.

Клініко-патогенетичне обгрунтування комплексного лікування хронічних сальпінгоофоритів, поєднаних з фоновими захворюваннями шийки матки: Автореф. дис.

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I?i?noa?noai ioi?iie caei?ia’y Oe?a?ie

Oa?e?anueeee aea?aeaaiee iaaee/iee oi?aa?neoao

EI?IOE* NA?OEAIA ?AI??AIA

OAeE 618. 11’12— 002:618.146-002]— 07-08-092.

EE?I?EI-IAOIAAIAOE*IA IAA?OIOOAAIIss

EIIIEAENIIAI E?EOAAIIss

O?II?*IEO NAEUeI?IAIIOI?EO?A.

II?AeIAIEO C OIIIAEIE CAOAI?THAAIIssIE

OEEEE IAOEE

14.01.01 — aeooa?noai oa a?iaeieia?y

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy iaoeiaiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Oa?e?a

1999

Aeena?oaoe??th ? ?oeiien

?iaioa aeeiiaia o Aei?i?iiao?ianuee?e aea?aeaai?e iaaee/i?e aeaaeai??
IIC Oe?a?ie

Iaoeiaee ea??aiee: aeieoi? iaaee/ieo iaoe, i?ioani? Aeoainna?nueea
C?ia?aea Ieoaee?aia, Aei?i?iiao?ianueea Aea?aeaaia iaaee/ia aeaaeai?y,
caa?aeoaa/ eaoaae?e aeooa?noaa, a?iaeieia?? oa ia??iaoieia?? oaeoeueoaoo
i?neyaeeieiiii? ina?oe, caneoaeaiee ae?y/ iaoee oa oaoi?ee Oe?a?ie.

Io?oe?ei? iiiiaioe:

— aeieoi? iaaee/ieo iaoe, i?ioani? Eioaiaae/ ?aaai?y A?eoi??aia,
Ee?anueea aea?aeaaia iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe ?i. I. E.
Ooieea, caa?aeoaa/ eaoaae?e aeooa?noaa oa a?iaeieia??;

— aeieoi? iaaee/ieo iaoe, i?ioani? A?euaiei Ieueaa Aaeaioei?aia,
Oa?e?anueea aea?aeaaia iaaee/ia aeaaeai?y i?neyaeeieiiii? ina?oe,
caa?aeoaa/ eaoaae?e ia??iaoieia?? oa a?iaeieia??.

— aeieoi? iaaee/ieo iaoe, i?ioani? Aiaaeaoeei Ieeiea A?eai?iae/ ,
Oa?e?anueeee aea?aeaaiee iaaee/iee oi?aa?neoao, i?ioani? eaoaae?e
aeooa?noaa oa a?iaeieia?? ?2

I?ia?aeia onoaiiaa:

?inoeooo iaae?ao???, aeooa?noaa ? a?iaeieia??’ AII Oe?a?ie,
aeooa?nueei-a?iaeieia?/iee a?aeae?e,

i. Ee?a.

Caoeno a?aeaoaeaoueny “27” n?/iy 2000 ?. i 13-30 aiaeei? ia
can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee

Ae 64.600.01. i?e Oa?e?anueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? ca
aae?anith:

61022, Oe?a?ia, i. Oa?e?a, i?. Eai?ia, 4.

C aeena?oaoe??th iiaeia iciaeiieoeny o a?ae?ioaoe? Oa?e?anueeiai
aea?aeaaiiai iaaee/iiai oi?aa?neoaoo (61022, Oe?a?ia, i. Oa?e?a, i?.
Eai?ia, 4).

