Treatment of patients with endometriosis

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Increasing every year the number of drugs that can be used to treat endometriosis. The success of surgery and anesthetic management allow to carry out complex, sometimes quite traumatic and long surgery for endometriosis if there are reasonable indications to them.
Combination hormone therapy, Immunostimulants, maintenance of protective-adaptive reactions of the organism and surgical treatment of the patients are young and reproductive age can do more than sparing the volume of activity.
The problem of treatment of patients with endometriosis remains difficult, it is not only in the suppression of clinically active endometriosis hormones or remove it surgically, but also at the disposal of the patients from the effects of endometriosis in the form scar-adhesive process in small pelvis and neuropsychiatric reactions that has a significant importance in the rehabilitation of disability of patients. Female patients of childbearing age the aim of normalization of the specific features of the female body. Interfere with the performance of a task of an allergic reaction, the frequency and severity of which endometriosis patients increases every year. Hypersensitivity occurs to various medicines, food, household, pollen and other allergens. N. Century Startseva et al. (1985) found an allergic reaction to a variety of drugs in 1/3 of the patients with endometriosis. Among 3000 patients, operated on us for endometriosis for 40 years, increased sensitivity to drugs was observed in approximately 25 % of patients. Over the last 5 years, the frequency of allergic reactions is increased to 30 %. There is a direct relationship between the severity of allergization of the organism and the duration of the disease, the prevalence and severity of it, the intensity of hormonal treatment, the condition of the liver, kidneys, and other organs and by pockets of local infection.
In addition to allergic reactions, based on the reaction between antigen and antibody in patients with endometriosis can occur psevdoallergicakie or anaphylactoid reactions. The latter are accompanied by a significant release of biologically active substances not the result of a specific reaction antigen - antibody, and due to direct effects of certain medications on immunocompetent cells (Metacity, basophils, phagocytes, cells).
In addition, it is possible and immune activation of complement, in particular its low molecular weight fragments Sa and Sa that relate to the peptides, with a strong anaphylactoid activity [Latvian Century N., 1984].
One of the main causes hypersensitivity this category of patients to medication and other exogenous allergens is expressed sensitizing the influence of the endometriosis caused by entering into the blood of products of tissue destruction. The latter are formed under the influence depoliticised and lipolytic enzymes secreted by the stroma of endometrioid heterotopia, and become the autoantigens, sensitizing the body. Similar influence and menstrualnopodobne selection imbibers fabrics, and inflammatory response in the area of location of the foci of endometriosis.
Very significant role in the development of allergic reactions is the change in immune homeostasis, which is an important pathogenetic factor of endometriosis.
A number of patients with congenital forms of endometriosis immune system dysfunction, also was congenital. They have since the early childhood detected allergic predostavlennogo body, manifested exudative, lymphatic or neiroallergicescom diathesis. Often at the same time there are adenoids, chronic tonsillitis, mumps, pyelonephritis, obstructive bronchitis and other diseases. The combination of allergic diathesis with pockets of infection has expressed sensitizing effect.
Artificial feeding during the first year of life, vaccination, childhood infections, giardiasis, worm infestation, enterocolitis also contribute to sensitization of the body.
Powerful allergenic effects, many components of complex conservative therapy for endometriosis (iodine preparations, hormones, enzymes, antibiotics and Radiocontrast drugs). Hepatitis, visceral candidosis, developing as a result of long-term hormone therapy, and a number of other diseases reinforce sensitization of the body.
Thus, the cause sensitization of the organism of patients with endometriosis to different allergens are very diverse.
Allergic and psevdoallergicakie reaction can develop as during scheduled conservative therapy for endometriosis or other diseases, and in the study with the use of radiopaque substance (RKV), for sedation, local and General anesthesia, and in the postoperative period.
In policlinics № 122 of MH of the USSR under the direction of doctor of medical Sciences Century N. Latvians and with the participation of the Century, Gaidenko we have developed a complex of measures aimed at prevention of allergic and psevdoallergicakie reaction:
I. During the planned conservative therapy:
1. Careful examination of the allergological anamnesis to ascertain intolerance to certain medications and prevent their use in this patient, as well as identify persons with allergic Constitution. In necessary cases are scratch, intradermal or provocative sublingual samples.
2. When in the process of treatment of the signs of hypersensitivity local and General nature (skin itching, hyperemia skin, various rashes, hypereosinophilia, tachycardia, shortness of breath and other) must cancel "guilty" drug and assign antisense funds.
3. Patients should know what medicines they have increased sensitivity. Information about the unbearable drugs made on the front sheet history.