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Resolution of the Expert Council «Unexplored Dyspepsia: Short-term and Long-term Patient Management Strategies» 专家委员会“未探索的消化不良:短期和长期患者管理策略”的决议
Pub Date : 2023-06-25 DOI: 10.33978/2307-3586-2023-19-8-16-24
I. Maev, L. Lazebnik, D. Bordin, N. Dekhnich, Yu.A. Kucheryavy, A. Tryakin, O. Gaus, M. Livzan
Purpose. To present the materials of the Expert Council, which was held on April 22, 2023 in Moscow and dedicated to modern approaches to the management of patients with unexplored dyspepsia, as well as the choice of the optimal Helicobacter pylori eradication therapy scheme in the Russian Federation. The main provisions of the resolution. An initial patient with recent dyspeptic symptoms who has not taken drugs that can cause gastric damage should be considered as a patient with undiagnosed dyspepsia. The first diagnosis to be excluded in a patient with unexplored dyspepsia is H. pylori-associated chronic gastritis. In order to alleviate or eliminate the symptoms of dyspepsia in the period before testing for H. pylori, the appointment of the prokinetic itopride hydrochloride is recommended, given the lack of influence on the results of the examination, proven efficacy and high safety profile, as demonstrated in studies on the original drug. The patient's presence of objective signs of gastrointestinal bleeding, unmotivated weight loss, aggravated family history of gastric cancer, as well as age over 50 years are indications for esophagogastroduodenoscopy with biopsy. An initial positive test for H. pylori is an indication for eradication therapy, as infection is a major etiological factor in gastric adenocarcinoma, including proximal gastric cancer and cancer of the gastroesophageal junction. Quadruple therapy with clarithromycin (amoxicillin + clarithromycin + proton pump inhibitor + bismuth tripotassium dicitrate) for 14 days can be defined as first-line therapy in the Russian Federation. In order to increase the effectiveness of eradication, the use of original preparations is recommended
目的。介绍专家委员会的材料,该委员会于2023年4月22日在莫斯科举行,致力于对未探索过的消化不良患者进行管理的现代方法,以及在俄罗斯联邦选择最佳的幽门螺杆菌根除治疗方案。决议的主要条款。最初出现消化不良症状但未服用可引起胃损害的药物的患者应视为未确诊的消化不良患者。第一个诊断被排除在一个病人未发现消化不良是幽门螺杆菌相关的慢性胃炎。为了缓解或消除幽门螺杆菌检测前的消化不良症状,鉴于原药的研究表明对检查结果没有影响,疗效已被证实,安全性高,建议使用促动力学盐酸伊托必利。患者有消化道出血的客观征象、非动机性体重减轻、胃癌家族史加重以及年龄超过50岁是食管胃十二指肠镜活检的指征。由于感染是胃腺癌(包括胃癌近端癌和胃食管交界处癌)的主要病因,因此幽门螺杆菌的初步阳性检测是根除治疗的指征。在俄罗斯联邦,克拉霉素四联治疗(阿莫西林+克拉霉素+质子泵抑制剂+三硝酸铋三钾)14天可定义为一线治疗。为了提高根除效果,建议使用原制剂
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引用次数: 0
Features of Food Intolerance in Patients with Irritable Bowel Syndrome 肠易激综合征患者食物不耐受的特点
Pub Date : 2023-06-25 DOI: 10.33978/2307-3586-2023-19-8-42-48
S. Dbar, S. Bykova, E. Sabelnikova, O.V. Akhmadulina, N. Belostotsky, A. Parfenov