Aaoi?aoa?ao ?ic?neaiee “ 27 ” a?oaeiy 1999 ?.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee

eaiaeeaeao iaaee/ieo iaoe, aeioeaio I. I. Oaiueei

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue oaie. Ca inoaii? aeanyoe??//y iaeiie/aii aaeeeee
oaeoe/iee iaoa??ae c ieoaiiy a?noio?c?ieia?? ? iaoieia?? oeeee iaoee
(OI), a?aeia?aaeai? o no/anieo eeaneo?eaoe?yo caoai?thaaiue ae?ii/eo
noaoaaeo i?aai?a, o I?aeia?iaei?e iiiaieeaoo?? oai?ia (IIO) oii V???
(caoai?thaaiiy ae?ii/i? noaoaai? nenoaie, 1992), o I?aeia?iaei?e
noaoenoe/i?e eeaneo?eaoe?? oai?ia (INEO) V ia?aaeyaeo ? o A?noieia?/i?e
eeaneo?eaoe?? iooeei (AEI) ae?ii/i? noaoaai? nenoaie, 2-a ?aaeaeoe?y
(1994).

Iaea?eueo iiaia ??ciiiai?oia iaoieia?y oeeee iaoee (OI) iaaaaeaia o
?iaioao Eioaiaae/ A.A. (1997, 1998), Eiiae??eiaa I.?. (1997, 1998),
?onaeaae/ I.N. (1998), o yeeo a?aoiao?oueny ia eeoa no/aniee noai
iaoeiaeo aeine?aeaeaiue c aeaiiai ieoaiiy, a e i?noeoueny caeeee aei
i?aeoe/ii? ioi?iie caei?ia’y a?aeiiaeoeny a?ae canoa??eeo iaeiaioaaiue ?
oa?i?i?a a?coaeueiiai iieno ci?i OI ? iaiao?aeiino? i???ioe?o ia aeai?
eieueii- ? oea?a?eineii??.

O nenoai? i?io?eaeoe/ieo caoiae?a, ni?yiiaaieo ia ai?ioueao c ?aeii OI,
e?eoaaiiy oiiiaeo ? ia?aae?aeiaeo caoai?thaaiue caeia? iaeia c ia?oeo
i?noeue (Aaneeaanueea E.I. ? ni?aaao. (1987), I?eeainueea A.I. (1987).
Aaaeeea?noue ieoaiiy iaoiiaeaia aenieith /anoioith oeeo caoai?thaaiue,
iaaeinoaoiueith aoaeoeai?noth e?eoaaiiy, a oaeiae iaaiith ?iia??i?noth
?o ia?a?iaeaeaiiy (Eica/aiei A.I., 1997).

Ca inoaii?e /an ?ic?iaeaii ? ai?iaaaeaeaii o ee?i?/io i?aeoeeo aaeeeo
e?euee?noue ??ciiiai?oieo iaoiae?a e?eoaaiiy caoai?thaaiue OI, ye? /anoi
anioe?ththoueny c o?ii?/iei caiaeaiiyi aeiaeaoe?a iaoee, eiaeai c yeeo
ia? iieacaiiy aei canoinoaaiiy, ia?aaaae e iaaeie?ee, oa?aeoa?eco?oueny
iaaiei a?aenioeii oneeaaeiaiue (No?oaaoeueeee A.I., 1997; Einoaaa I.I.,
1997), (Hillard et al, 1996), i?ioa ni?iae ?ic?iaeoe oi?aa?naeueiee
iaoiae ia oa?i/aeeny oni?oii.

Aeua neacaia noaei i?aenoaaith aeey ?ic?iaee iaoiaeieia?/ieo aniaeo?a
oe??? i?iaeaie, ooi/iaiiy aoaiiino? e?eoaaeueii-?aaa?e?oaoe?eii?
i?ia?aie o oai?eo c oiiiaeie caoai?thaaiiyie oeeee iaoee (OCOI), ye?
ii?aeiothoueny c o?ii?/iei naeuei?iaiioi?eoii (ONI) ? oi?ioaaiiy
ioe?ii/ieo e?eoa???a ?eceeo aeieeiaiiy oe??? iaoieia?? o
?iciianthaeaeaiiai eiioeiaaioo a?iaeieia?/ieo oai?eo aeey ?aaeueii?
i?io?eaeoeee a?coaeueieo oi?i ?aeo aai?oae?e, /ei ? aoea i?iaeeeoiaaia
iaiao?aei?noue iaoiai aeine?aeaeaiiy.

