3 research outputs found
ΠΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ, ΡΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½Π°Ρ Ρ Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠ° Π³Π΅ΠΌΠΎΡΡΠ°Π³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π»ΠΈΡ ΠΎΡΠ°Π΄ΠΊΠΈ Ρ ΠΏΠΎΡΠ΅ΡΠ½ΡΠΌ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ Π² Π‘Π°Π½ΠΊΡ-ΠΠ΅ΡΠ΅ΡΠ±ΡΡΠ³Π΅ ΠΈ Π΅Π³ΠΎ ΠΏΡΠΈΠ³ΠΎΡΠΎΠ΄Π°Ρ
The goal is to identify the epidemiological, territorial-epidemiological, environmental, clinical and features of hemorrhagic fever with renal syndrome in order to improve epidemiological surveillance in a large metropolis of the Northwestern Federal District.Materials and methods. An epidemiological analysis of cases of hemorrhagic fever with renal syndrome in St. Petersburg for 2005β2019 was carried out and the clinical and epidemiological characteristics of 135 patients hospitalized in the S.P. Botkin Clinical Infectious Disease Hospital were studied. 70 patients identified combined HFRS diseases associated with other pathogens of viral and bacterial nature. An epidemiological analysis of cases of hemorrhagic fever with renal syndrome in St. Petersburg for 2005β2018 and long-term monitoring of the zoological, epizootological state of small mammals in several districts of St. Petersburg and its suburbs were carried out. The clinical and epidemiological characteristics of 135 patients were studied, of which 70 patients identified combined hemorrhagic fever with renal syndrome diseases associated with other pathogens of a viral and bacterial nature. To assess the epizootological situation, trapped rodents were examined for the presence of viral antigen and antibodies using the method of indirect immunofluorescence with the Xantagnost diagnosticum and enzymelinked immunosorbent assay.Results. The long-term dynamics of the incidence rate in St. Petersburg had a fluctuant rising character with two peaks. The proportion of diseases during the first rise was 11,5%, the second β 44,2% of the long-term incidence. Men prevailed in the age groups of 20-49 years without changes in periods. The proportion of women 20β49 years old was 20,7%, increased to 52,8 % in age groups over 50 years old. When distributed by month in a period of high incidence, the seasonal rise began in September with a peak in October. Infection with hemorrhagic fever with renal syndrome patients β residents of the city occurred mainly (with 35.5%), in the nearby territories of the Northwestern Federal District with 8.9% - in remote areas and with 5,9% in the countries of near and far abroad. The epidemiological situation in places