The aim was to evaluate the activity of intestinal carbohydrases in patients with irritable bowel syndrome (IBS) with symptoms of food intolerance. Material and methods. 126 patients with IBS (83 women and 43 men, median age – 32.0 years (Q1–Q3: 27–38 years)) were examined. The diagnosis of IBS was established on the basis of Roman Criteria IV. A questionnaire was conducted for all patients to identify food intolerances, according to the results of which the patients were divided into three groups: the first – patients with isolated intolerance to foods with a high content of FODMAP; the second – patients with isolated intolerance to milk and dairy products; the third – patients with combined intolerance. To determine the activity of intestinal carbohydrates: lactase, sucrose, maltase and glucoamylase, all patients underwent esophagogastroduodenoscopy with biopsy samples from the duodenum. The activity of carbohydrases was determined by the Dahlquist method in the modification of N.I. Belostotsky. The control group consisted of 30 conditionally healthy people (10 men and 20 women, median age – 33.9 years (Q1–Q3: 24–35)), comparable in age and gender with patients with IBS. The activity of intestinal enzymes in this group was within the reference values. Statistical data processing was carried out using the computer program Statistica 8.0. Results. According to the results of the survey, it was found that out of 126 patients with IBS, 52 (41.3%) patients believed that they had food intolerance to certain foods. Isolated intolerance to foods with a high content of FODMAP was noted by 13 (10.3%) patients, 16 (12.7%) patients believed that they had isolated intolerance to milk and dairy products, and 23 (18.3%) patients indicated combined intolerance. In patients with IBS and isolated intolerance to foods high in FODMAP, the median activity of glucoamylase was 120.0 (68.5–209.2) ng/mg of glucose per 1 mg of tissue per minute (ng/mg × min), maltase – 630.5 (480.7–951.0) ng/mg × min, sucrose – 50.0 (32.8–68.8) ng/mg × min, lactase – 10.5 (5.5–40.5) ng/mg × min. Comparing the activity of carbohydrases with the control group revealed the statistically significant difference (p < 0.05) for each enzyme studied.In the group of patients with IBS and isolated intolerance to milk and dairy products, the median activity of all the intestinal enzymes studied was also lower than that in the control group: the activity of glucoamylase was 107.0 (64.0–174.0) ng/mg × min, maltase – 622.0 (481.5–887.0) ng/mg × min, sucrose – 48.0 (35.5-60.0) ng/mg × min, lactase – 8.0 (3.0–22.5) ng/mg × min. Among patients with IBS and the presence of combined intolerance to foods (with a high content of FODMAP and dairy products), the median activity of all enzymes significantly differed from the control group (p < 0.05). The activity of glucoamylase was 107.5 (57.5–194.2) ng/mg × min, maltase – 627.0 (480.7–911.7) ng/mg × min, sucrose - 47.5(34.8–61.5) ng/mg × min, lactase - 9.0 (4