Ne?ae a?aei?oeoe, ui aeacai? ieoaiiy aoee a?aeianai? aei i?ei?eoaoieo ia
O c’?cae? aeooa??a-a?iaeieia?a Oe?a?ie (1996) ? ia OV? anana?oiueiio
eiia?an? aeooa??a-a?iaeieia?a o Aeai?? (Eiiaiaaaai, 1997).

Ca’ycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. ?iaioa iia’ycaia
c aeeiiaiiyi iaoeiai-aeine?aeieoeueei? ?iaioe ia eaoaae?? aeooa?noaa,
a?iaeieia?? oa ia?eiaoieia?? Aei?i?iiao?ianueei? aea?aeaaii? iaaee/ii?
aeaaeai?? ? Aea?ae?a?no?aoe?? 1970009374: “Iaoeiaa iaa?oiooaaiiy nenoaie
caoiae?a ii iie?auaiith noaio caei?ia’y, cieaeaiith caoai?thaaiino? ?
nia?oiino? iaoa??a oa ae?oae Oe?a?ie.”

Iaoa aeine?aeaeaiiy. ?ic?iaea iaoeiaeo iniia i?iaiicoaaiiy, i?io?eaeoeee
? e?eoaaiiy OCOI, ii?aeiaieo c ONI, c o?aooaaiiyi noaio aiaeie?eiieo
ni?aa?aeiioaiue, i?e?ia?ioeaiico noaoaaeo oeyo?a ae?iee, iieiia?ea??a
aeey cieaeaiiy a?coaeueieo oi?i ?aeo.

Caaea/? aeine?aeaeaiiy:

1. I?iaanoe ee?i?ei-noaoenoe/ia aeine?aeaeaiiy aeey aea/aiiy
aca?iica’yceo i?ae OCOI o oai?eo c o?eaaeei o?ii?/iei caiaeaiiyi
aeiaeaoe?a iaoee, ci?iith noaio aiaeie?eiiiai aiiainoaco, o?eaae?noth ?
aoaii?noth i?iaaaeaiiy eiiieaenii? i?ioecaiaeueii? oa?ai??.

2. Ooi/ieoe ?ieue ? i?noea CINO, ye? iae/ano?oa cono??/athoueny o
aeieeiaii? OCOI i?e ONI.

3. Aea/eoe ooieoe?iiaeueiee noai aiaeie?eiii? nenoaie o oai?eo c OCOI ?
o?eaaeeie caiaeaiiyie aeiaeaoe?a iaoee.

4. Noi?ioaaoe ioe?ii? e?eoa??? ?eceeo aeieeiaiiy OCOI c o?aooaaiiyi
oi?iaeueiino? iieiia?ea??a.

5. ?ic?iaeoe ? ee?i?/ii ai?iaoaaoe nenoaio i?aai?caoe?eii-i?io?eaeoe/ieo
caoiae?a ? e?eoaaeueio oaeoeeo (?c canoinoaaiiyi eaca?ii? oa?ai??
iecueeiaia?aaoe/iei eaca?ii) aeey iaoiaaiaoe/ii? ei?aeoe?? i?e OCOI ?
noiooiueiio ONI.

Iaoeiaa iiaecia. ?noioiith iiaeciith a?aecia/a?oueny cai?iiiiiaaiee iaie
iiaee aa??aio iaoiaeieia?/iiai aniaeoo aeine?aeaeaiue o oai?eo ?c
niieo/aieie aeia?iye?nieie caoai?thaaiiyie aai?oae?e (NAeCA), ui
aeeth/athoue no/ani? ae?aaiinoe/i? oaoiieia?? o a?iaeieia??
(eieueiioea?a?eineii?th, ?ioiiioa?iaioiee, ?aae?i?ioiiee aiae?c,
aecia/aiiy iieiia?ea??a), ye? aeicaieythoue i?iaiicoaaoe iaaaoeai?
iane?aeee oe??? iaoieia??, ui i?eaiaeeoue aei aeieeiaiiy
iieicaoai?thaaiue.

