM, Bc.11.e,n,CTBHe xpoHM'!ecKoro rrporpaJJ.HeHTHoro T e'l.Hllil, naTOAOrH'leCKHHnpouecc npHBO,ll,HT K o6pa30BaHHIO BOCnaAHTe.11.bHbIX y3.11.os, HHcpH.11.bTpaToB H CTOHKOMy paclllHpeHHIO cocy,n,oB.

,llHarH03 ,n,eMo,n,eK03a CTaBHTC.H Ha OCHOBaHHH .11.a6opaTOpHOH

,n,H arH OCTHKH

COCKo6os c KO:Hrn AHi.I.a, 6poBeH H peCHHU. (OilHCaHHe

MCTOJ~HKH ·-

B npaKTH'ICCKOH'laCTH)"iC6Horo noco6HS1) .

Ae-c.eH.ue

oeM.ooeJCo3a BKAIO'laeT B ce6a rrpHMeHeHHe H a-

p p KHb IX cpe,n,CTB

H o6m.ero .11.eqeHIDI. AHTHnapa3HTapHaH Tepanllil

n pOBO,ll,HTCSI nyreM IlOC.ll.C,ll,OBaTe.11.bHOro CMa3hIBa Hllil KOJKH .II.HU.a npe-

n a paTOM •Cnpera.11.h• H 4 % rrepMeTPHHOBHM KpeMOM. CooTBeTCT-

BYIOIIJ.He npou.e.z:zypbI nposo,n,RTC.H nauHeHTaM ABruKJl.bl B ,n,eHb. Kypc

AC'lCHllil COCTaB.11.ReT 18-20 ,n,HeH. HaAH'IHe y 60.11.bHblX

KACIIJ.CH-

,n,e MOJI.HU.H,ll, Ha peCHHU.ax r.11.a3 H)')KJJ.aeTCH B C2Ke,ll,He BHOM

CMa3bIBa-

HHH Kpae s seK H peCH HU. KpeMOM •Jlef M0.11.aH• B Te'leH e 18-20 ,ll,HCH.

IIpH TIDKe.11.Prx cpopMax Hcno.ll.h3yIOTCH npenapaTbI MeTpOHH,n,a3oAosoro paA~. renaTonpOTeKTOpbI, 3y6JIOTHKH, HMM)'HOMO.try.11.RTOpbI.

Mna3 - napa3HTapHrui: HHcpeKUllil, BbI3BaHHaR nopruKeHHeM

qe.11.oBeKa AH'IHHKaMH ,n,syKpbl.11.bIX HaCeKOMb!X

OBOAaMH

(Dermatobia hominis). Ha6A10,n,aeTCH y AHU., sepeysun1:xca

H3 paii-

OHOB l(eHTpa.11.bHOH H IQ)KHQH AMepHKH .

 

.KnuH.u&f.eCKasl Kap muH.a. 5lHu.a HaCCKOMbIX OTKA~IBalOTCH

Ha KO:>Ke, npOHHKaIOT no,n, KO)KHYJO TKaHb, r,n,e AH'IHHKH,ll,OCTHraIOT 3 p e.11.0CTH . AH'IHHKa:HrnBeT B 3pHTeMaT03HOH rrarryAe MAH y3.11.e, KOTOpbie M O:>KHO ourn6o'IHO npHHRTb 3a BOCilaAHBillYIOC.H KHCTy. Q qarH noproKe HHSI 06bl'lHO.ll.OKaAH3yIOTCH Ha KO:lKe B0.11.0CHCTOH 'laCTHI'OA.0- Bbl , .11.Hu.e, n p e,n,Il.11.e'lhliX H rpy,n,H . BbICbIIlaHllil npeJI.C'raBA.eHbI6oAe3HeHHhIMH soc na.11.eHHbIMH nany11aMH H.11.H y3AaMH .a:1mMeTpoM 2-5 MM,

35

B u,eHTpe narryAbI HMeeTCSI TO'ie'iHOeOTBepCTHe, KOTOpoe BbIIIOAHSleT cpymu~mo .ZJ.bIXaTeAbHOM T p y6KH AH'iHHKH. M02KHO Ha611.ro,n:aTb KaK Tpy6Ka OTKpbIBaeTCSI H 3aKpbIBae TCSI B KO:lKe, npHMepHO 1 pa3 B MHH . , H 3 Tpy6KH MO:lKeT BbI,n:eASITbCSI cep03HOe MAH rHOHHOe co,n:ep- ::lKHMOe .

Ae'leHHeMHa3a:

Xupyprwi:ecKoe yp;aJieHtte.