of temporary residence and infection of people was characterized by an increase in the number of small mammals (redbacked voles) and, in particular, infection from 2,9 to 4,4%. Hemorrhagic fever with renal syndrome diseases occurred in the form of moderate severity in 94,4% cases. Severe forms were found in only 5,6% of cases. In the structure of combined infection in 25,9β22,3%, there was a combination of hemorrhagic fever with renal syndrome with gastroenterocolitis and influenza, serologically confirmed. In 17,6% of cases, hemorrhagic fever with renal syndrome was combined with other zoonoses (Lyme disease, tick-borne encephalitis, pseudotuberculosis, leptospirosis, tularemia), in 17,6% with of various etiologies. The presence of combinations of hemorrhagic fever with renal syndrome with other infections complicates the clinical diagnosis.Β Π¦Π΅Π»Ρ β Π²ΡΡΠ²Π»Π΅Π½ΠΈΠ΅ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
, ΡΠ΅ΡΡΠΈΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-ΡΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
, ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠ΅ΠΉ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½ΠΈΡ Π³Π΅ΠΌΠΎΡΡΠ°Π³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π»ΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠΈ Ρ ΠΏΠΎΡΠ΅ΡΠ½ΡΠΌ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ Π² ΠΊΡΡΠΏΠ½ΠΎΠΌ ΠΌΠ΅Π³Π°ΠΏΠΎΠ»ΠΈΡΠ΅.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· Π³Π΅ΠΌΠΎΡΡΠ°Π³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π»ΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠΈ Ρ ΠΏΠΎΡΠ΅ΡΠ½ΡΠΌ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ Π² Π‘Π°Π½ΠΊΡ-ΠΠ΅ΡΠ΅ΡΠ±ΡΡΠ³Π΅ Π·Π° 2005β2019 Π³Π³., Π° ΡΠ°ΠΊΠΆΠ΅ ΠΌΠ½ΠΎΠ³ΠΎΠ»Π΅ΡΠ½ΠΈΠΉ ΠΌΠΎΠ½ΠΈΡΠΎΡΠΈΠ½Π³ Π·ΠΎΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ, ΡΠΏΠΈΠ·ΠΎΠΎΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΌΠ΅Π»ΠΊΠΈΡ
ΠΌΠ»Π΅ΠΊΠΎΠΏΠΈΡΠ°ΡΡΠΈΡ
Π½Π° ΡΠ΅ΡΡΠΈΡΠΎΡΠΈΠΈ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΈΡ
ΡΠ°ΠΉΠΎΠ½ΠΎΠ² Π‘Π°Π½ΠΊΡ-ΠΠ΅ΡΠ΅ΡΠ±ΡΡΠ³Π° ΠΈ Π΅Π³ΠΎ ΠΏΡΠΈΠ³ΠΎΡΠΎΠ΄ΠΎΠ². ΠΠ»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΏΠΈΠ·ΠΎΠΎΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΈΡΡΠ°ΡΠΈΠΈ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π»ΠΈ ΠΎΡΠ»ΠΎΠ²Π»Π΅Π½Π½ΡΡ
Π³ΡΡΠ·ΡΠ½ΠΎΠ² Π½Π° ΠΏΡΠΈΡΡΡΡΡΠ²ΠΈΠ΅ Π²ΠΈΡΡΡΠ½ΠΎΠ³ΠΎ Π°Π½ΡΠΈΠ³Π΅Π½Π° ΠΈ Π°Π½ΡΠΈΡΠ΅Π» Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΌΠ΅ΡΠΎΠ΄Π° Π½Π΅ΠΏΡΡΠΌΠΎΠΉ ΠΈΠΌΠΌΡΠ½ΠΎΡΠ»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠΈΠΈ Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΡΠΌΠΎΠΌ Β«Π₯Π°Π½ΡΠ°Π³Π½ΠΎΡΡΒ» ΠΈ ΠΈΠΌΠΌΡΠ½ΠΎΡΠ΅ΡΠΌΠ΅Π½ΡΠ½ΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π°. ΠΠ·ΡΡΠ΅Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠ° 135 Π±ΠΎΠ»ΡΠ½ΡΡ
, Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π² ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΡΡ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½ΡΡ Π±ΠΎΠ»ΡΠ½ΠΈΡΡ ΠΈΠΌ Π‘.Π. ΠΠΎΡΠΊΠΈΠ½Π°, ΠΈΠ· ΠΊΠΎΡΠΎΡΡΡ
Ρ 70 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΈΠ΄Π΅Π½ΡΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Ρ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π³Π΅ΠΌΠΎΡΡΠ°Π³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π»ΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠΎΠΉ Ρ ΠΏΠΎΡΠ΅ΡΠ½ΡΠΌ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Ρ Π΄ΡΡΠ³ΠΈΠΌΠΈ Π²ΠΎΠ·Π±ΡΠ΄ΠΈΡΠ΅Π»ΡΠΌΠΈ. ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½Ρ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΠ±ΡΠ°Π±ΠΎΡΠΊΠΈ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠ°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΡ Π² Π‘Π°Π½ΠΊΡ-ΠΠ΅ΡΠ΅ΡΠ±ΡΡΠ³Π΅ ΠΈΠΌΠ΅Π»Π° Π²ΠΎΠ»Π½ΠΎΠΎΠ±ΡΠ°Π·Π½ΡΠΉ Ρ
Π°ΡΠ°ΠΊΡΠ΅Ρ Ρ Π΄Π²ΡΠΌΡ ΠΏΠΎΠ΄ΡΠ΅ΠΌΠ°ΠΌΠΈ. ΠΠΎΠ»Ρ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ Π² ΠΏΠ΅ΡΠΈΠΎΠ΄ 1-Π³ΠΎ ΠΏΠΎΠ΄ΡΠ΅ΠΌΠ° ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 11,5%, Π²ΡΠΎΡΠΎΠ³ΠΎ β 44,2%. ΠΡΠΆΡΠΈΠ½Ρ ΠΏΡΠ΅Π²Π°Π»ΠΈΡΠΎΠ²Π°Π»ΠΈ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΡΡ
Π³ΡΡΠΏΠΏΠ°Ρ
20β49 Π»Π΅Ρ. ΠΠΎΠ»Ρ ΠΆΠ΅Π½ΡΠΈΠ½ 20β49 Π»Π΅Ρ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π»Π°ΡΡ Ρ Π²ΠΎΠ·ΡΠ°ΡΡΠΎΠΌ Ρ 20,7 Π΄ΠΎ 52,8%. Π‘Π΅Π·ΠΎΠ½Π½ΡΠΉ ΠΏΠΎΠ΄ΡΠ΅ΠΌ Π² ΠΏΠ΅ΡΠΈΠΎΠ΄ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΡΠΎΠ²Π½Π΅ΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ Π΄ΠΎΡΡΠΈΠ³ ΠΌΠ°ΠΊΡΠΈΠΌΡΠΌΠ° Π² ΠΎΠΊΡΡΠ±ΡΠ΅. ΠΠ°ΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ ΠΆΠΈΡΠ΅Π»Π΅ΠΉ Π³ΠΎΡΠΎΠ΄Π° Π² 35,5% ΡΠ»ΡΡΠ°Π΅Π² ΠΏΡΠΎΠΈΠ·ΠΎΡΠ»ΠΎ Π½Π° Π±Π»ΠΈΠ·Π»Π΅ΠΆΠ°ΡΠΈΡ
ΡΠ΅ΡΡΠΈΡΠΎΡΠΈΡΡ
Π‘Π΅Π²Π΅ΡΠΎ-ΠΠ°ΠΏΠ°Π΄Π½ΠΎΠ³ΠΎ ΡΠ΅Π΄Π΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΠΊΡΡΠ³Π°, Π² 8,9 % β Π½Π° ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΡ
ΡΠ΅ΡΡΠΈΡΠΎΡΠΈΡΡ
Π΄ΡΡΠ³ΠΈΡ
ΡΠ΅Π³ΠΈΠΎΠ½ΠΎΠ² ΠΈ Π² 5,9 % β Π² ΡΡΡΠ°Π½Π°Ρ
Π±Π»ΠΈΠΆΠ½Π΅Π³ΠΎ ΠΈ Π΄Π°Π»ΡΠ½Π΅Π³ΠΎ Π·Π°ΡΡΠ±Π΅ΠΆΡΡ.ΠΠΏΠΈΠ·ΠΎΠΎΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΎΠ±ΡΡΠ°Π½ΠΎΠ²ΠΊΠ° Π² ΠΌΠ΅ΡΡΠ°Ρ
Π·Π°ΡΠ°ΠΆΠ΅Π½ΠΈΡ Π»ΡΠ΄Π΅ΠΉ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΠΎΠ²Π°Π»Π°ΡΡ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΠΈΡΠ»Π΅Π½Π½ΠΎΡΡΠΈ ΠΌΠ΅Π»ΠΊΠΈΡ
ΠΌΠ»Π΅ΠΊΠΎΠΏΠΈΡΠ°ΡΡΠΈΡ
ΠΈ ΠΈΡ
ΠΈΠ½ΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΡΡΠΈ Ρ 2,9 Π΄ΠΎ 4,4 %, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎ Π·Π° ΡΡΠ΅Ρ ΡΡΠΆΠΈΡ