Oia?oa eiiieaenii i?iaiae?ciaai? ioe?ii? e?eoa??? ?eceeo aeieeiaiiy OCOI
? cai?iiiiiaai? aeey ee?i?/ii? i?aeoeee no/ani?, i?aeoiaee e?eoaaiiy,
ye? aaciina?aaeiuei aieeaathoue ia iaoieia?/ia na?aaeiaeua, ia
aieeaathoue ia iieiaaiac (eaca?ioa?ai?y, i?aia?aoe nieeiaaa?i,
nieeio?eoiaae), a oaeiae eiiieaen e?eoaaeueii-?aaa?e?oaoe?eii? i?ia?aie
aeey ii?iae?caoe?? ii?ooaiiy iae?iaiaeie?eiieo ni?aa?aeiioaiue.

Iaie noai?aia i?ea?iaeueia eiii’thoa?ia i?ia?aia aeey ?ic?iaee
?iaeea?aeoaeueii? iiaeae? i?iaiico, ?aoeeaeea?a caiaeaiiy aai?oae?e,
OCOI ? i?io?eaeoe/ieo caoiae?a o ?iciianthaeaeaiiai eiioeiaaioo
a?iaeieia?/ieo oai?eo, aeey cieaeaiiy /anoioe ceiye?nieo iiaiooai?aiue
ae?ii/eo noaoaaeo i?aai?a.

I?aeoe/ia cia/aiiy io?eiaieo ?acoeueoao?a. Io?eiai? ?acoeueoaoe
aeicaieeee ia iniia? ee?i?ei-noaoenoe/ieo aeine?aeaeaiue noai?eoe
eiioeaiooaeueio iiaeaeue iniaeeainoae NAeCA o ae?iie I?eaei?i?ianueeiai
?aa?iio c o?aooaaiiyi iniaeeainoae ai?iiiaeueiiai aiiainoaco,
naenoaeueii? iiaaae?iee, ??ciiiai?oieo oi?i canoiniaaiiai e?eoaaiiy;
anoaiiaeoe ao?ieia?/io cia/ei?noue CIIO (oeai?ae?ico, aa?aeia?aeaco,
o?iaai?oaeueiiai eaiae?aeii?eico) o aeieeiaii? OCOI i?e ?o niieo/aii? c
ONI;

aia?oa aeieacaii, ui ii?iae?caoe?y iae?iaiaeie?eiieo ni?aa?aeiioaiue ?c
canoinoaaiiyi iaai?iiiaeueieo iaoiae?a aieeao aeicaiey? aeinyaoe
aenieiai oa?aiaaoe/iiai aoaeoo, ui ?aaeueii cieaeo? ?ecee aeieeiaiiy
a?coaeueieo oi?i ?aeo ? ia? iaaeeei-nioe?aeueiee aoaeo; aeieacaii, ui
iaiao?aeia eiiieaenia e?eoaaiiy iaio noaoaaeo ia?oia??a ia oii?
aa?’??-oa?ai?? aei ii?iae?caoe?? i?e?ia?ioeaiico na/inoaoaaiai o?aeoo,
ui aeicaiey? aeinyaoe aoaeoeaiino? cai?iiiiiaaii? iaie iiaeae?
e?eoaaeueii-i?io?eaeoe/ii? i?ia?aie.

Iaoiaee ianoaaeaiiy ? cai?iiiiiaai? iaoiaee i?iaiicoaaiiy, i?io?eaeoeea
? e?eoaaiiy oai?eo c OCOI ? noiooi?i ONI ai?iaaaeaeai? o i?aeoeeo
Iiaiiineianueeiai oa?eoi??aeueiiai iaaee/iiai ia’?aeiaiiy (aieiaiee
e?ea? A.N. Aooa?ia), IN* o?oaiiai caaiaeo I.Iiaiiineianueea,
Aei?i?iiao?ianueeiai ee?i?/iiai i?nueeiai iieiaiaiai aoaeeieo ?2
(aieiaiee e?ea? E.?. Iaaeaeei). Io?eiai? o ?acoeueoao? aeeiiaiiy ?iaioe
iaoa??aee aeei?enoiaothoueny o iaaeaaia?/iiio i?ioean? eaoaae?e
aeooa?noaa, a?iaeieia?? ? ia?eiaoieia?? oa eaoaae?e aeooa?noaa oa
a?iaeieia?? iaaee/iiai oaeoeueoaoo AeAeIA.

