RU2153333C2 - Method of treatment of patient with endocervicitis - Google Patents

Abstract

FIELD: medicine, gynecology. SUBSTANCE: method involves effect on mucous and adjacent tissues of cervical channel by electrophoresis using drugs. In initial course of electrophoresis 1% solution of dioxidine is used as drug which is administrated under control of smear results and data of objective examination before opening "bunches" forming in cervicitis. In the end of course sofradex is used as drug. Method ensures to attain the direct effect on cervical channel endothelium and stimulate reparative processes in cervical channel mucosa. EFFECT: enhanced effectiveness of treatment. 1 tbl, 1 ex

Description

 The invention relates to medicine and can be used in the treatment of gynecological diseases, namely endocervicitis.

 Therapy of endocervicitis is one of the important problems of modern gynecology. Often, endocervicitis is an independent cause of female infertility. In addition, the presence of endocervicitis impedes the implementation of such diagnostic procedures as hysteroscopy, kimoperturbation, cryodestruction, as well as surgical interventions for laparoscopy for endometriosis, uterine fibroids, tubal obstruction, etc.).

 Known drug methods for treating endocervicitis with drugs such as tetracycline, cephalosporin, trichopolum by their oral administration [1] or by exposing the mucous membrane and adjacent tissues of the cervical canal by irrigation, baths, tampons from drugs [2]. However, the effectiveness of these methods remains low due to the structural features of the cervical canal.

 Closest to the claimed is a method of treating endocervicitis, in which a drug is applied to the mucosa and adjacent tissues of the cervical canal using electrophoresis. Zinc sulfate (Kellat's technique) is used as a medicinal substance [3]. For the procedure, a zinc conical intracranial electrode is used. In the cervical canal enter the narrowed part of the intracervical electrode. Using a rubber bottle with a capacity of 100 ml, 1% zinc sulfate solution is poured into the vagina in such an amount that the entire vaginal part of the cervix is completely immersed in the drug substance. The folding mirror is not removed during the procedure. They pass current up to 10 mA. The duration of the procedure is 10 to 15 minutes. Treatment is carried out once a week, excluding the period of menstruation. Course up to 10 procedures. However, this method is not sufficiently accurate. So, after a full course of treatment, an increase in the content of leukocytes in smears is observed, the colposcopic picture of endocervicitis is preserved. In addition, the course of treatment is extended for 2 to 3 months. Contact bleeding can also be observed, since a coagulation, gradually rejected scab forms on the cervix, i.e. patients should refrain from sexual intercourse.

 The claimed invention solves the problem of creating a method for the treatment of endocervicitis, in which they directly affect the endothelium of the cervical canal and adjacent tissues, with which it would be possible to directly influence the "brushes" formed during the disease process and stimulate reparative processes in the mucosa of the cervical canal. The technical result of this invention is that in the course of treatment, loosening of the mucous membrane of the cervical canal, opening of the "brushes" and repair of the mucosa occur. In addition, the invention allows to expand the arsenal of agents used to treat endocervicitis.

 This result is achieved by the fact that in the treatment of endocervicitis, in which the mucous membrane and adjacent tissues of the cervical canal are simultaneously exposed to a low-frequency galvanic or pulsed monopolar current and drug ions introduced into the tissues (electrophoresis), they use a one percent solution of dioxidine at the beginning of the course of treatment, and in the end - sofradex, while dioxidine is administered daily under the control of smear results and objective examination data before opening the “brushes”.

 In this case, one electrode is a conical intracervical electrode, introduced together with the gasket moistened with a medicinal substance into the cervical canal.

 The method is as follows.

 The procedure is performed on a gynecological chair using the well-known apparatus "Potok". For the procedure, special cervical electrodes were used, made in the form of a cone with a limiter made of electrically conductive material (metal, graphite). Using a gynecological mirror, the working part of the electrode is inserted into the cervical canal with a pad moistened with a 1% dioxidine solution. The folding mirror is not removed during the procedure. The second electrode (cathode) measuring 10x12 cm, the pad is moistened with water, located under the sacrum. Current strength up to 7 mA. The duration of the procedure is 15 to 20 minutes.