目的是评估肠易激综合征(IBS)患者肠道糖酶的活性,并伴有食物不耐受症状。材料和方法。126例IBS患者(女性83例,男性43例,中位年龄- 32.0岁(Q1-Q3: 27-38岁))接受了检查。根据Roman标准IV建立IBS的诊断。对所有患者进行问卷调查,以确定食物不耐受,根据问卷结果将患者分为三组:第一组-对FODMAP含量高的食物孤立性不耐受患者;第二种是对牛奶和奶制品有孤立性不耐受的患者;第三种是合并不耐受的患者。为了测定肠道碳水化合物:乳糖酶、蔗糖酶、麦尔糖酶和葡萄糖淀粉酶的活性,所有患者都进行了食管胃十二指肠镜检查,并从十二指肠活检样本。采用Dahlquist法测定糖酶活性。对照组包括30名有条件健康的人(10名男性和20名女性,中位年龄- 33.9岁(Q1-Q3: 24-35)),年龄和性别与IBS患者相当。该组肠道酶活性在参考值范围内。统计数据处理采用统计软件Statistica 8.0进行。结果。调查结果显示,126名肠易激综合征患者中,52名(41.3%)患者认为自己对某些食物不耐受。13例(10.3%)患者对FODMAP含量高的食物存在分离性不耐受,16例(12.7%)患者认为对牛奶和乳制品存在分离性不耐受,23例(18.3%)患者表现为联合不耐受。在对高FODMAP食物不耐受的IBS患者中,葡萄糖淀粉酶的中位活性为120.0 (68.5-209.2)ng/mg葡萄糖/ 1 mg组织每分钟(ng/mg × min),麦芽糖酶为60.5 (480.7-951.0)ng/mg × min,蔗糖酶为50.0 (32.8-68.8)ng/mg × min,乳糖酶为10.5 (5.5-40.5)ng/mg × min。与对照组比较,各酶活性差异均有统计学意义(p < 0.05)。在肠易激综合征和孤立性牛奶和乳制品不耐受患者组中,所研究的所有肠道酶的中位数活性也低于对照组:葡萄糖淀粉酶活性为107.0 (64.0 ~ 174.0)ng/mg × min,麦芽糖酶活性为622.0 (481.5 ~ 887.0)ng/mg × min,蔗糖酶活性为48.0 (35.5 ~ 60.0)ng/mg × min,乳糖酶活性为8.0 (3.0 ~ 22.5)ng/mg × min。在合并食物不耐受(FODMAP和乳制品含量高)的肠易激综合征患者中,各项酶活性中位数与对照组相比差异显著(p < 0.05)。葡萄糖淀粉酶活性为107.5 (57.5 ~ 194.2)ng/mg × min,麦芽糖酶活性为627.0 (480.7 ~ 911.7)ng/mg × min,蔗糖酶活性为47.5(34.8 ~ 61.5)ng/mg × min,乳糖酶活性为9.0 (4.0 ~ 28.8)ng/mg × min。52例(41.3%)肠易激综合征患者出现食物不耐受。在所有被研究的食物不耐受(对牛奶和乳制品以及FODMAP含量高的产品的单独或联合不耐受)的患者中,肠道酶(葡萄糖淀粉酶、乳糖酶、蔗糖酶和麦芽糖酶)的活性与对照组相比显著降低(p < 0.05),这可能表明他们存在二糖酶缺乏症
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引用次数: 0
Efficacy and Safety of Vedolizumab in the Treatment of Ulcerative Colitis in Real Clinical Practice: Five Years of Observation Vedolizumab治疗溃疡性结肠炎的临床疗效和安全性:5年观察
Pub Date : 2023-06-25 DOI: 10.33978/2307-3586-2023-19-8-26-33
O. Knyazev, A. Kagramanova, I. Li, A. Lischinskaya, E. Sabelnikova, N. Fadeeva, T. Shkurko, B. Nanaeva, T. Baranova, M.Yu. Timanovskaуа, A. Parfenov
In real clinical practice, unlike in the registered controlled trials, the analytical group includes all patients who are being treated with a drug. The aim is to evaluate the efficacy and safety of vedolizumab (VDMB) therapy in real clinical practice in patients with ulcerative colitis (UC) for five years. Material and methods. The study included 136 patients with UC (men 53.7%, women 46.3%), average age – 33.8 ± 4.4 years, duration of the disease – 3.1 ± 0.4 years (52.9% of patients with moderate severity, 72.1% with total lesion and 64.4% with chronic recurrent course, in 17.6% of cases – extra-intestinal manifestations). Results. After 12 weeks, 53 (38.9%) patients with UC achieved a clinical response, 72 (52.9%) achieved clinical remission, 13 (9.5%) did not respond or did not respond sufficiently to therapy. After 24 weeks, clinical remission reached 72.1%, clinical response – 18.4% of patients. Of 112 patients who underwent colonoscopy (CS), 68 (60.7%) had clinical and endoscopic remission at week 24. After 52 weeks of therapy, endoscopic remission persisted in 68 (60.7%) patients, endoscopic response – in 40 (36.6%), clinical remission – in 112 (82.3%) and clinical response – in 21 (15.4%). After five years of VDMB therapy, endoscopic remission persisted in 70 (51.5%) patients, endoscopic response in 36 (26.5%), clinical remission in 105 (77.2%) and clinical response in 19 (14.0%). The survival rate of VDMB therapy in patients with UC was 90.4% after 12 months and persisted for a year, 82.3% after two years, 81.6% after five years. Steroidal remission was 91.0%. The regression of extra-intestinal manifestations after 24 weeks was noted in 58.3% of patients with UC. Conclusion. Our clinical observation of 136 patients with UC demonstrated the high efficacy and safety of VDMB