ΠΏΠΎΠ»Π΅Π²ΠΎΠΊ.ΠΠ°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΏΡΠΎΡΠ΅ΠΊΠ°Π»ΠΈ Π² 94,4% ΡΠ»ΡΡΠ°Π΅Π² Π² ΡΠΎΡΠΌΠ΅ ΡΡΠ΅Π΄Π½Π΅ΠΉ ΡΡΠΆΠ΅ΡΡΠΈ. Π’ΡΠΆΠ΅Π»ΡΠ΅ ΡΠΎΡΠΌΡ Π²ΡΡΡΠ΅ΡΠ°Π»ΠΈΡΡ Π² Π»ΠΈΡΡ Π² 5,6% ΡΠ»ΡΡΠ°Π΅Π². Π ΡΡΡΡΠΊΡΡΡΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ ΡΠΎΡΠ΅ΡΠ°Π½Π½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ΅ΠΉ Π² 25,9β22,3 % ΠΈΠΌΠ΅Π»ΠΈ ΠΌΠ΅ΡΡΠΎ ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΡ Π³Π΅ΠΌΠΎΡΡΠ°Π³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π»ΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠΈ Ρ ΠΏΠΎΡΠ΅ΡΠ½ΡΠΌ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ Ρ Π³Π°ΡΡΡΠΎΡΠ½ΡΠ΅ΡΠΎΠΊΠΎΠ»ΠΈΡΠ°ΠΌΠΈ ΠΈ Π³ΡΠΈΠΏΠΏΠΎΠΌ. Π 17,6% ΡΠ»ΡΡΠ°Π΅Π² Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ ΡΠΎΡΠ΅ΡΠ°Π»ΠΎΡΡ Ρ Π±ΠΎΠ»Π΅Π·Π½ΡΡ ΠΠ°ΠΉΠΌΠ°, ΠΊΠ»Π΅ΡΠ΅Π²ΡΠΌ ΡΠ½ΡΠ΅ΡΠ°Π»ΠΈΡΠΎΠΌ, ΠΏΡΠ΅Π²Π΄ΠΎΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·ΠΎΠΌ, Π»Π΅ΠΏΡΠΎΡΠΏΠΈΡΠΎΠ·ΠΎΠΌ, ΡΡΠ»ΡΡΠ΅ΠΌΠΈΠ΅ΠΉ ΠΈ Π΄ΡΡΠ³ΠΈΠΌΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΠΌΠΈ, ΡΡΠΎ Π·Π°ΡΡΡΠ΄Π½ΡΠ»ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΡ.
ΠΠ»ΠΈΠ½ΠΈΠΊΠΎ-ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ Ρ Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠ° Π·Π°Π²ΠΎΠ·Π½ΠΎΠΉ ΡΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠΉ Π»ΠΈΡ ΠΎΡΠ°Π΄ΠΊΠΈ Π΄Π΅Π½Π³Π΅
Dengue fever is a zooantroponotic, vector-borne viral disease. It is common among the population of tropical countries and is characterized by a tendency to expand to other countries as a result of infection drifts.Objective: to identify epidemiological, clinical and laboratory features of imported dengue fever in St. Petersburg.Materials and methods. The obtained data of official registration of cases of diseases in the Department of accounting and registration of infectious and parasitic diseases of the city of St. Petersburg and clinical case histories from the Π‘linical Infectious diseases hospital named after S.P. Botkin for 2012β2018 were used as the basis for epidemiological analysis. 144 cases of dengue fever were identified on the basis of registration materials in the city during this period, of which 86 cases were studied on clinical histories. Standards methods of epidemiological diagnostics and statistics were used in the article.Results and discussion. Epidemiological anamnesis has been seen in a wide variety of countries in which tourists stayed and became infected. The hemorrhagic form of dengue fever was diagnosed in only 18 (19,1%) out of 86 patients. This form usually develops with repeated encounters with the virus and is more severe than the classic version of the disease. Dengue fever