Features of condition of hemodynamic and homeostasis at acute gynecologic diseases

Abstract

In recent years, there has been a significant increase in urgent conditions in gynecology. The use of inadequate and sometimes unjustified surgical interventions due to the peculiarities of the clinical course of the disease, the difficulties of early diagnosis, uncertainty of treatment tactics can lead to complications and even death of the patient. Therefore, improving early diagnosis and emergency care is one of the priorities of modern medicine. The objective: to improve the early diagnosis and comprehensive treatment of acute gynecological conditions to study the structure and features of urgent gynecological diseases in modern conditions; analyze indicators of hemodynamics and homeostasis (including immune) to reduce possible complications in patients with acute gynecological diseases. Materials and methods. A 5-year retrospective clinical and anamnestic analysis of 1261 case histories of patients with various acute gynecological diseases, the most common of which are acute pelvic inflammatory disease (PID), uterine and intraperitoneal bleeding, impaired blood supply to internal tumors. Patients in the comparative groups were comparable in age and course of the pathological process in the genitals. Results. The study found that among acute gynecological diseases dominated by acute PID (41,4%), uterine bleeding (31,6%), intra-abdominal bleeding (20,8%), impaired blood supply to tumors of the internal genitalia (6,2%), and in the last two groups the incidence increased. The age of patients varied significantly depending on the type of pathology. Clinical manifestations of acute PID and impaired blood supply to tumors of the internal genitalia in most cases were characterized by a predominance of pain and intoxication syndromes. Intra-abdominal and uterine bleeding was dominated by symptoms associated with hemodynamic disturbances and posthemorrhagic anemia. A high frequency of anemia of toxic genesis was observed in patients with acute PID and impaired blood supply to tumors of the internal genitalia. Conclusion. In modern conditions, the percentage of patients in need of emergency care is increasing, mainly due to an increase in the number of patients with intraperitoneal bleeding and impaired blood supply to tumors of the uterus and ovaries. The course of urgent gynecological diseases is accompanied by a violation of the adaptive-regulatory mechanisms of detoxification, indicators of homeostasis, immune system, hemodynamics, acid-base state of the blood. Given the clinical picture of the disease and the established diagnosis, it is necessary to develop individual management tactics for each patient.