PATHOGENETIC SIGNIFICANCE OF LOCAL HYPOXIA IN THE EFFECTIVENESS OF TREATMENT OF VAGINAL INFECTION
The analysis of the results of treatment of 112 women with chronic infectious vulvovaginitis was carried out. All study participants signed informed consent and an additional bilateral agreement on non-disclosure of personal data and the specifics of the study program. Depending on the oxygen content in the vaginal wall, according to oximetry data, the patients were divided into 2 groups. Group I included 68 women, whose coefficient of oxygen content in the wall of the vaginal mucosa (Kliz%) exceeded 97.0%. Group II consisted of 44 women, whose coefficient of oxygen content in the wall of the vaginal mucosa (Kliz%) was below 97.0%. Accordingly, in group I K-muc% was 97.9 ± 0.2%, and in group II - 96.5 ± 0.3%, while the differences in the indices of the K-muc% coefficient, reflecting the oxygen content in the vaginal wall before the start of treatment, were significant. (P <0.05). Treatment of patients was carried out in accordance with the "Clinical guidelines for the diagnosis and treatment of diseases accompanied by pathological discharge from the genital tract of women" of the Ministry of Health of the Russian Federation. The criteria for evaluating the effectiveness of standard treatment of an infectious vaginal pathology, taking into account the peculiarities of the association of microorganisms and sensitivity to antibacterial drugs, were the results of the analysis of clinical symptoms 14 days after treatment and the results of microscopic examination of a vaginal smear, with a mandatory assessment of local immunodeficiency, in which the number of "key cells" is assessed in the material under study, in which the standard indicators do not exceed 3.0%. An analysis of the clinical symptoms of an infectious vaginal pathology showed that 14 days after treatment, against the background of a local oxygen deficiency in group II, the clinical manifestation of vaginal pathology was detected significantly more often than in group I (P <0.05). Microscopic examination of the material from the vagina showed that in group II, against the background of local hypoxia, 14 days after completion of treatment, leukocytosis was significantly more often detected in the material from the vagina (P <0.05), which indicated a relapse of the inflammatory process in the vagina. At the same time, the frequency of detection of pathogenic microflora in the material from the vagina in group II exceeded the indicators in group I, but the differences were insignificant (P> 0.05). The frequency of detection of "key cells" in the material from the vagina, the number of which exceeded the permissible threshold of 3.0% in group II, where local hypoxia took place, was significantly higher than in group I (P <0.05). The results obtained indicated that against the background of hypoxia of the vaginal walls, the development of local immunodeficiency of its mucous membrane is noted, which negatively affects the results of treatment and increases the risk of recurrence of the pathological process. Evaluation of the effectiveness of general and local ozone therapy for the correction of local hypoxia of the mucous membrane in the treatment of chronic vulvovaginitis seems to be a promising direction for further research.