Surgical sanitation in complex therapy of acute inflammatory diseases of appendages of uterus in young women: the analysis of typical clinical practice
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Abstract
Among recommendations of leading Russian experts on conducting patients with acute inflammatory diseases of appendages of a uterus (AIDAU) the indication to laparoscopic sanitations at young women occurs at availability of suspicion on purulent character of inflammation. Objective: to study of typical clinical practice among gynecologists in definition of readings to surgical sanitation at AIDAU in young women. Methods: the retrospective analysis of 62 cases of repeated hospitalization of 29 patients in the age of from 19 till 37 years. The automated technology of examination of quality of medical aid (QMA) is used. The group of defects QMA «it’s not applied, but it’s shown» in cases of refusal from lapariscopic sanitations are carried out. Results: operative treatment is undertaken at 24.1 % of patients at primary hospitalization and 9,1 % at repeated. In all cases surgical sanitations were undertaken at availability of complications AIDAU. It is established, that at repeated hospitalization the risk organremoving operations reliably increases (р = 0.033). QMA «it’s not applied, but it’s shown» it is revealed in 10,1 % of cases of primary hospitalization and 3,3 % at repeated. Conclusions: Contrary to existing recommendations gynecologists do not undertake a laparoscopy in noncomplicated purulent AIDAU in young not given birth women. Refusal of a surgical component of treatment at 10,1 % of patients with clinical signs of purulent adexitis can be the factor of insufficient efficiency of treatment at primary hospitalization and the reason of recurrent disease in the further
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