medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-084medsovet-10017Research ArticleРЕПРОДУКТИВНОЕ ЗДОРОВЬЕ И ВРТREPRODUCTIVE HEALTH AND ARTАктуальный подход к лечению воспалительных заболеваний органов малого таза у женщин в амбулаторных условияхAn up-to-date approach to the treatment of pelvic inflammatory diseases in women on an outpatient basishttps://orcid.org/0000-0002-1462-4987ТихомировА. Л.TikhomirovA. L.

Тихомиров Александр Леонидович, д.м.н., профессор, профессор кафедры акушерства, гинекологии и репродуктивной медицины лечебного факультета

127006, Россия, Москва, ул. Долгоруковская, д. 4

Aleksander L. Tikhomirov, Dr. Sci. (Med.), Professor, Professor of the Department of Obstetrics, Gynecology  and Reproductive Medicine, Faculty of Medicine

4, Dolgorukovskaya St., Moscow, 127006, Russia

tikhomiroval@yandex.ruhttps://orcid.org/0000-0002-1599-0399КазенашевВ. В.KazenashevV. V.

Казенашев Виктор Викторович, к.м.н., ассистент кафедры акушерства, гинекологии и репродуктивной медицины лечебного факультета

127006, Россия, Москва, ул. Долгоруковская, д. 4

Victor V. Kazenashev, Cand. Sci. (Med.), Assistant Professor of the Department of Obstetrics, Gynecology  and Reproductive Medicine, Faculty of Medicine

4, Dolgorukovskaya St., Moscow, 127006, Russia

vkazenashev@mail.ruhttps://orcid.org/0009-0005-6707-4164МаминоваМ. В.MaminovaM. V.

Маминова Мария Владимировна, врач-ординатор по специальности акушерство и гинекология

127006, Россия, Москва, ул. Долгоруковская, д. 4

Maria V. Maminova, Resident Physician in Obstetrics and Gynecology

4, Dolgorukovskaya St., Moscow, 127006, Russia

mv_maminova@mail.ruhttps://orcid.org/0009-0003-2318-1377ГараеваЛ. Р.GaraevaL. R.

Гараева Лилия Рашитовна, к.м.н., врач – акушер-гинеколог, заведующая отделением гинекологии, 

140181, Россия, Московская обл., Жуковский, ул. Фрунзе, д. 1 

Liliya R. Garaeva,Cand. Sci. (Med.), Obstetrician-Gynecologist, Head of the Gynecology Department

1, Frunze St., Zhukovsky, Moscow Region, 140180, Russia 

garaevlil@mail.ruРоссийский университет медицины (РосУниМед)РоссияRussian University of Medicine (ROSUNIMED)Russian FederationЖуковская областная клиническая больницаРоссияZhukovsky Regional Clinical HospitalRussian Federation202611052026042532Copyright © Тихомиров А.Л., Казенашев В.В., Маминова М.В., Гараева Л.Р., 20262026Тихомиров А.Л., Казенашев В.В., Маминова М.В., Гараева Л.Р.Tikhomirov A.L., Kazenashev V.V., Maminova M.V., Garaeva L.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/10017

В настоящий момент воспалительные заболевания верхних отделов репродуктивного тракта являются одной из самых распространенных гинекологических проблем в мире: ежегодно регистрируется около 448 млн новых случаев воспалительных заболеваний органов малого таза (ВЗОМТ), что составляет до 60% от общего числа гинекологических заболеваний. Пик заболеваемости (4–12%) приходится на возраст 17–28 лет, что связано с сексуальной активностью и низкой частотой использования барьерных методов контрацепции. ВЗОМТ представляют собой серьезную проблему здравоохранения, оказывающую значительное влияние на здоровье женщин репродуктивного возраста. Эта группа заболеваний занимает лидирующее положение в структуре гинекологической заболеваемости и является наиболее частой причиной госпитализации женщин. Целью статьи явилось всестороннее рассмотрение проблемы ВЗОМТ у женщин репродуктивного возраста с позиции междисциплинарного подхода. В статье приведен клинический случай лечения пациентки с диагнозом: ВЗОМТ, двусторонний сальпингоофорит. Пациентка ранее получала антибактериальную терапию в стационаре, куда обратилась в связи с острыми симптомами (тянущие боли внизу живота, желтые выделения из половых органов). Симптомы появились у нее после незащищенного полового акта. В связи с тем, что при лечении в стационаре у пациентки не учли такие возможные этиологические факторы развития ВЗОМТ, как инфицирование хламидиями и микоплазмами, при повторном обращении до получения результатов ПЦР-исследований была назначена эмпирическая терапия: доксициклина моногидрат 100 мг 2 раза в сутки в течение 14 дней. К концу 2-го дня назначенного лечения пациентка отметила улучшение состояния: дискомфорт и тянущие боли внизу живота не беспокоят. Менструация в срок, безболезненная, выделения умеренные. Эффективность лечения оценена через 21 день после завершения 14-дневного курса терапии с использованием препарата Доксициклин ЭКСПРЕСС: отмечено клиническое и микробиологическое излечение.

Currently, pelvic inflammatory diseases (PID) are one of the most common gynecological problems in the world, with more than 448 million new cases reported annually (up to 60% of the total number of gynecological diseases). The peak of the disease (4–12%) occurs at the age of 17–28, which is associated with sexual activity and a low frequency of using barrier methods of contraception. PID represent a serious health problem that has a significant impact on the health of women of reproductive age. This group of diseases occupies a leading position in the structure of gynecological morbidity and is the most common cause of hospitalization in women. The aim of this article is to provide a comprehensive review of the issue of PID in women of reproductive age from an interdisciplinary perspective. This article presents a clinical case of a patient diagnosed with PID and bilateral salpingoophoritis. The patient had previously received antibiotic therapy in the hospital, where she sought medical help due to acute symptoms (pulling pain in the lower abdomen, yellow vaginal discharge). The symptoms appeared after unprotected sex. As during hospital treatment, potential etiological factors contributing to the onset of PID in the patient such as exposure to chlamydia and mycoplasma were not taken into account, empirical therapy with doxycycline monohydrate (100 mg twice daily for 14 days) was prescribed at patient’s follow-up visit before the results from the PCR test were available. By the end of the second day of prescribed therapy, the patient noted that her well-being was improved: discomfort and pulling pain in the lower abdomen disappeared. Periods were regular, pain-free, with moderate menstrual flow. The treatment efficacy was evaluated 21 days after completion of a 14-day course of Doxycycline EXPRESS, which showed that the patient achieved clinical and microbiological cure.

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The authors declare that there are no conflicts of interest present.