Sytnik P. Prognosis of severity and diagnosis of pelvic inflammatory disease

The dissertation is devoted to the solution of the actual problem – to increase the effectiveness of prediction of severity and diagnosis of inflammatory diseases of the uterus appendages in order to preserve the reproductive health of women. Supplemented and expanded representations of risk factors and peculiarities of the clinical course of purulent-inflammatory diseases of the pelvic organs, depending on the severity of the reaction of the systemic inflammatory response. The comparative analysis of genetic polymorphism has shown that application in the diagnosis and prediction of complications of the analysis of genetic polymorphism of cytokines TNF-alpha, IL-6, IL-10 in patients with purulent-inflammatory diseases of the uterine appendages may be useful for predicting the course of the disease. It is determined that in order to predict the severity of the PID course, it is expedient to take into account the coefficient which takes into account the presence of STD, the duration of the disease, the severity of the febrile reaction, changes in the leukocyte formula, the severity of the pain syndrome, the content of CRD and hourly diuresis (Se = 0.84; PPV = J = 0.45). On the basis of the obtained results, the algorithm for diagnosing and assessing the severity of infectious and inflammatory diseases of the uterus appendages is substantiated and introduced into the work of the institutions of practical health care, which allows active management of patients with PID by reducing the waiting time of the tactics, which at the same time avoids unreasonable surgical interventions. The results of monitoring of long-term clinical outcomes in the postoperative period showed that the most frequent patients undergoing surgical treatment were signs of CPPS (25.7% 12 months after treatment, 68.6% after 24 months, 80.0 % after 36 months). In patients in the Ia group, 4 (11.4%) cases of ectopic pregnancy were registered, and in 5 (14. 3 %) cases, there were repeated episodes of PID.