在真正的临床实践中,与注册对照试验不同,分析组包括所有正在接受药物治疗的患者。目的是评估vedolizumab (VDMB)治疗溃疡性结肠炎(UC)患者5年的临床疗效和安全性。材料和方法。本研究纳入136例UC患者(男性53.7%,女性46.3%),平均年龄- 33.8±4.4岁,病程- 3.1±0.4年(52.9%为中度,72.1%为全病变,64.4%为慢性复发,17.6%为肠外表现)。结果。12周后,53例(38.9%)UC患者达到临床缓解,72例(52.9%)达到临床缓解,13例(9.5%)对治疗无反应或反应不充分。24周后,临床缓解率达72.1%,临床缓解率为18.4%。在112例接受结肠镜检查(CS)的患者中,68例(60.7%)在第24周时临床和内镜缓解。治疗52周后,68例(60.7%)患者的内窥镜缓解持续,40例(36.6%)患者的内窥镜缓解持续,112例(82.3%)患者的临床缓解持续,21例(15.4%)患者的临床缓解持续。经过5年的VDMB治疗,70例(51.5%)患者的内镜缓解持续,36例(26.5%)患者的内镜缓解持续,105例(77.2%)患者的临床缓解持续,19例(14.0%)患者的临床缓解持续。VDMB治疗UC患者12个月后生存率为90.4%,持续1年,2年生存率为82.3%,5年生存率为81.6%。类固醇缓解率为91.0%。24周后,58.3%的UC患者肠道外症状消退。结论。我们对136例UC患者的临床观察表明,VDMB具有较高的疗效和安全性
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引用次数: 0
Long-Term Use of Non-Steroidal Anti-Inflammatory Drugs in Patients with Axial Spondyloarthritis to Suppress Acute Bone Marrow Inflammation in the Sacroiliac Joints 长期应用非甾体抗炎药抑制骶髂关节急性骨髓炎症
Pub Date : 2023-05-14 DOI: 10.33978/2307-3586-2023-19-9-12-18
M. Kurbanmagomedov, A. Starkova, S. Erdes
Long-term use of nonsteroidal anti-inflammatory drugs in daily therapeutic practice is not welcome and often causes rejection due to the potential for the development of a variety of adverse events. However, in axial spondyloarthritis, these drugs play the role of not only symptomatic therapy, but also modify the course of the disease. Therefore, they should be prescribed for a long period, much longer than that described in the instructions for the drug. A brief description of clinical cases of the use of various non-steroidal anti-inflammatory drugs lasting 3 or more months is presented. Against the background of good clinical efficacy, adverse events did not develop during many months of continuous use
在日常治疗实践中长期使用非甾体类抗炎药是不受欢迎的,并且由于可能发生各种不良事件而经常引起排斥反应。然而,在轴型脊柱炎中,这些药物不仅起到对症治疗的作用,而且还能改变疾病的进程。因此,它们应该开很长一段时间,比药物说明书上描述的要长得多。简要介绍了使用各种非甾体抗炎药持续3个月或更长时间的临床病例。临床疗效良好,连续使用数月未发生不良事件
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引用次数: 0
Optimal Management of Comorbid Patients with Spondyloarthritis: Focus on Cardiovascular Safety 脊椎关节炎合并症患者的最佳管理:关注心血管安全
Pub Date : 2023-05-14 DOI: 10.33978/2307-3586-2023-19-9-20-27
D. Karateev, E. Luchikhina, E. Markelova
Comorbidity and multimobidity are typical for rheumatic diseases (RD) in general. Comorbidities have a complex negative impact on the patient with RD: they are often a direct cause of the premature death of patients, they may contribute to the severe course of the inflammatory process, comorbidities reduce choice of treatment options. Spondyloarthritis, such as psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), is also characterized by the frequent presence of comorbid conditions, in particular, cardiovascular diseases. Pleiotropic effects of pro-inflammatory cytokines such as interleukin 17A (IL-17A) promote these processes. IL-17A is a versatile pro-inflammatory T cell cytokine. At the same time, there is evidence that IL-17 involved in many other pathological processes: bone tissue remodeling, the development of endothelial dysfunction, formation of the unstable atherosclerotic