IlepeKpbIBalOT ,[t;bIXaTeJibHOe OTBepCTKe JIH<n1HKJ1 Ba3eJil1HOM 1iUll1 Ma3bl0 c aHT116HOTHKOM, JTH~IHHKa 3ap;bIXaeTC51 H nona.a;aeT B :>K11poBYIO JiosymKy, B TeqeHHe 1-3 qacos nocJie ttaHeceHlUI. Ma3H rri;i:qHHKy MO)l(HQ YAaJIJ1Tb OMHIJ,eTOM.

KOHTpOnbHblH reCT K CORep>KarenbHOMY MORyn10 N!! 2

1.KaKttMM rryTHMtt ocy~eCTBJIHeTCH 3apil)KeHwe qecoTKol1?

a)IloJIOBbIM,

6)qepe3 mpyIDKH,

s)qepe3 6eJihe 11 rroc:re.nh,

r) OT :lKHBOTHbIX,

A)BCe sepHo, KpOMe r).

2.f.o;e Ha6Jirop;aeTC.SI T'l1IIJ1'1HallJIOKaJIH3aIJ,J1ll qecOTKH y B3pOCJibIX?

a) Me:lKDaJih!leBhie cKJiap;KH x11crew,

'

6) reHHTaJIHl1,

B) )!(HBOT,

r ) MOJIO<JHbTe .)KeJie3bI,

A)BCe BepHO, KpOMe r).

3.K aKOBbI Haw6onee qacrb1e nepBM'lHhieMopcponorwqecKwe 3JieMeHTbI

npw qecOTKe?

a) I1y3brpeK,

6) y3eJIOK,

B) II51THO, r) 6yropoK,

A)septto a) 11 6).

4.K aKOB HaH6onee xapaKTepHbIH npw3HaK 'LleCOTKw? a) Beqepn11Ji1HHoqHoJ.1:3y.a;,

6) YTPeHHvt1'r3y.a;,

s)OTCyTCTBvte 3yp;a, r ) 3y.a; H )K)J(eHtte,

.a;) )f()f(eHtte 11 6oJie3HeHHOCTb.

5.KaKoBo Hatt6onee q acroe ocJIO)l(HeHtte qecoTKw?

a)BTOpl1'llia51nwo.a;epMl151,

36

6) M1%1K03 KO)J(H,

B) aTPoqnrn: KO)l(H, r) ¢ypym<yneJ, A) anone~IDI.

6. llro npeii;ycMarpttsaer o6m;ee neqettue 60JibHbIX qecOTKon? a) Ha3Ha"leHli1e swraMHHOB,

6) npHMeHeHtte TOJJbKO Hapy)KHOK Tepan1%111, B) )J,e3l1HTOKeMKau;MOHHrul repanIDI,

r) aJIT1%16flIOTI1KOTep arrIDI,

A)see nepeq11CJieHHoe septto.

7.KaKtte JieKapcrseHHble npenapaTbI np1%1Mem1.10r .rvu1 Hapy)1<Horo ne- 'leH1'UIqecOTKM?

a)33 % cepttrui Ma3b,

6)cnpeV! « CnperaJib»,

s)20 % 3MyJibour 6eH3'11Jl-6e1uoara,

r)nepMeTpWHOB<UI Ma3b,

A)sep1m see nepe411:cJieHHoe.

8.r)J.e 06HTalOT BIIIH?

a) lUeTMHMeTble BOJIOCbI - JI06KOBaJi BOIIlb, 6) AJil1H Hbie BOJJOCbl - rOJIOBHa.ll. BOIIIb,

B)6eJTbe - IlJJOTIDfruJ BOlllb;

r)TOJlbKO AJHIHHbie BOJIOCbI;

A)sepHo a), 6), s).

9.KaKHe rrperrapaTbl npttMeHHIOT )J.JIJI ne'!eHMJI IIeAMKyne3a?

a)lliaMrryHh e anm,

6)«Hmn 1¢op» ,

s)BWcMyT,

r) JT1%1)J.a3a,

A)nepHo see rrepeq111CJ1e1moe.

10.KaKOBbI p a3HOBMJJ.HOCTtt ne)J.11KyJie3a?

a)roJIOBHOllt, IIJJaT.SIHOM, JJ06KOBblH,

6) nnarn:HOH, roJIOBHOT1:, MMrpl1py10u~WH,

B)JI06KOBbrM, roJJOBHOM, ¢wKC11pOBaHHbn1,

r)¢MKC11pOBaHHbIK, IlJJaTID-rolir, ronOBHOK,

A)r OJlOBHOK, TOTaJibHbn1, JI06KOBb!H.

ll. B KaKOM cnoe 3nMp,ep111wca caMKa 'leCOTO'lHOI'O3YAIDI npoKJia,u,brnaer xo,a;?

a)Porosolir:,

6)6necrma;niil,

B)3epHli1CTbIH,

37

r)illl1IIOBl1L!;HbIM, A) 6a3aJibHbICi..

