Zyatina O. The Pathogenetic grounded approaches during the medical treatment of the Inflammatory diseases of uterine appendages.

Object of the study: Acute and chronic inflammatory diseases of uterine appendages. Purpose of the study: To improve the efficacy of diagnosis and treatment of inflammatory diseases of the uterine appendages based on determining of clinical, biochemical, laparoscopic and hemodynamic changes as well as to work out and introduce into practice a pathogenetically validated technique for complex treat-ment. Methods of the study: General clinical, biochemical, im-munological, echographic, dopplerometric, rheographic, laparoscopic, statistical. Practical significance: The performed investigation allowed to propose an algorithm of IDUA management which included determining concentration of ceruloplasmin, seromucoids and neutrophil phagocytic activity in the punctate from the abdominal cavity, doppler ultrasound and rheography of regional blood flow in the uterus and its appendages, which allowed to specify the stage of the inflammatory process and to administer the proper treatment. An improved technique for treatment of acute and chronic IDUP, which promoted reduction of drug load, was suggested. The use of the suggested technique resulted in reduction of IDUA complications incidence and to reduce the terms of the hospital stay. Novelty of the obtained results: The performed research allowed a differential approach to evaluation of local acute-phase immunological and hemodynamic indices taking into consideration various forms of IDUA. Based of the revealed changes in local concentration of ceruloplasmin, seromucoids and neutrophic phagocytic activity, the stages of the inflammatory process were specified. Based on Doppler and rheographic investigations local hemodynamic characteristics of various forms of IDUA were studied. A correlation between the shifts of biochemical indices in the punctate from the abdominal cavity, the degree of disturbances of local hemodynamics and the state of central and vegetative nervous system was revealed, which allowed to validate an individualized complex treatment with minimum ofdrugs. For the first time, the efficacy of the suggested differentiated approach was proven with emphasis on correction of local inflammatory changes and hemodynamic disorders at treatment with the use of intravaginal hirudotherapy. Introduction: The suggested method was introduced to gynecological practice of Poltava City Clinical Maternity hospital, gynecology departments of Donetsk Center for Protection of Maternity and Childhood, Poltava and Chenigov CDH, out-patient department for women of Sviatoshino district (Kiev). Sphere of application: medicine, obstetrics and gynecology.