plaques, heart ventricle remodeling after ischemic attack, etc. Clinical data confirm the role of hyperproduction of IL-17A in the development of cardiovascular diseases. On the example of Secukinumab IL-17A inhibition in PsA and axSpA, it has been shown that this treatment is associated with a high level of cardiovascular safety, and it is likely may help reduce cardiovascular risk. Therapy with IL-17A inhibitors, in particular, Secukinumab, in combination with generally accepted methods of correction of traditional cardiovascular risk factors, may be a promising direction in the management of patients with SpA and concomitant cardiovascular diseases
一般来说,风湿病(RD)的合并症和多病是典型的。合并症对RD患者有复杂的负面影响:它们通常是患者过早死亡的直接原因,它们可能导致炎症过程的严重过程,合并症减少了治疗方案的选择。脊柱炎,如银屑病关节炎(PsA)和轴性脊柱炎(axSpA),也以经常存在合并症为特征,特别是心血管疾病。促炎细胞因子如白细胞介素17A (IL-17A)的多效性促进了这些过程。IL-17A是一种多功能的促炎T细胞细胞因子。同时,有证据表明IL-17参与了许多其他病理过程:骨组织重塑、内皮功能障碍的发展、不稳定动脉粥样硬化斑块的形成、缺血性发作后心室重塑等。临床数据证实了IL-17A的过量产生在心血管疾病发展中的作用。以Secukinumab IL-17A抑制PsA和axSpA为例,已经证明这种治疗与高水平的心血管安全性相关,并且可能有助于降低心血管风险。IL-17A抑制剂治疗,特别是Secukinumab治疗,结合普遍接受的传统心血管危险因素纠正方法,可能是SpA患者和伴随心血管疾病管理的一个有希望的方向
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引用次数: 0
Reactivation of Chronic Hepatitis B in a Patient with Rheumatoid Arthritis 慢性乙型肝炎在类风湿关节炎患者中的再激活
Pub Date : 2023-05-14 DOI: 10.33978/2307-3586-2023-19-9-6-11
G. Gridneva, B. Belov, E. Aronova
The problem of hepatitis B reactivation in patients with rheumatology profile has been and remains relevant due to the widespread use of various immuno-suppressive drugs. As new drugs are introduced into practice, there is a need to clearly understand the likelihood of HBV reactivation and personalize the management of such patients. A case of reactivation of HBV infection in a patient treated with upadacitinib and prophylactic with entecavir is presented. This review briefly summarizes the latest data on the mechanisms of HBV reactivation and the relative frequency of HBV reactivation, associated with various antirheumatic drugs
由于各种免疫抑制药物的广泛使用,风湿病患者乙型肝炎再激活的问题一直是并且仍然是相关的。随着新药物的应用,有必要清楚地了解HBV再激活的可能性,并对这类患者进行个性化管理。一个病例的HBV感染再激活的病人与upadacitinib治疗和预防恩替卡韦提出。本文简要综述了各种抗风湿药物对HBV再激活机制和HBV再激活相对频率的影响
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引用次数: 0
Possible Risk Factors for Postoperative Pelvic Organ Prolapse 术后盆腔器官脱垂的可能危险因素
Pub Date : 2023-04-06 DOI: 10.33978/2307-3586-2023-19-7-28-32
O. Pauzina, I. Apolikhina, S. V. Romanov, A. R. Dudkina, A. Saidova, O.P. Abaevа, K.V. Yevdokimova
The aim of the study was to analyze possible risk factors for the development of postoperative recurrence of pelvic organ prolapse. The study included 245 patients (median age – 68 years) who underwent surgery for the first time during the two to three years preceding the study. The recurrence rate was 45.3%. As a result of statistical analysis, there was no statistically significant correlation between the occurrence of relapse and/or the period before its occurrence and the period from the detection of symptoms to the doctor and surgical treatment, as well as the fact of prescribing conservative therapy before surgical treatment.
