What unites the diagnostic criteria for groups

None of the known tool or laboratory studies can not be considered universal for the diagnosis. The whole plan of the survey should include a whole range of diagnostic measures. The first evaluated the clinical picture, the data of objective examination. Although a detailed description of the symptoms in the literature correctly diagnose possible in all cases of inflammatory diseases. This fact has contributed to the establishment of diagnostic criteria that help to reliably estimate the clinical situation. You can not be based only on symptoms, you should put into practice the syndromic approach, including a combination of symptoms.

Diagnostic criteria

There are minimum criteria that allow you to designate the presence of timely treatment. This group of criteria refer complaints about pain in the presence of appendages and changes when viewed from the woman (the occurrence of pain in cervical traction, palpation of the projection area of ​​the appendages). If there is no other established causes of disease, the presence of these criteria should conduct an empirical therapy of inflammatory pelvis. Such a tactic is justified in the treatment of sexually active women of reproductive age, as it helps prevent serious consequences after suffering inflammation.

The majority of patients the pain is localized in the inguinal-iliac region, mainly on the right or left of the midline of the abdomen. Often, however, the patient is unable to pinpoint location of the pain, noting the fairly extensive section that covers the epigastric and hypogastric region. This uncertainty creates great difficulties in carrying out diagnostic measures, such as the localization of the pain can be observed in various diseases of the abdominal cavity (eg, pathology intestines, urinary tract, inguinal hernia). The nature of the pain of inflammation characterized by heterogeneity. Most often it is pulling or pressing pain, which can acquire cramping, pulsating character. If you change the severity of pain should be excluded complications.

Increase the specificity of diagnostic measures additional criteria .  They combine the data of objective examination and laboratory studies .  Temperature rises above inflammation appendages 37C .  When purulent inflammation observed a significant increase in temperature, which can be a criterion for assessing the severity of the disease .  The degree of increase in body temperature is largely dependent on the intensity and extent of inflammation .  The temperature response of the body is considered one of the most significant clinical illness, as evidenced by the change of thermoregulation .  But not in all cases, the lack of heat may indicate low prevalence of pathological process .  The temperature is a reflection of the reactivity of the body, so with a significant depletion of the body's defenses and reduce resistance even expressed inflammation of the appendages will take place against the background of subfebrile body temperature .  In severe, complicated by inflammation temperature reduction is seen as a poor prognostic sign .

Tests and examinations

As laboratory confirmation of the pathological process are the general clinical examination and blood infection. In an analysis of blood Blood tests: a mirror of health   draws attention to changes in leukocyte (its shift towards the young forms of cells or left), increased white blood cells. Non-specific signs of inflammation is to increase the content of C-reactive protein. In order to identify the causative agent using specially developed methods (microbiological testing, the use of enzyme immunoassay method or PCR diagnostics), which are particularly indicated for the diagnosis of intracellular bacteria or protozoa.

The defining diagnostic criteria are the changes identified in the course of the survey instrument. Signs of inflammation of the reliably detected during an ultrasound scan of the pelvic organs and laparoscopy Laparoscopy - why is it necessary? . According to the ultrasound visible changes in the appendages, which may have a character education tubo-ovarian or thickening of the fallopian tubes. The abdominal cavity is defined by the free liquid in a small quantity, which confirms the presence of inflammation. If the diagnosis is inflammation of the proceeds were obliterated, then confirm it may laparoscopy. This method of diagnosis allows you to visually assess the state of the female reproductive system, the nature of pathological changes in the field of appendages.

It is difficult to identify specific symptoms that will help determine in a variety of clinical manifestations, and will answer the question as manifested inflammation of the appendages. It is necessary to adopt an integrated diagnostic approach proved effective in practice. Using this approach, you can quickly identify complications. Inflammation of the consequences affect the condition of the reproductive function in general, including menstrual function, reproductive health. Inflammatory processes may cause infertility The causes of infertility - heredity and lifestyle   due to the formation of adhesions of varying severity. The most pronounced tendency to adhesions in inflammation caused by Chlamydia trachomatis. Parallel to the development of possible hormonal dysfunction, which is confirmed by tests of functional diagnostics. Basal Temperature in inflammation appendages becomes monotonous rhythm that characterizes the lack of ovulation Ovulation - How to determine as accurately as possible? . Deeper violations special survey identifies the level of sex hormones.

Stages of therapeutic measures

Treating inflammation of the appendages made up of several stages. The first step is to eliminate the injurious effect of the etiological factor, conduct a complete elimination of the pathogen. This helps to achieve the antibacterial therapy. Inflammation of the drugs should be administered in view of overlapping spectrum of activity, the main pathogens. It is recommended to use a combination regimen, according to which appointed several antibiotics.