remains a topical imported disease and is associated with an increase in tourists, often re-visiting disadvantaged tropical countries. Both sexes were equally exposed to the disease. The age characteristic of patients is represented by persons of 20β29 and 30β39 years of age. An increase in the number of patients over a 7-year period was noted in May and November. Such countries as Thailand (37%), Vietnam (13,9%) and India (9,3%) were the predominant tourist destinations. Besides, single infections occurred in 13 countries of the Asian, African and American regions. The primary diagnosis in 50,3% of patients referred to hospital were acute respiratory diseases, combined with diarrhea and other manifestations. Clinical manifestations fit into 5 syndromes, which pass with a variety of symptoms, complicating both clinical diagnosis and laboratory confirmation of the diagnosis. Imported dengue fever is characterized by combined infections caused by pathogens of acute intestinal diseases, cytomegalovirus, hemorrhagic fever with renal syndrome, West Nile fever, hepatitis A, Legionella and Plasmodium malaria. In General, combined infection was detected in 39.5% of patients.ΠΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠ° Π΄Π΅Π½Π³Π΅ β Π·ΠΎΠΎΠ°Π½ΡΡΠΎΠΏΠΎΠ½ΠΎΠ·Π½ΠΎΠ΅, Π²ΠΈΡΡΡΠ½ΠΎΠ΅ ΡΡΠ°Π½ΡΠΌΠΈΡΡΠΈΠ²Π½ΠΎΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅, ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΠ΅ ΡΡΠ΅Π΄ΠΈ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ ΡΡΡΠ°Π½ ΡΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΡΡΠ°, ΠΊΠΎΡΠΎΡΠΎΠ΅ Π·Π°Π²ΠΎΠ·ΠΈΡΡΡ Π² Π΄ΡΡΠ³ΠΈΠ΅ ΡΡΡΠ°Π½Ρ ΠΈΠ· ΡΠ½Π΄Π΅ΠΌΠΈΡΠ½ΡΡ
ΡΠ΅Π³ΠΈΠΎΠ½ΠΎΠ² ΠΌΠΈΡΠ°.Π¦Π΅Π»Ρ: Π΄Π°ΡΡ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΡΡ ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΡ Π»ΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠΈ Π΄Π΅Π½Π³Π΅ Π·Π°Π²ΠΎΠ·Π½ΠΎΠ³ΠΎ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ° Π² Π‘Π°Π½ΠΊΡ-ΠΠ΅ΡΠ΅ΡΠ±ΡΡΠ³Π΅.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΎΡΠ½ΠΎΠ²Ρ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΎΡΠΈΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ΅Π³ΠΈΡΡΡΠ°ΡΠΈΠΈ ΡΠ»ΡΡΠ°Π΅Π² Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ Π² 2011β2019 Π³Π³. Π² ΠΎΡΠ΄Π΅Π»Π΅ ΡΡΠ΅ΡΠ° ΠΈ ΡΠ΅Π³ΠΈΡΡΡΠ°ΡΠΈΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½ΡΡ
ΠΈ ΠΏΠ°ΡΠ°Π·ΠΈΡΠ°ΡΠ½ΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ Π‘Π°Π½ΠΊΡ-ΠΠ΅ΡΠ΅ΡΠ±ΡΡΠ³Π°, ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ ΠΈΡΡΠΎΡΠΈΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½ΠΎΠΉ Π±ΠΎΠ»ΡΠ½ΠΈΡΡ ΠΈΠΌ. Π‘.Π. ΠΠΎΡΠΊΠΈΠ½Π° Π·Π° 2012β2018 Π³Π³. ΠΡΠ΅Π³ΠΎ ΠΏΠΎ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Π°ΠΌ ΡΠ΅Π³ΠΈΡΡΡΠ°ΡΠΈΠΈ Π·Π° ΡΡΠΎΡ ΠΏΠ΅ΡΠΈΠΎΠ΄ Π² Π³ΠΎΡΠΎΠ΄Π΅ Π±ΡΠ»ΠΎ Π²ΡΡΠ²Π»Π΅Π½ΠΎ 144 Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π»ΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠΎΠΉ Π΄Π΅Π½Π³Π΅, ΠΈΠ· ΠΊΠΎΡΠΎΡΡΡ