本研究的目的是分析盆腔器官脱垂术后复发的可能危险因素。该研究包括245例患者(中位年龄- 68岁),他们在研究前两到三年内首次接受手术。复发率为45.3%。经统计分析,复发发生及/或复发前时间与发现症状到就诊及手术治疗的时间,以及术前开保守治疗的情况均无统计学意义的相关性。
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引用次数: 0
Reproductive Health of Girls and Adolescents in Moscow. Development of Specialized Care 莫斯科女孩和青少年的生殖健康。专科护理的发展
Pub Date : 2023-04-06 DOI: 10.33978/2307-3586-2023-19-7-48-52
I. Karachentsova, YElyena Sibirskaya, M. Chernysheva
Due to a steady trend towards an increase in the incidence of various gynecological diseases, one of the most significant problems of modern society is the protection of the reproductive health of girls and adolescents. Diseases that are asymptomatic or with an erased clinical presentation but have a significant impact on the reproductive potential of the young population deserve close attention. Purpose. To reveal the prevalence of gynecological diseases among the female population of the neutral, prepubertal and pubertal period in Moscow and to determinate ways to reduce incidence of preventable diseases. Material and methods. An analysis of the data on gynecological morbidity of girls and adolescents in Moscow is presented based on the data of the annual report of the chief freelance specialist gynecologist of childhood and adolescence in Moscow in 2021 (n = 925 632). According to the report, the prevalence of gynecological pathologies during examinations in 2021 is (n = 82 517): delayed puberty (n = 182), premature thelarche (n = 779), menstrual disorders (n = 11 748), other endocrine disorders (n = 15), premenstrual tension syndrome (n = 353), dysmenorrhea (n = 5265), inflammatory diseases of vulva and vagina (n = 18 796), ovarian cysts (n = 2384), labial adhesion (labia minora) (n = 6261), disorders of breast (n = 1136), anogenital warts (n = 26), congenital disorders of female genital organs (n = 71), unspecified injury of external genitals (n = 223), sexual transmitted diseases (n = 39), Turner’s syndrome (n = 21), unspecified malignant primary neoplasms (n = 5). Results. An analysis of the prevalence of gynecological diseases in girls and adolescents in Moscow in 2021 (n = 925 632) has revealed that the highest incidence among all diseases of the reproductive system (n = 82 517) is: inflammatory diseases of the external and internal genital organs – 23% (n = 18 796), as well as menstrual disorders – 14% (n = 11 748), including dysmenorrhea – 6% (n = 5265), and labial adhesions – 8% (n = 6261). Reducing the incidence of gynecological diseases among girls and adolescents in Moscow can be achieved through regular full well-child examinations and improving the quality of specialized gynecological care. Conclusion. Providing regular preventive physical examinations and educational activities among adolescents and parents is one of the ways to timely detect various diseases of the reproductive system. The incidence of gynecological diseases among this age group can also be significantly reduced by increasing the coverage of the population with medical care and improving the quality of its provision