Treatment

At the initial stage of therapy should be held at the specialized hospital. Antibacterial agents are administered by injection, after switching to tablet formulations. After reducing the severity of clinical symptoms and improve the general condition of the woman can continue to receive treatment in a clinic, which will be under the supervision of a doctor gynecologist. Tablets from inflammation of the appendages can not suppress the activity of all kinds of microorganisms, so they successfully combine the following schemes:

• Augmentin (amoxicillin clavulanic acid) with ofloxacin or doxycycline Doxycycline - penetrates into the tissue cells   (drug "JUnidoks-soljutab")
• ofloxacin with metronidazole Metronidazole - what is it? . Metronidazole in inflammation appendages affects anaerobic flora, so this scheme works effectively when non-specific inflammatory diseases

Be sure to carry out prevention of Candida infection, which is attached on a background of reducing the body's immune. For this purpose it is possible to use preparations fluconazole Fluconazole - used with caution Which are available under various trade names. The best will be the appointment of a single dose of 150 mg. If the dose is lower (50 mg), the intake should be extended to seven days.

Enhances the effect of antibacterial drugs proteolytic enzymes. Fermentoterapii also carried out to improve the metabolic processes, the healing process is faster, with no complications after suffering a pronounced inflammation. It proved the existence of immunostimulatory effect in this group of drugs, so this non-specific immunostimulation affect beneficially the entire healing process. Administered orally drug "Wobenzym", which should be at least ten days prior to 9-15 pills a day. If necessary, the drug can be extended to three weeks.

If it is decided to carry out a correction of the immune status of special means, the patient should be screened and hand over an immunogram. Specific effects on the immune system Immunity - types and characteristics in children in adults   It is shown in the case of long flowing, recurrent, chronic forms of the disease. This type of therapy is carried out by the scheme in a strictly certain days. Immunostimulatory and antiviral properties have drug "Lavomax." Antibiotic therapy is conducted in parallel with taking this medication. "Lavomax" can not be assigned each day, the optimal receive mode must be in a day.

In inflammatory diseases affected tissue metabolism, metabolic rate, so should be included in the treatment regimen metabolic agent. Are capable of improving metabolic processes vitamin E, ascorbic acid, methionine. It can be used for this purpose drug "aktovegin" which is derived from bovine blood. It improves processes at the cellular level, eliminates the effects of oxygen starvation, emerging as a result of inflammation. It takes quite a long reception of the drug for a month, two pills a day.

There is a high likelihood of urgent surgical intervention if the pathological process is complicated by the formation of an inflammatory tumor .  Most often it is a one-sided education, which should be removed surgically .  In the absence of signs of purulent inflammation of the operation is carried out after appropriate preoperative preparation .  The need for surgical treatment due to the risk of rupture of the tumor, the development of inflammation of the peritoneum (or peritonitis) .  In identifying the inflammatory tumor necessarily required to assess the condition of the intestine, which is especially shown in the left-sided localization of Education .  Inflammation of the left appendage, which takes the form of tubo-ovarian tumor can spread to the intestines .  For radiographic studies must be included in the set of survey, since the condition of the bowel in the future depends how much interference will be produced .

On Prevention

Inflammatory changes in the appendages tend to recur in the chronic course of the disease. To prevent re-exacerbation of the disease, it is necessary to carry out preventative measures. Prevention involves inflammation of the whole complex of rehabilitation treatment, which is administered after completion of the primary course of therapy.

An important place is vitamin therapy, restorative therapy .  Vitamin therapy, carried out in a cyclic mode, helps restore menstrual function, if it is marked violation after suffering inflammation .  Rehabilitation treatment can be carried out in a sanatorium or resort, which has a focus gynecological .  To prevent the development of irreversible changes, adhesions help physiotherapy .  Physiotherapy in inflammation of the appendages is an effective means of prevention and treatment .  After removing the effects of acute physical therapy may be recommended in the area of ​​the appendages .  Successfully applied cyclical effects (electrophoresis medicine on days of the cycle), treatment with ultrasound, laser, currents of different frequencies .  An indication of the effectiveness of preventive treatment can be called lengthening of "light gaps" between periods of acute inflammatory disease of the appendages, the achievement of sustained remission .

It is important to start treatment on time, otherwise it will be difficult to avoid the development of irreversible changes. In this regard, the physician has a value of the time factor, the woman turned to the first symptoms of the disease. A practical solution to the question of how to determine the inflammation of the appendages, depends on the survey in its entirety, using modern methods of laboratory diagnostics and instrumental studies, including endoscopic techniques.

Marina Solovyov