medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-23-236-246medsovet-7324Research ArticleГИНЕКОЛОГИЯGYNECOLOGYОсобенности клинической картины и выраженности болевого синдрома у девочек с генитальным эндометриозом на фоне консервативной терапии заболевания в подростковом возрастеFeatures of the clinical picture and severity of pain syndrome in girls with genital endometriosis on the background of conservative therapy of the disease in adolescencehttps://orcid.org/0000-0002-3195-307XХащенкоЕ. П.KhashchenkoE. P.

Хащенко Елена Петровна – кандидат медицинских наук, врач-гинеколог, старший научный сотрудник 2-го гинекологического отделения (детского и юношеского возраста).

117997, Москва, ул. Академика Опарина, д. 4

Elena P. Khashchenko - Cand. Sci. (Med.), Gynecologist, Senior Researcher of the 2nd Gynecology of Children and Adolescents Department, Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology.

4, Academician Oparin St., Moscow, 117997

khashchenko_elena@mail.ruhttps://orcid.org/0000-0002-8014-114XПустынниковаМ. Ю.PustynnikovaM. Yu.

Пустынникова Маргарита Юрьевна - студентка факультета фундаментальной медицины.

119991, Москва, ул. Колмогорова, д. 1

Margarita Yu. Pustynnikova - Student of the Faculty of Fundamental Medicine, Lomonosov Moscow State University.

1, Kolmogorov St., Moscow, 119234

m.pustynnikova@inbox.ruhttps://orcid.org/0000-0002-6316-1325КюрдзидиС. О.KyurdzidiS. O.

Кюрдзиди Станислав Олегович - аспирант кафедры акушерства, гинекологии, перинатологии и репродуктологии Института профессионального образования.

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Stanislav O. Kyurdzidi - Postgraduate Student at the Department of Obstetrics, Gynaecology and Perinatology, Institute of Professional Education, Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119991

dr.kyurdzidis@gmail.comhttps://orcid.org/0000-0002-3105-5640УвароваЕ. В.UvarovaE. V.

Уварова Елена Витальевна - член-корреспондент РАН, доктор медицинских наук, профессор кафедры акушерства, гинекологии, перинатологии и репродуктологии Института профессионального образования, ПМГМУ им. И.М. Сеченова (Сеченовский Университет); заведующая 2-м гинекологическим отделением (детского и юношеского возраста), НМИЦ акушерства, гинекологии и перинатологии им. ак. В.И. Кулакова.

119991, Москва, ул. Трубецкая, д. 8, стр. 2; 117997, Москва, ул. Академика Опарина, д. 4

Elena V. Uvarova - Corr. Member RAS, Dr. Sci. (Med.), Professor at the Department of Obstetrics, Gynaecology and Perinatology, Institute of Professional Education, Sechenov First Moscow State Medical University (Sechenov University); Head of the 2nd Gynecology of Children and Adolescents Department, Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology.

8, Bldg. 2, Trubetskaya St., Moscow, 119991; 4, Academician Oparin St., Moscow, 117997

elena-uvarova@yandex.ruhttps://orcid.org/0000-0001-6997-643XСальниковаИ. А.SalnikovaI. A.

Сальникова Ирина Александровна - научный сотрудник 2-го гинекологического отделения (детского и юношеского возраста).

117997, Москва, ул. Академика Опарина, д. 4

Irina A. Salnikova - Researcher of the 2nd Gynecology of Children and Adolescents Department, Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology.

4, Academician Oparin St., Moscow, 117997

i_salnikova@oparina4.ruНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. КулаковаРоссияKulakov National Medical Research Center of Obstetrics, Gynecology and PerinatologyRussian FederationМосковский государственный университет имени М.В. ЛомоносоваРоссияLomonosov Moscow State UniversityRussian FederationПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова; Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияKulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology; Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202220012023023236246Copyright © Хащенко Е.П., Пустынникова М.Ю., Кюрдзиди С.О., Уварова Е.В., Сальникова И.А., 20232023Хащенко Е.П., Пустынникова М.Ю., Кюрдзиди С.О., Уварова Е.В., Сальникова И.А.Khashchenko E.P., Pustynnikova M.Y., Kyurdzidi S.O., Uvarova E.V., Salnikova I.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7324Введение

Введение. Эндометриоз характеризуется хроническим течением и значимо влияет на качество жизни молодых пациенток. Цель. Изучить особенности клинической картины и болевого синдрома у девочек-подростков с генитальным эндометриозом на фоне терапии в течение 1 года.