由于各种妇科疾病的发病率呈稳步上升的趋势,现代社会最重要的问题之一是保护女孩和青少年的生殖健康。对无症状或无临床表现但对青年人口生殖潜力有重大影响的疾病应予以密切关注。目的。揭示莫斯科中性期、青春期前和青春期女性人口中妇科病的发病率,并确定减少可预防疾病发病率的方法。材料和方法。根据2021年莫斯科儿童和青少年首席自由职业妇科专家年度报告(n = 925 632)的数据,对莫斯科女孩和青少年妇科发病率数据进行了分析。根据该报告,2021年检查期间妇科疾病的患病率为(n = 82 517):青春期延迟(n = 182),过早乳房初长(n = 779),月经失调(n = 11 748),其他内分泌疾病(n = 15),经前期紧张综合征(n = 353),痛经(n = 5265)、外阴和阴道的炎症(n = 18 796),卵巢囊肿(n = 2384),唇粘连(小阴唇)(n = 6261),疾病的乳房(n = 1136),肛门-生殖器疣(n = 26),先天性疾病的女性生殖器官(n = 71),伤势不明的外部生殖器(n = 223),性传播疾病(n = 39),特纳综合征(n = 21),未明确的原发性恶性肿瘤(n = 5)。对2021年莫斯科女孩和青少年妇科疾病患病率的分析(n = 925632)表明,在所有生殖系统疾病(n = 82517)中发病率最高的是:外部和内部生殖器官的炎症性疾病- 23% (n = 18796),以及月经失调- 14% (n = 11748),包括痛经- 6% (n = 5265)和唇粘连- 8% (n = 6261)。减少莫斯科女孩和青少年的妇科疾病发病率可以通过定期的全面儿童健康检查和提高专门妇科护理的质量来实现。结论。为青少年和家长提供定期的预防性体检和教育活动是及时发现各种生殖系统疾病的途径之一。通过扩大医疗保健的覆盖范围和提高医疗服务的质量,也可以大大减少这一年龄组的妇科疾病发病率
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引用次数: 1
Long-Term Results of Prevention of Complications After Medical Abortion 药物流产后并发症预防的远期效果
Pub Date : 2023-04-06 DOI: 10.33978/2307-3586-2023-19-7-24-27
A. E. Esedova, A.Yu. Islamova, T.S. Magomedova, F.S. Mamedov
Relevance. The frequency of abortion complications ranges from 2.0 to 52.0%. The effectiveness of the magneto-IR light laser and ozone, which have immunomodulatory, bactericidal, analgesic effects. Purpose to increase the effectiveness of measures to reduce the number of complications after medical abortion. Material and methods. 124 patients after abortion were examined and divided into 3 groups. In the main group I 52 (42.0%) women who were treated with antibiotics with magneto-IR light laser and ozone. In the main group II, 24 (19.3%) patients were treated with magneto-IR light-laser and ozone therapy, without antibiotics. The control subgroup consisted of 48 (38.7%) patients without prophylaxis. Results. The patients were examined 3, 6 and 12 months after the abortion. In the main group I, menstrual function was restored after 3 months in 36 (69.2%) patients, in the main group II 16 (66.7%) and control 26 (54.1%), more than 8 days continued in 16 (30.8%), 8 (33.7%) and 22 (45.9%) accordingly. After 6 months and a year, menstruation remained impaired in 2 (3.9%) patients of the main group I, in 1 (4.1%) of the main group II and in 6 (12.5%) of the control group. In the main group I, 27 (52.0%) women planned pregnancy. Pregnancy occurred in 10 (19.2%) patients: 7 (13.4%) ended in childbirth, 2 (3.9%) miscarriage, 1 abortion. In the main group II, 12 (50.0%) women planned pregnancy. Pregnancy occurred in 5 (20.9%): 4 (16.7%) they ended in childbirth and 1 (4.1%) miscarriage. In the control group, 25 (52.0%) patients planned pregnancy. It occurred in 7 (14.5%) patients: 3 (6.2%) ended in childbirth and 4 (8.3%) miscarriage. Conclusions. Magneto-IR light-laser and ozone therapy is an effective way of prevention, promotes faster recovery of menstrual and reproductive function
的相关性。流产并发症发生率为2.0 ~ 52.0%。磁-红外激光和臭氧的有效性,它们具有免疫调节、杀菌、镇痛的作用。目的探讨降低药物流产后并发症发生率的措施,提高措施的有效性。材料和方法。对124例流产后患者进行检查,分为3组。在主要组中,52例(42.0%)妇女接受抗生素磁红外激光和臭氧治疗。在主要II组中,24例(19.3%)患者接受磁红外光激光和臭氧治疗,不使用抗生素。对照组为48例(38.7%)未采取预防措施的患者。结果。分别于流产后3、6、12个月进行检查。1组患者3个月后月经功能恢复者36例(69.2%),2组患者16例(66.7%),对照组26例(54.1%),持续时间超过8天者分别为16例(30.8%)、8例(33.7%)和22例(45.9%)。经6个月和1年后,主要I组2例(3.9%)、主要II组1例(4.1%)和对照组6例(12.5%)患者月经仍有障碍。在第一组中,27名(52.0%)妇女计划怀孕。妊娠10例(19.2%),分娩7例(13.4%),流产2例(3.9%),流产1例。在主要的II组中,有12名(50.0%)妇女计划怀孕。妊娠5例(20.9%),分娩4例(16.7%),流产1例(4.1%)。对照组计划妊娠25例(52.0%)。7例(14.5%),分娩3例(6.2%),流产4例(8.3%)。结论。磁红外激光和臭氧治疗是有效的预防方法,促进月经和生殖功能的更快恢复