86 ΠΈΠ·ΡΡΠ΅Π½Ρ ΠΏΠΎ ΠΈΡΡΠΎΡΠΈΡΠΌ Π±ΠΎΠ»Π΅Π·Π½ΠΈ, 46 β ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΡΠ΅Π³ΠΈΡΡΡΠ°ΡΠΈΠΈ. ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½Ρ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ ΡΡΠ°ΡΠΈΡΡΠΈΠΊΠΈ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅. ΠΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π΄Π°Π½Π½ΡΡ
Π·Π° 2012β2018 Π³Π³. ΠΏΠΎΠΊΠ°Π·Π°Π», ΡΡΠΎ Π·Π°ΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ ΡΡΡΠΈΡΡΠΎΠ² Π»ΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠΎΠΉ Π΄Π΅Π½Π³Π΅ ΠΏΡΠΎΠΈΠ·ΠΎΡΠ»ΠΎ ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ Π² ΡΡΡΠ°Π½Π°Ρ
ΠΠ·ΠΈΠΈ. ΠΠ· 86 Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ 18 (20,9%) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠΎΠ²Π°Π½Π° Π³Π΅ΠΌΠΎΡΡΠ°Π³ΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠΎΡΠΌΠ° Π»ΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠΈ Π΄Π΅Π½Π³Π΅, Π² 68 ΡΠ»ΡΡΠ°ΡΡ
(79,1%) β ΠΊΠ»Π°ΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π²Π°ΡΠΈΠ°Π½Ρ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ. ΠΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠ° Π΄Π΅Π½Π³Π΅ ΠΎΡΡΠ°Π΅ΡΡΡ Π°ΠΊΡΡΠ°Π»ΡΠ½ΠΎΠΉ Π·Π°Π²ΠΎΠ·Π½ΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΡΡ ΠΈ ΡΠ²ΡΠ·Π°Π½Π° Ρ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°ΡΡΠΈΠΌΡΡ ΡΠΈΡΠ»ΠΎΠΌ ΡΡΡΠΈΡΡΠΎΠ², ΠΏΠΎΡΠ΅ΡΠ°ΡΡΠΈΡ
Π½Π΅Π±Π»Π°Π³ΠΎΠΏΠΎΠ»ΡΡΠ½ΡΠ΅ ΡΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΡΡΠ°Π½Ρ. Π ΠΏΠΎΠ»ΠΎΠ²ΠΎΠΉ ΡΡΡΡΠΊΡΡΡΠ΅ Π±ΠΎΠ»ΡΠ½ΡΡ
Π² ΡΠ°Π²Π½ΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ Π±ΡΠ»ΠΈ ΠΊΠ°ΠΊ ΠΌΡΠΆΡΠΈΠ½Ρ (50,4%), ΡΠ°ΠΊ ΠΈ ΠΆΠ΅Π½ΡΠΈΠ½Ρ (49,6%). Π Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΠΎΠΉ ΡΡΡΡΠΊΡΡΡΠ΅ Π±ΠΎΠ»ΡΠ½ΡΡ
, ΠΊΠ°ΠΊ Ρ ΠΌΡΠΆΡΠΈΠ½, ΡΠ°ΠΊ ΠΈ Ρ ΠΆΠ΅Π½ΡΠΈΠ½, ΠΏΡΠ΅Π²Π°Π»ΠΈΡΠΎΠ²Π°Π»ΠΈ Π»ΠΈΡΠ° 20β29 ΠΈ 30β39 Π»Π΅Ρ. Π£Π²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ ΡΠΈΡΠ»Π° Π±ΠΎΠ»ΡΠ½ΡΡ
Π·Π° 7-Π»Π΅ΡΠ½ΠΈΠΉ ΠΏΠ΅ΡΠΈΠΎΠ΄ ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ Π² ΠΌΠ°Π΅ ΠΈ Π½ΠΎΡΠ±ΡΠ΅. ΠΡΠ΅Π²Π°Π»ΠΈΡΡΡΡΠΈΠΌΠΈ ΠΌΠ΅ΡΡΠ°ΠΌΠΈ Π·Π°ΡΠ°ΠΆΠ΅Π½ΠΈΡ ΡΡΡΠΈΡΡΠΎΠ² Π±ΡΠ»ΠΈ Π’Π°ΠΈΠ»Π°Π½Π΄ (37%), ΠΡΠ΅ΡΠ½Π°ΠΌ (13,9%) ΠΈ ΠΠ½Π΄ΠΈΡ (9,3%); Π΅Π΄ΠΈΠ½ΠΈΡΠ½ΡΠ΅ Π·Π°ΡΠ°ΠΆΠ΅Π½ΠΈΡ ΠΏΡΠΎΠΈΠ·ΠΎΡΠ»ΠΈ Π΅ΡΠ΅ Π² 13 ΡΡΡΠ°Π½Π°Ρ
