Risnychenko V. Differential approach for diagnostic and treatment of tuboovaric inflammatory diseases in reproductive aged women

Inflammatory diseases of small pelvic organs take an important place in structure of gynecological patients. Their rate riches 65% among ambulatory and 30% among hospitalisated women. A prominent necrotic destruction hinders from adhesive process by pelvic inflammatory diseases. Vice versa an increasing of adhesion in acute salpingitis seems like evidence supporting laparoscopic way in treatment of patients with tubal infertility. The same possibilities of reproductive function in patients with purulent tuboovaric process, particular with salpinx injury, are considered in the investigation. The combination of low invasive laparoscopic surgery, systemic and local ozone therapy with a selective immunomodulator polioxydonium lets to optimize the indexes of unspecific resistance and immune response. For example, using of named combination had as a result increasing of phagocyte activity on 12-18% and phagocytic point on 16%. An obligatory anaerobic microorganism has been isolated in patients of II -IV clinical groups without expressive prevalence any kinds of germs. Something above in one to seven observations (no less then 15%) cervical cultures coincident with intraoperative ones. It seems that cervical bacterial cultures can't be useful as predictors or prognostic signs of possible pelvic inflammatory diseases. The low invasive laparoscopic operative technique has a preference in a comparison to traditional laparotomic surgery because of low trauma by enough intervention value. The advantage of using dynamic laparoscopy by tuboovaric inflammatory diseases is considered in a work, it lets to corregate treatment, to conserve an inflammated organ and in 26-32% cases to recover reproductive function. Using of laparoscopic surgery has as a result decreasing of treatment term, frequent of postoperative complications. Including to complex treatment ozone therapy allows increasing tissue oxygenation level and normalizing phagocytic activity of neutrophils. Morphological studies have shown the presence of patients with purulent lesions of pelvic symptoms of accelerated proliferation of dystrophic and necrotic processes in tissues and organs, as well as the structural manifestations of non-compliance of the inflammatory and immune response, particularly in the prevalence of granulomatous inflammation. Eosynophilic granulocytes, labrocytes and plasmatic cells have observed in various histological specimens. Neutrophilic granulocites so usual in acute inflammation were found in chronic forms with long-term duration due to year and above.