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引用次数: 0
Analytical Review of the Status of Reproductive Health of Girls and Young Women in Moscow Region. Analysis of Work 莫斯科地区少女和青年妇女生殖健康状况分析。工作分析
Pub Date : 2023-04-06 DOI: 10.33978/2307-3586-2023-19-7-40-47
YElyena Sibirskaya, S. Torubarov, Ye.D. Burkhanskaya, G.N. Abbasova, L.G. Papyan
Introduction. The protection of the reproductive health of the younger generation is one of the most significant problems due to the steady growth of various gynecological diseases, including those that are asymptomatic, which has a significant impact on the reproductive potential of the young population. Purpose to reveal the prevalence of gynecological pathologies among girls in the Moscow region. Material and methods. We have analyzed the main gynecologic diseases among patients aged 0–17 years according to the results of preventive examinations and data of visits to the pediatric gynecologist in the outpatient clinic for the year 2021. Results. Recent analytical data on the prevalence of gynecological morbidity of girls and young women in Moscow region showed that in children aged 0–4 years and 5–9 years, inflammatory diseases of the vulva and vagina (vulvitis) and labia minora adhesions predominate. In patients aged 10–14 years gynecological pathology is represented by various menstrual cycle disorders, dysmenorrhea, inflammatory diseases of the vulva and vagina (vulvitis), non-inflammatory ovarian diseases (follicular cysts and cysts of the yellow body of the ovary) and also mammary gland diseases. The predominant gynecological pathology in girls aged 15–17 is inflammatory diseases of the vulva and vagina, menstrual disorders, non-inflammatory ovarian diseases (follicular cysts, cysts of the corpus luteum), fallopian tubes and the vagina, breast diseases, and sexually transmitted infections are also frequent. Conclusion. We can talk about the general trends in the prevalence of gynecological morbidity among girls and young women in Moscow region and in the whole territory of the Russian Federation. Following the order of the Russian Ministry of Health of 20.10.2020 № 1130n «On approval of the Order of medical care in the profile „obstetrics and gynecology“», we can achieve a reduction in gynecological morbidity among girls and young girls in the Moscow region by improving specialized gynecological care
介绍。保护年轻一代的生殖健康是最重要的问题之一,因为各种妇科疾病(包括无症状疾病)的稳步增长,对年轻人口的生殖潜力产生重大影响。目的了解莫斯科地区女孩妇科疾病的患病率。材料和方法。我们根据2021年预防检查结果和门诊儿科妇科医生就诊数据,分析0-17岁患者的主要妇科疾病。结果。最近关于莫斯科地区女童和年轻妇女妇科发病率的分析数据表明,在0-4岁和5-9岁的儿童中,外阴和阴道炎症(外阴炎)和小阴唇粘连占主导地位。在10-14岁的患者中,妇科病理表现为各种月经周期紊乱、痛经、外阴和阴道炎症性疾病(外阴炎)、非炎症性卵巢疾病(卵泡囊肿和卵巢黄体囊肿)以及乳腺疾病。15-17岁女孩的主要妇科病理是外阴和阴道的炎症性疾病、月经紊乱、非炎症性卵巢疾病(卵泡囊肿、黄体囊肿)、输卵管和阴道、乳房疾病,性传播感染也很常见。结论。我们可以谈谈莫斯科地区和俄罗斯联邦全境女童和年轻妇女妇科发病率的总体趋势。根据俄罗斯卫生部2020年10月20日第1130n号“关于批准“妇产科”医疗保健命令”的命令,我们可以通过改善专门的妇科护理来减少莫斯科地区女孩和年轻女孩的妇科发病率
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引用次数: 0
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Effective Pharmacotherapy
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