Iniaenoee aianie caeiaoaa/a. Aaoi? iniaenoi i?iaiae?coaaa ye aieiaiee
aeooa?-a?iaeieia i.Iiaiiineianueea iieacieee yeino? a?iaeieia?/ii?
aeiiiiiae ae?ieai i.Iiaiiineianueea ca 1996-1998 ??., iniaenoi ianoaaeea
? aea/ea ?acoeueoaoe ianoaaeaiiy 120 ae?iie c OCOI niieo/aieie c ONI, 20
i?aeoe/ii caei?iaeo ae?iie, ye? neeaee eiio?ieueio a?oio, aeine?aeea
io?eiai? ?acoeueoaoe.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iaoa??aee aeine?aeaeaiue
aeieeaaeaeeny ia iaoeiai-i?aeoe/ieo can?aeaiiyo anioe?aoe??
aeooa??a-a?iaeieia?a Aei?i?iiao?ianueei? iaeano? (1997, 1998, 1999 ??.),
a oaeiae ia Ieaioiao I?aae?iiy Oe?a?inueei? anioe?aoe??
aeooa??a-a?iaeieia?a (1997,1998??.), iaoeia?e nan?? Aei?i?iiao?ianueei?
AeIA (1997, 1998 ??.).

Ioae?eaoe??. Ca oaiith aeena?oaoe?? iioae?eiaaii 7 ?ia?o, c ieo 3 o
oaoiaeo aeaeaiiyo Oe?a?ie.

Ianya oa no?oeoo?a aeena?oaoe??. Aeena?oaoe?y aeeeaaeaia ia 180
noi??ieao iaoeiiieno ? neeaaea?oueny c anooio, iaeyaeo e?oa?aoo?e, 5
?icae?e?a aeanieo aeine?aeaeaiue, aeniiae?a, i?aeoe/ieo ?aeiiaiaeaoe?e,
ia?ae?eo e?oa?aoo?e. ?iaioa ?ethno?iaaia 8 iaethieaie oa 10 oaaeeoeyie,
ui caeiathoue 18 noi??iie.

INIIAIEE CI?NO ?IAIOE

Iaoa??aee ? iaoiaee aeine?aeaeaiiy. O a?aeiia?aeiino? c caaaeaiiyie
aeine?aeaeaiue aoei ianoaaeaii 120 ae?iie ?c OCOI ? ONI, oa 20 caei?iaeo
ae?iie ?c caa?aaeaiith iaino?oaeueiith ? ?ai?iaeoeoeaiith ooieoe??th.

Oai??, ye? ciaoiaeeeenue i?ae iaaeyaeii, i?aeaeaeeny iiaeeaeaiiio
ee?i?/iiio ianoaaeaiith c aeaoaeueiei aea/aiiyi niaaeeiaino?,
caaaeueiiai ? niaoe?aeueiiai aiaiiaco ia?aianaieo ?ioaeoe?eieo,
niiaoe/ieo ? a?iaeieia?/ieo caoai?thaaiue.

Ca aeiiiiiaith i?ia?aiiiai iaoaiaoe/iiai aiae?co ?c cia/ii? e?eueeino?
aiaiianoe/ieo ? ee?i?/ieo aeaieo aoee aeae?eai? ? ioa?aeoa?eciaai?
iaea?eueo cia/i? oaeoi?e ?eceeo ?icaeoeo OCOI.

On?i oai?ei i?iaiaeeee caaaeueiiee?i?/i? ianoaaeaiiy, ai?iaaaeaeai? a
no/ani?e a?iaeieia?/i?e ee?i?oe?: aeine?aeaeaiiy caaaeueiiai aiae?co
e?ia? ? na/?, e?ia? ia RW ? A?E, Hbs Ang aaeoa??ieia?/ia,
aaeoa??ineii?/ia oa ?ioiioa?iaioia aeine?aeaeaiiy aiaeioea?a?eaeueiiai
ai?noo, o?ao?e, e?ia? ca aeiiiiiaith aiae?caoi?a AAAIO (NOA), iin?a na/?
ia noa?eeuei?noue, eae ia aeenaaeoa??ic.