12.KaK npe1oryru;ecrBeHHO MO)l(eT npott:CXOAl1Tb 3ap~ett11e qecoTKon?'

a)Tiptt pyKono)KaTHl1,

6)BO Bpewr yryca MOCKMTa,

B) nptt: IlOJIOBOM KOHTIIKTe,

r) BO BpeM5! IIJiaBaHM51:,

A)rrptt KOHTaKTe c l1Hcpl1I:I,l1pOBaHHhIMl1 IIpe.r.i;MeTaMH.

13.K KaKOtt rpynne 3THOJJOI'l1'leCKHXcpaKTopon OTHOCHTCJI B036yp;MTeJlh

qecoTKM?

a)Btt:pyc1>r,

6)6aKTeptttt,

B)KJI€II~l1,

r) rrpocreiirmtte,

/J,) I'eJibMl1HTbI.

14.KaKH:e npenapaTbl H CIIOJlb3Y!OTC.H B Jie'!eHHHneP,HKJJie3a?

a)«Httrrttcpop»,

6)«Cttnacprr a H» ,

B)10-20% 3M)'JihClIB6eH3ttrr-6eH3oarn,

r ) «MttK030 JIOH», ,i:i;) «Cnperam»>.

15. qTO npe.r.i;ycMaTpttnaeT Jie'!eJ-Itte60JlhHOI'OqecOTKOM?

a)lilcKJIIO'leJ-Itteocrpo11 IIt1JJJ;M,

6)JI€<1€Hl1€ 6eH3l1JI-6eJ-I30aTOM, B) rrpttMeJ-IeI-me Ye.DO,

r) rrp11tMeHe1-rne TIYBa-Tepamrn,

µ,) KOpnn<OCTepoH,D;bI.

16.KaKOBbI Mecra TffIIM'lHOMJIOKaJitt3an;m1 qecOTKtt?

a)Me)J(IlaJihl~eBhie CKJia,D,Kl1 Kl1CTe11:,

6)BOJIOCl1CTMI "TaCTb roJIOBbI,

B)Jll1ll;O tt llI€5!,

r) clll1Ha,

A)Jia)J.OHl1 H IIOAOillBbI.

17.qTO l'IBJlJieTCJIHatt6orree xapaKTepHbIM nptt:3HaKOM qecoTKH?

a)l1HCpl1IIbTpan;tffi B oqarax rropa)l(€HT15!,

6)3K3eMaTtt:3arrIDI B oqarax nopa:>KeHIDI,

B)MMneTttrl1Htt3arrIDI B oqarax nopa:>KeHIDI,

r)HO'IHOH3YA.

.r.i;) rromrn,o;eHMT.

38

18. KyJJ.a BTHpa10TC.!I rrponrnonapa3l1Tapnhie cpe,!l,crBa nptt Jie'<leHHHqe-

coTKH?

a)B Beeb Ko:>KHbiii! noKpon,

6)B Beeb KO)((}{blii! rroKpOB 33 l1CKJIIOqeHJ1eM Jlttu;a l1 IIIett,

B)B MeeTa J10KaJIJ13all;ID1 BbICbIIl3HHJi!,

r)B t<pym·Ibie eKJTa,u;KVl KQ)KH,

.o:) nee oTBenr npaBttJThHbre.

19.KaKtte ,o:ttaruocrtt"<IeCKl1e rrptt3HaKH xapaKTepHbI )J,Jl.!I qeeOTKM rrptt MttKpOCKOilJ1H?

a)BbISIBJieHtte eaMr<H 1oreD.J,a,

6)snlu;a '-IeeoTo~rnoro 3J,O:lill,

B)JlH'IMHKJ1,

r)orry creBIII"1e si:l1.u;eBb1e 06ono'<IK11,

.o:) nee n ep e•rncneHHoe nepHo.

20. qTO OTHOettTOI K JJ,e3l1HCeKu;HOHHbIM MeponpH.!ITttJIM npH ne.o:HKyJie3e?

a)ITponrn)KttBaHHe OAe)K}J,bI,

6)A-TIAP,

n) KaMepmm o6pa6oTKa o}J,e)K,IJ;bl,

r) KMIUI<reHVIe 11 nporrra)KH1.1atttte 6enhsi:,

A)nee OTBeTbI npaBHJlbHbre.

