The ways to ameliorate the efficiency of treatment for women with pelvic inflammatory disease

The inflammatory diseases of the pelvic organs are known to be one of the important problems of modern gynecology, which is due to the high frequency of chro-nicity of the process and a large number of complications. The article provides a theoretical and practical substantiation of the use of the drugs Rheosorbilact and Grandazol to increase the efficacy of empirical therapy in patients with acute salpingo-oophoritis.

The objective: study of the effectiveness of the use of hyperosmolar combined solution of sorbitol with a balanced content of electrolytes for low-volume infusion therapy (Rheosorbilact) and a solution of levofloxacin 2.5 mg and ornidazole 5 mg (Grandazole) in the treatment of women with acute PID.

Materials and methods. Totally 98 women of reproductive age were examined and divided into three clinical groups. The I (control) group included 30 healthy women. In group II (comparison), 33 patients with acute bilateral adnexitis were included, who were prescribed traditional treatment. In group III (main) group, there were 35 women who were additionally prescribed Rheosorbilact and Grandazole was used as an antibacterial agent.

Results. A survey of women with acute bilateral adnexitis found that among all clinical characteristics the most common were: lower abdominal pain (89,7%), abnormal vaginal discharge (88,2%), and fever (83,8%). The variables of the level of C-reactive protein, the number of leukocytes, and the value of the resistance index in the ovarian arteries were elevated in the study population before treatment, respectively: 52,4±8,3 mg/l, 11,8±2,2×109/l, 1,4±0,2, which differed from the control values (p<0,05). The study of the pseudo-R2 Nagelkerke confirmed the relationship between increased resistance index and lower abdominal pain, abnormal vaginal discharge and fever with high sensitivity (88,2%) and insufficient specificity (60,4%).

Thus, in women with acute salpingo-oophoritis, the presence of inflammatory symptoms (even in the absence of Doppler data) is an indication for the use of infu-sions of vasotrophic drugs with the hemorheological action.The priority effect of this method of treatment was the optimization of hemodynamics in the large vessels of the small pelvis, which provided the effective delivery and accumulation of antibacterial drugs in the inflammation focus.

Conclusion. The specified combination of drugs Rheosorbilact and Grandazole has demonstrated the maximum clinical effect, which justifies the possibility of widespread use of this method of therapy.

Keywords: inflammatory diseases of the pelvic organs, Doppler ultrasound, treatment, Rheosorbilact, Grandazole.

Authors:

I.V. Lakhno, A.E. Tkachov, O.V. Grischenko