 Electrophoresis procedures of 1% dioxidine are carried out daily, excluding the period of menstruation, in total up to 10 - 12 procedures (depending on the results of smears, objective examination data and colposcopy results) before opening the brushes.

 Then, in the same way, 5 to 10 procedures of endocervical electrophoresis of sofradex were performed.

 These effects led to loosening of the mucous membrane, opening of the "brushes" into the cavity of the cervical canal and its somination, contributed to the strengthening of reparative processes in the mucosa of the cervical canal.

 A second course of treatment aimed at preventing recurrence of endocervicitis was carried out through one or two menstrual cycles.

The observed patients were divided into groups depending on age (up to 25 years old, 25-30 years old, older than 35 years old) and disease duration (up to 1 year, 1-5 years old, more than 5 years old), but the dependence of treatment results on the duration of the disease and age of patients is not noted. (tab.)
Example. Patient S., born in 1970, first contacted the Family Center in 1993 about infertility. The husband is examined, healthy. When applying complaints did not show. In the analysis of smear L in large quantities, the cytogram is the cytogram of inflammation, with colposcopy and upon examination, the picture of endocervicitis. Diagnosis: Endocervicitis.

 Appointed: trichopolum, tetracycline, cervical treatment with chlorhexidine, tampons with “levomikol”. After treatment, the amount of L in the smear from the cervical canal is 25-30, the cytogram of inflammation, colposcopically - endocervicitis.

 During 1994, she was treated three times with antibiotics, received local treatment - treatment of the cervix with hydrogen peroxide, baths with chlorophyllint, tampons with Levomekol. In January 1995, smear tests returned to normal, kimopertubation was performed, after which endocervicitis recurred. Antibacterial therapy was again carried out (tetracycline with levorin, trichopolum, vitamin therapy, topically hydrogen peroxide baths, tampons with Levomekol, vaginal clotrimazole. No effect. Directed to FTL (IV 1995). 2 courses of treatment with endocervical electrophoresis 1% were performed. dioxidine followed by e / f Sofradex.

 During the first course, the patient received 11 endocervical electrophoresis procedures, 11 dioxidine and 2 sofradex endocervical electrophoresis procedures. Already after the 7th procedure, the number of leukocytes in the smear from the cervical canal decreased to 15-18, after 10 the smear normalized.

 The course was interrupted after 13 procedures due to the onset of menstruation. After menstruation, analyzes of the smear from the cervical canal are normal, the cytogram is without features. Colposcopy was performed after 3 weeks - without features.

 After 2 menstrual cycles, a course of anti-relapse treatment was carried out. 7 procedures of endocervical electrophoresis of 1% dioxidine and 3 procedures of endocervical electrophoresis of sofradex. Smear analyzes, cytogram, colposcopy - without features. After this, the patient underwent hysteroscopy, diagnostic laparoscopy (I 1996), and kimopertubation (procedures previously postponed due to poor analyzes).

 All observed patients tolerated treatment well. The treatment showed high efficiency of this method. In 79 patients (57%), recovery occurred, in 23 (17%) caused prolonged remission, in 35 (26%), improvement did not occur. Data confirmed by laboratory tests and colposcopy results.

 The control group consisted of 30 patients who received galvanization of the cervical canal. Improvement occurred in 2 patients (7%).

 Thus, the conducted studies allow us to consider endocervical electrophoresis of dioxidine and sofradex as the method of choice in the complex treatment of endocervicitis.

Sources of information
1. V.I.Bodyankina, L.M. Vasilevskaya, V.M. Strugatsky "Diagnosis and treatment of gynecological diseases in the antenatal clinic." M., Medicine, 1980

 2. "Means and methods of treating chronic inflammatory diseases of the internal genital organs." M., Medicine, 1978

 3. V. M. Strugatsky "Physical factors in obstetrics and gynecology." M., Medicine, 1981, p. 126.

Claims (1)

 A method of treating endocervicitis, in which electrophoresis of the drug is carried out simultaneously on the mucous membrane and adjacent tissues of the cervical canal, characterized in that at the beginning of the course of treatment, a one percent solution of dioxidine is used as a drug, which is administered daily under the control of smear results and objective examination data for opening " brushes ", and at the end of the course, Sofradex is used as a medicinal substance.

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