21.KaKoB 1-u1Ky6au;110HH1>n1: neptto,o: rrpH qecOTKe? a) l-2)J,fIB,

6) OTey TeTByeT,

n) 3-4 qaea,

r) 7-10 JlHei-1,

.o:) 1 Memo;.

22. lITO OTHOCMTCH K Jia6opaTopHbIM MeTop;aM }J,HarHOCTl1KH qeeOTKJ1?

a)6ttonc11SJ,

6)MttKpOeKOilIDl eoeKo6a,

n) M<DA,

r ) 6aKi:epMonoruqeeKttilJ:,

n)nee nepeqttcrreHHoe nep1m.

23.KaKHe npenapaTbI ua3uaqa10T npH Jie'<leHHH'<leCOTKHy ,a;eTel1?

a)20 % 3MfJibeWJI 6eH3Mn-6eH3oaTa,

6)10 .% 3My n1>eHS1 6emMJI-6eH3oaTa,

B) 33BttettT OT TSl)KeeTtt TelJeHMSI 3a6oJieBaHJ-OI,

r) 10 % JMfJlbeJ-OI 6ett3MJI-6ett3oaTa M aun16MoT11Korepanrui:,

A) nepHo n) Hr).

·

24. K KaKOMY 3a6oneBaHJ'.110OTHOCHTC.!I p;eMO)l;eK03?

39

a) Ilapa3wrapHoe Ja6onesaH111e KO)Kll!,

6) rrapa3ttTapttoe 3a6oneBaHJ!le KO)Kll! 111 cycraBOB,

s) napa3ttTapttoe Ja6oneBaHHe KO)Kll! H Horreiil:,

r) aYTOHMM)'HI-IOeJa6011esaH11e,

A)Henapa3i-rrapttoe Ja6onenaH111e KO)Ktt.

25.l.ITO '1B.IUl€TC'1B036yAHTeJieM p;eMOA€K03a y '1€JIOBeKa?

a)Demodex foll.iculorum, 6) Demodex brevis,

B)BepHO a) l1 6),

r)Demodex cati,

A)see rrepe'l11CJieHHoe sepHo.

26.f.z:~e JIOKaJil1.3YIOTOI BbICbIIlaHH'1rrpH JJ,eMO)J;€K03€ ?

a)ToJihKO KOHe•IHOCTH,

6)KOHe'IHOCTl111 T)'Jl0Bl1:UJ,e,

B)TOJJbKO o6naCTb cycraBOB,

r)TOJlbKO KO)Ka JIMIJ;eBOWqacr11 roJIOBbI,

A)Beeb KO:lKHbIWnoKpOB.

27.c KaKHM 3a6onesan11eM npOBOA'1T,u111cpcpepeH~HaJibHLni p;HarH03

p;eMOJJ,€K03a?

a)Ty6epKyneJ KmKM,

6)nenpa,

a)serpHHaH ocna,

r)rnqnurn.c,

A)ce6opeii1HbIW A€pMaTIIT, cpoTOAepMaT03bI, yrpesaH 60Jie3Hb.

28.KaKow ·sup; HMeIOT BbICb1natt1n1 np11 AeMo,o;eKo3e?

a)EyropKM w ryMMbI,

6)TOJlbKO 3pHTeMaT03Hble IDITHa,

B)3pMTeMaTo3Hbie I1'1THa,nanyJILI, nanynoBH3HKfJlhI, menyweHIDJ,

r)ruenyweIIJll'11%l3p03HM,

A)TOJ1bKO ny3blpbKl!I.

29.B ~1eM 3aKJJIO'laeTc'1)l.HarHOCTHKa p;eMOAeKo3a?

a)TOJlbKO BM3yaJibHbIM OCMOTp,

6)a1-raMHe3 M na6opaToptta11.a.warttocrttKa (cocKo6),

B)attaMtte3, B113YaJJLHhrn oc:r.mrp, na6opaTop1-1asI ,o;MarHOCTHKa (co-

cKo6),

r ) 6aKTeptt0Jl0Hl'leCKMHMeTop;,

A)6~1oncID1 nopa)KeHHoro yi::raCTKa KO)!<M.

30.l.{To BKJJIO'laeTn ce611 ne'lettHe.o;eMo,a;eKo3a? a) TonLKo ;:i;MeTy ,

6) p;11e1y, npenapaTbI 111erpo1-1Mp;a3ona, 1-1apy)!<Hf10 repam1m,

40