akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2020.107akusherstvo-800Research ArticleREVIEW ARTICLESНАУЧНЫЕ ОБЗОРЫCurrent aspects of pathogenesis and prophylaxis of pelvic adhesionsСовременные аспекты патогенеза и профилактики спаечного процесса органов малого тазаhttps://orcid.org/0000-0002-8882-8317ПучкинаГ. А.PuchkinaG. A.

Пучкина Галина Анатольевна – ассистент кафедры акушерства, гинекологии и перинатологии № 1

Россия, 295006 Республика Крым, Симферополь, бульвар Ленина, д. 5/7

Galina A. Puchkina – Assistant, Department of Obstetrics, Gynecology and Perinatology № 1

5/7 Lenin Boulevard, Simferopol, Republic of Crimea 295006, Russia

puchkina.g.a@mail.ruhttps://orcid.org/0000-0002-2671-6985СулимаА. Н.SulimaA. N.

Сулима Анна Николаевна – д.м.н., профессор кафедры акушерства, гинекологии и перинатологии № 1

Россия, 295006 Республика Крым, Симферополь, бульвар Ленина, д. 5/7

Anna N. Sulima – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatology № 1

5/7 Lenin Boulevard, Simferopol, Republic of Crimea 295006, Russia

Медицинская академия имени С.И. Георгиевского ФГАОУ ВО «Крымский федеральный университет имени В.И. Вернадского»РоссияMedical Academy named after S.I. Georgievsky, Crimean Federal University named after V.I. VernadskyRussian Federation202014102020144523533Copyright © Puchkina G.A., Sulima A.N., 20202020Пучкина Г.А., Сулима А.Н.Puchkina G.A., Sulima A.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/800Introduction

Introduction. Adhesive process of the pelvic organs is a pressing issue for operative gynecology that does not allow to consider results of therapeutic and preventive measures as sufficient.

Aim

Aim: to analyze published data regarding contemporary aspects of etiopathogenesis of the adhesive process in pelvic organs as well as methods of its prevention.

Materials and Methods

Materials and Methods. The literature sources retrieved from electronic databases PubMed, Embase, Medline, Ovid HealthSTAR, Cochrane, Google Scholar, eLibrary, CyberLeninka as well as scientific articles published in peer-reviewed open access journals over the last 30 years, including basic research in the field have been analyzed. While searching, the following keywords and their combinations in Russian and English were used: "adhesive process of the pelvic organs", "pathogenesis of the adhesive process", "prevention of the adhesive process", "gynecology", "pelvic adhesions", "pathogenesis of adhesions", "аdhesion prophylaxis", "gynecology".

Results

Results. The current aspects of the etiology and pathogenesis for adhesive process have been summarized. Existing adhesion classifications are presented. The proposed methods for preventing formation of peritoneal adhesions are described exerting most prominent effectiveness as well as describing the properties and characteristics according to the application method, the composition of contained substances and drug form. A phenotype profile of peripheral blood and peritoneal fluid lymphocytes from patients with adhesive process remains debated.

Conclusion

Conclusion. A need to further examine formation of peritoneal adhesions at molecular and cellular levels for developing a comprehensive pathogenetically substantiated method to prevent and treat adhesions of the pelvic organs is in demand.

Введение

Введение. Спаечный процесс органов малого таза является актуальной проблемой оперативной гинекологии, в отношении которого результаты лечебно-профилактических мероприятий нельзя считать достаточными.

Цель

Цель: анализ литературных данных о современных аспектах этиопатогенеза спаечного процесса органов малого таза и методах его профилактики.

Материалы и методы

Материалы и методы. Проанализированы литературные источники электронных баз данных PubMed, Embase, Medline, Ovid HealthSTAR, Cochrane, Google Scholar, eLibrary, CyberLeninka и научные статьи в рецензируемых журналах с открытым доступом за последние 30 лет, включая базовые исследования по данной патологии. В ходе поиска использовали ключевые слова и их сочетания на русском и на английском языках: «спаечный процесс органов малого таза», «патогенез спаечного процесса», «профилактика спаечного процесса», «гинекология», «pelvic adhesions», «pathogenesis of adhesions», «adhesion prophylaxis», «gynecology».

Результаты

Результаты. Обобщены современные аспекты этиологии и патогенеза спаечного процесса. Представлены существующие классификации спаечного процесса. Изложены предлагаемые способы профилактики формирования перитонеальных спаек, обладающие наиболее значимой эффективностью с описанием свойств и характеристик по способу их использования, составу входящих в них веществ и форме выпуска. Дискутабельным остается вопрос о фенотипическом профиле лимфоцитов в крови и перитонеальной жидкости пациенток со спаечным процессом.

Заключение

Заключение. Существует необходимость дальнейшего изучения формирования перитонеальных спаек на молекулярном и клеточном уровнях с целью разработки комплексного патогенетически обоснованного способа профилактики и лечения спаечного процесса органов малого таза.

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The authors declare that there are no conflicts of interest present.