Материалы и методы

Материалы и методы. В проспективное продольное исследование включены 32 девочки (14–17 лет) с подтвержденным диагнозом генитального эндометриоза. Проведена оценка клинической картины и выраженности болевого синдрома на фоне консервативной терапии препаратом НПВС (напроксен) с целью купирования дисменореи и гестагеном (диеногест) в течение 1 года.

Результаты

Результаты. Основной жалобой девочек с эндометриозом являлась боль, появляющаяся у большинства накануне менструации или в середине цикла с менархе (64%) или усилившаяся через 1–1,5 года после менархе (23%) до значений очень интенсивной боли по ВАШ (8,3 ± 1,6 балла) тянущего (44%) или схваткообразного (25%) характера. Треть подростков отмечали ежедневную боль (24%), большинство (75%) – жалобы на ограничение повседневной активности и работоспособности, гастроинтестинальные симптомы (44%) и дизурию (22%). Через 1 год на фоне лечения гестагенами и НПВС у пациенток значимо снизилась выраженность боли в дни менструации (p < 0,001), а также вне менструации (p < 0,001), частота ограничения повседневной активности (p < 0,001), слабости, снижения работоспособности в дни менструации (p < 0,001), гастроинтестинальных симптомов (p < 0,001) и нарушения мочеиспускания (p < 0,001), а также необходимость в обязательном приеме обезболивающих препаратов (р < 0,001).

Заключение

Заключение. На фоне консервативной терапии эндометриоза у пациенток подросткового возраста в течение 1 года отмечено значимое снижение болевого синдрома и клинических проявлений дисменореи на фоне улучшения качества жизни. В изучаемой группе не было отмечено усиления или учащения приступов головной боли, а также значимого изменения ИМТ, что говорит о хорошей переносимости и способствует приверженности к лечению молодых пациенток.

Introduction

Introduction. Endometriosis is characterised by a chronic course and significantly affects the quality of life of young patients. Aim. To study the features of the clinical picture and pain syndrome in adolescent girls with genital endometriosis against the background of 1 year of therapy.

Materials and methods

Materials and methods. A prospective longitudinal study included 32 girls (14–17 years old) with a confirmed diagnosis of genital endometriosis. The clinical picture and severity of pain syndrome were assessed against the background of conservative therapy with NSAID (naproxen) to relieve dysmenorrhea and gestagen (dienogest) for 1 year.

Results

Results. The main complaint of girls with endometriosis was pain, which appeared on the day before menstruation or in the middle of the cycle since menarche (64%) or increased in 1–1.5 years after menarche (23%) to very intense pain (8.3 ± 1.6 V scale) of a tensive (44%) or clutching (25%) nature. One third of adolescents reported daily pain (24%), the majority (75%) complained of restricted daily activity and performance, gastrointestinal symptoms (44%) and dysuria (22%). After 1 year of treatment with gestagens and NSAIDs patients had a significant decrease in pain on the days of menstruation (p <0,001), as well as outside menstruation (p <0,001), frequency of restriction of daily activities (p <0,001), weakness, lowered working capacity on menstrual days (p < 0.001), gastrointestinal symptoms (p < 0.001) and urinary disorders (p < 0.001) and the need for mandatory pain medication (p < 0.001).

Conclusion

Conclusion. A significant reduction in pain syndrome and clinical manifestations of dysmenorrhea against the background of an improved quality of life was observed in the adolescent patients during 1 year of conservative endometriosis therapy. No intensification or increase in the frequency of headache attacks or significant changes in BMI were observed in the study group, which is indicative of good tolerance and contributes to treatment adherence in young female patients.

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