Diagnosis of severity and choice of tactics for the treatment of pelvic inflammatory diseases in women

Abstract

Purpose of the study: to analyze the diagnosis of severity and the choice of treatment tactics for pelvic inflammatory diseases in women.Material and methods. The analysis of clinical studies of 14 women with pelvic inflammatory diseases, including 9 women who were treated conservatively and 5 patients who underwent urgent surgical treatment in the City Clinical Hospital №1 of the city of Odesa in 2020-2021, was carried out. For the diagnosis of the severity of the disease and the choice of tactics for the treatment of pelvic inflammatory diseases, the level of procalcitonin and the data of calculations of the leukocyte index of intoxication of Kalf-Kalif were taken into account.Results. The average age of the patients participating in the study was 34.1 ± 1.2 years, the median was 33.5 years, and the mode was 32 years. The average age of patients who were operated on for pelvic inflammatory diseases was 37.4 ± 1.3, while the average age of patients treated conservatively reached 32.2 ± 1.4 years. The patients were in the hospital for 4 to 10 days, on average - 6.9 ± 0.4 days. In patients who underwent conservative treatment, the level of procalcitonin averaged 1.14 ± 0.3 ng / L, while in operated women, it was 3.67 ± 0.6 ng / L. At the same time, the average index of the leukocyte index of intoxication in women receiving conservative therapy was 2.2 ± 0.1, and in patients who were subsequently operated on 2.9 ± 0.2. A comparative assessment determines the strong and direct relationship between procalcitonin and leukocyte intoxication index (rS = 0.78; p <0.05). There was a significant increase in the level of procalcitonin and the leukocytic index of intoxication in women who were subsequently operated on OR = 2.0; RR = 7.2.Conclusions1. In a comparative assessment of the severity state, strong and direct relationships between procalcitonin and the leukocyte intoxication index (rS = 0.78; p <0.05) are determined in women with pyoinflammatory diseases of the pelvic organs.2. In women who were subsequently operated on, a significant increase in the level of procalcitonin and the leukocyte index of intoxication OR = 2.0 was revealed; RR = 7.2.3. The analysis for the content of procalcitonin in most cases requires time (up to 1 working day), which is sometimes unacceptable when it is necessary to make a clinical decision on further treatment tactics.4. The data for calculating the leukocyte index of intoxication can be used after receiving the results of a general blood test. But the calculation of the leukocyte index of intoxication also takes time and is not always convenient. Therefore, it makes sense to use a simplified and more mobile intoxication index.5. The data obtained require more extensive and detailed analysis and should be used in a prospective study with a larger sample to choose the tactics for treating women with pelvic inflammatory diseases and the possibility of predicting postoperative purulent-septic complications.