ΠΠ·ΠΈΠ°ΡΡΠΊΠΎΠ³ΠΎ, ΠΡΡΠΈΠΊΠ°Π½ΡΠΊΠΎΠ³ΠΎ ΠΈ ΠΠΌΠ΅ΡΠΈΠΊΠ°Π½ΡΠΊΠΎΠ³ΠΎ ΡΠ΅Π³ΠΈΠΎΠ½ΠΎΠ². ΠΠ΅ΡΠ²ΠΈΡΠ½ΡΠΌΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π°ΠΌΠΈ ΠΏΡΠΈ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°Ρ Π² 50,3% ΡΠ»ΡΡΠ°Π΅Π² Π±ΡΠ»ΠΈ ΠΎΡΡΡΡΠ΅ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΡΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, ΡΠΎΡΠ΅ΡΠ°ΡΡΠΈΠ΅ΡΡ Ρ Π΄ΠΈΠ°ΡΠ΅ΠΉΠ½ΡΠΌ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ ΠΈ Π΄ΡΡΠ³ΠΈΠΌΠΈ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΠΌΠΈ. Π‘ΠΏΠ΅ΠΊΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠΉ Π»ΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠΈ Π΄Π΅Π½Π³Π΅ ΡΠΊΠ»Π°Π΄ΡΠ²Π°Π΅ΡΡΡ Π² 6 ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠ², ΠΏΡΠΎΡΠ΅ΠΊΠ°ΡΡΠΈΡ
Ρ ΡΠ°Π·Π½ΠΎΠΎΠ±ΡΠ°Π·Π½ΠΎΠΉ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΡΠΈΠΊΠΎΠΉ, Π·Π°ΡΡΡΠ΄Π½ΡΡΡΠ΅ΠΉ ΠΊΠ°ΠΊ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΡ, ΡΠ°ΠΊ ΠΈ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΠΎΠ΅ ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½ΠΈΠ΅ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π°. ΠΠ»Ρ Π·Π°Π²ΠΎΠ·Π½ΠΎΠΉ Π»ΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠΈ Π΄Π΅Π½Π³Π΅ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ½Ρ ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΡ Ρ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΠΌΠΈ Π΄ΡΡΠ³ΠΎΠΉ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ, Π²ΠΊΠ»ΡΡΠ°Ρ Π²ΠΎΠ·Π±ΡΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ ΠΎΡΡΡΡΡ
ΠΊΠΈΡΠ΅ΡΠ½ΡΡ
ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΉ, ΡΠΈΡΠΎΠΌΠ΅Π³Π°Π»ΠΎΠ²ΠΈΡΡΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ, Π³Π΅ΠΌΠΎΡΡΠ°Π³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π»ΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠΈ Ρ ΠΏΠΎΡΠ΅ΡΠ½ΡΠΌ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ, Π»ΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠΈ ΠΠ°ΠΏΠ°Π΄Π½ΠΎΠ³ΠΎ ΠΠΈΠ»Π°, Π³Π΅ΠΏΠ°ΡΠΈΡΠ° Π, Π»Π΅Π³ΠΈΠΎΠ½Π΅Π»Π»Π΅Π·Π° ΠΈ ΠΌΠ°Π»ΡΡΠΈΠΈ. Π ΡΠ΅Π»ΠΎΠΌ, ΡΠΎΡΠ΅ΡΠ°Π½Π½Π°Ρ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΡ Π²ΡΡΠ²Π»Π΅Π½Π° Ρ 39,5% Π±ΠΎΠ»ΡΠ½ΡΡ
MODERN APPROACHES IN THE DIAGNOSIS AND CONSERVING THERAPY OF ADENOMYOSIS
At this point in modern gynecology there are no uniform standards in the diagnosis and treatment of adenomyosis. This problem requires special attention, since there is a tendency to increase the incidence of this disease, especially in younger women. The paper presents the data in the literature about the different methods of diagnosis (hysteroscopy, ultrasound, MRI), and provides criteria for evaluation of these methods. Of greatest interest are the data of foreign authors on a new method of treatment of adenomyosis β magnetic resonance- guided focused ultrasound surgery