On?i oai?ei o aeeiai?oe? ianoaaeaiiy aoei i?iaaaeaii oeueo?acaoeiaa
aeine?aeaeaiiy ia aia?ao? “AEIEA”-630 aai?oae?e, ueoiaeaeii? caeice,
ia/?iee, ie?ie.

Ie?aii aecia/eee iooeeiiee ia?ea? Na-19-9 iaoiaeii ?OA ca aeiiiiiaith
iaai??a o NI “Ae?a – iethn”.

Ooieoe?iiaeueio aeoeai?noue noaoaaeo caeic, iaaeie?iee?a ? noaio
aiiaaeio?iiii? ?aaoeyoe?? ioe?ithaaee ii ai?noo noa?i?aeieo ai?iii?a ?
aiiaaeio?ii?i?a o ne?iaaooe? e?ia?, aecia/ath/e ?o ?aae?i?ioiieia?/iei
iaoiaeii ?c aeei?enoaiiyi noaiaea?oieo iaai??a o??ie I?inuee
(A?ei?on?y). Anueiai c?iaeaii 869 aeine?aeaeaiue ai?iii?a iaoiaeii
?aae?i?ioiiiai aiae?co.

Aea/aee eiioeaio?aoe?th a e?ia? aiiaaeio?iiieo, noa?i?aeieo ai?iii?a ?
?o ni?aa?aeiioaiiy a aeeiai?oe? iaino?oaeueiiai oeeeeo: EA, ONA,
i?ieaeoei, ano?aae?ie, i?iaanoa?ii, ei?oecie, ano?aae?ie/i?iaanoa?ii,
ano?aae?ie/ei?oecie, ano?aae?ie/oanoinoa?ii, i?iaanoa?ii/oanoinoa?ii.

Oa?aeoa?enoeea aiaeie?eiiiai aiiainoaco ae?iie eiio?ieueii? a?oie
i?eaaaeaia o oaae.1.

?acoeueoaoe aeine?aeaeaiue o eiaei?e a?oi? oai?eo ia?iaeaii
aa??aoe?eii-noaoenoe/iei iaoiaeii c aecia/aiiyi aeinoia??iino?
?acoeueoao?a ca O?oa?ii-Nouethaeaioii (TH.E. Eaaiia, I.I. Iiai?aethe,
1990).

Oaaeeoey 1.

EIIOeAIO?AOe?ss A E?IA? AIIAAeIO?IIIEO,

NOA?I?AeIEO AI?III?A ? ?O NI?AA?AeIIOAIIss

A AeEIAI?Oe? IAINO?OAEUeIIAI OeEEEO O CAeI?IAEO AE?IIE

Ai?iiie Aeeiai?ea aeine?aeaeaiiy

aei? oeeeeo

6-10 13-15 20-24

EA iea/e 2,93±0,331 9,20±0,721 3,18±0,351

ONA iea/e 4,39±0,302 8,01±0,782 1,86±0,232

I?IEAEOEI iea/e 9,96±0,703 10,96±1,013 10,00±0,863

ANO?AAe?IE iiieue/e 343,61±24,154 1250,16±38,644 510,63±17,364

I?IAANOA?II iiieue/e 2,21±0,185 6,22±0,365 21,56±1,385

EI?OECIE iiieue/e 193,79±18,976 223,81±19,866 231,56±17,016

ANO?AAe?IE/

I?IAANOA?II 162,84±31,127 200,99±29,317 231,56±17,017

ANO?AAe?IE/

EI?OECIE 1,77±0,218 5,58±0,418 2,21±0,188

ANO?AAe?IE/

OANOINOA?II 327,24±42,619 603,94±32,269 276,02±29,689

EI?OECIE/

OANOINOA?II 209,74±32,8710 113,13±13,1710 128,57±9,6810

I?IAANOA?II/

OANOINOA?II 2,03±0,2711 3,00±0,4911 1,65±1,2911

I?ei?oea: (?) – a??ia?aei?noue ?ic??ciaiue

I. 1 – ? – 1:2

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