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            [PARAMS] => Array
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                    [FROM_IBLOCK] => 1
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                    [DEPTH_LEVEL] => 3
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            [DEPTH_LEVEL] => 3
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            [TEXT] => Удаление Фибромы
            [LINK] => /services/lechenie-kozhnykh-zabolevaniy/obrazovaniya-kozhi-i-slizistyh/fibroma/
            [SELECTED] => 
            [PERMISSION] => R
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                    [0] => /services/lechenie-kozhnykh-zabolevaniy/obrazovaniya-kozhi-i-slizistyh/fibroma/
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                    [0] => Удаление Фибромы
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            [DEPTH_LEVEL] => 3
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    [25] => Array
        (
            [TEXT] => Лечение базалиомы или базальноклеточного рака
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            [PERMISSION] => R
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            [IS_PARENT] => 
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    [26] => Array
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            [TEXT] => Лечение гемангиомы
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            [SELECTED] => 
            [PERMISSION] => R
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            [TEXT] => Лечение атеромы
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            [PERMISSION] => R
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            [TEXT] => Лечение грибка кожи и ногтей
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                    [0] => Лечение грибка кожи и ногтей
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            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [29] => Array
        (
            [TEXT] => Дерматология
            [LINK] => /services/lechenie-kozhnykh-zabolevaniy/dermatologiya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/lechenie-kozhnykh-zabolevaniy/dermatologiya/
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 29
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
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                    [DEPTH_LEVEL] => 2
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            [CHAIN] => Array
                (
                    [0] => Дерматология
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [30] => Array
        (
            [TEXT] => Антивозрастная физиотерапия
            [LINK] => /services/antivozrastnaya-fizioterapiya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 30
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 1
                    [DEPTH_LEVEL] => 1
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            [CHAIN] => Array
                (
                    [0] => Антивозрастная физиотерапия
                )

            [DEPTH_LEVEL] => 1
            [IS_PARENT] => 1
        )

    [31] => Array
        (
            [TEXT] => Поверхностная шлифовка лица
            [LINK] => /services/antivozrastnaya-fizioterapiya/shlifovka/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/shlifovka/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 31
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Поверхностная шлифовка лица
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [32] => Array
        (
            [TEXT] => Плазмолифтинг
            [LINK] => /services/antivozrastnaya-fizioterapiya/plazmolifting/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/plazmolifting/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 32
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Плазмолифтинг
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [33] => Array
        (
            [TEXT] => Устранение мимических морщин
            [LINK] => /services/antivozrastnaya-fizioterapiya/morshhiny/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/morshhiny/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 33
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Устранение мимических морщин
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [34] => Array
        (
            [TEXT] => Механическая алмазная микродермабразия
            [LINK] => /services/antivozrastnaya-fizioterapiya/mikrodermabraziya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/mikrodermabraziya/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 34
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Механическая алмазная микродермабразия
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [35] => Array
        (
            [TEXT] => Мезотерапия
            [LINK] => /services/antivozrastnaya-fizioterapiya/mezoterapiya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/mezoterapiya/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 35
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Мезотерапия
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [36] => Array
        (
            [TEXT] => Карбоновый пиллинг
            [LINK] => /services/antivozrastnaya-fizioterapiya/karbonovyy-pilling/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/karbonovyy-pilling/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 36
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Карбоновый пиллинг
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [37] => Array
        (
            [TEXT] => Коррекция объема и формы губ
            [LINK] => /services/antivozrastnaya-fizioterapiya/guby/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/guby/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 37
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Коррекция объема и формы губ
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [38] => Array
        (
            [TEXT] => Лечение гипергидроза
            [LINK] => /services/antivozrastnaya-fizioterapiya/gipergidroz/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/gipergidroz/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 38
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Лечение гипергидроза
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [39] => Array
        (
            [TEXT] => Фотоомолаживание кожи
            [LINK] => /services/antivozrastnaya-fizioterapiya/fotoomolozhenie/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/fotoomolozhenie/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 39
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Фотоомолаживание кожи
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [40] => Array
        (
            [TEXT] => Биоревитализация
            [LINK] => /services/antivozrastnaya-fizioterapiya/biorevitalizaciya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/biorevitalizaciya/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 40
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Биоревитализация
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [41] => Array
        (
            [TEXT] => Безинъекционная мезотерапия
            [LINK] => /services/antivozrastnaya-fizioterapiya/bezinekcionnaya-mezoterapiya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/bezinekcionnaya-mezoterapiya/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 41
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Безинъекционная мезотерапия
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [42] => Array
        (
            [TEXT] => Восстановление иммунитета
            [LINK] => /services/vosstanovlenie-immuniteta/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/vosstanovlenie-immuniteta/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 42
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 1
                    [DEPTH_LEVEL] => 1
                )

            [CHAIN] => Array
                (
                    [0] => Восстановление иммунитета
                )

            [DEPTH_LEVEL] => 1
            [IS_PARENT] => 1
        )

    [43] => Array
        (
            [TEXT] => Аллергический ринит
            [LINK] => /services/immunologiya-i-allergologiya/allergicheskiy-rinit/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 43
            [PARAMS] => Array
                (
                    [SHITTY] => 1
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Аллергический ринит
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [44] => Array
        (
            [TEXT] => Гинекология
            [LINK] => /services/ginekologiya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 44
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 1
                    [DEPTH_LEVEL] => 1
                )

            [CHAIN] => Array
                (
                    [0] => Гинекология
                )

            [DEPTH_LEVEL] => 1
            [IS_PARENT] => 1
        )

    [45] => Array
        (
            [TEXT] => Лечение вульвовагинита
            [LINK] => /services/ginekologiya/vulvovaginit/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/vulvovaginit/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 45
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Лечение вульвовагинита
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [46] => Array
        (
            [TEXT] => Лечение вульвита
            [LINK] => /services/ginekologiya/vulvit/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/vulvit/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 46
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Лечение вульвита
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [47] => Array
        (
            [TEXT] => Лечение вагинита
            [LINK] => /services/ginekologiya/vaginit/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/vaginit/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 47
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Лечение вагинита
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [48] => Array
        (
            [TEXT] => Лечение спаек
            [LINK] => /services/ginekologiya/spajki-prichina-besplodiya.-spajki/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/spajki-prichina-besplodiya.-spajki/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 48
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Лечение спаек
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [49] => Array
        (
            [TEXT] => Лечение сальпингоофорита (аднексита)
            [LINK] => /services/ginekologiya/salpingooforit-adneksit/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/salpingooforit-adneksit/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 49
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Лечение сальпингоофорита (аднексита)
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [50] => Array
        (
            [TEXT] => Плазмолифтинг в гинекологии
            [LINK] => /services/ginekologiya/plazmolifting-v-ginekologii/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/plazmolifting-v-ginekologii/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 50
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Плазмолифтинг в гинекологии
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [51] => Array
        (
            [TEXT] => Фотодинамическая терапия в гинекологии
            [LINK] => /services/ginekologiya/fotodinamicheskaya-terapiya-v-ginekologii/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/fotodinamicheskaya-terapiya-v-ginekologii/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 51
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 1
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Фотодинамическая терапия в гинекологии
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 1
        )

    [52] => Array
        (
            [TEXT] => Лечение лейкоплакии вульвы и шейки матки
            [LINK] => /services/ginekologiya/fotodinamicheskaya-terapiya-v-ginekologii/lechenie-leykoplakii-s-pomoshchyu-fdt/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/fotodinamicheskaya-terapiya-v-ginekologii/lechenie-leykoplakii-s-pomoshchyu-fdt/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 52
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 3
                )

            [CHAIN] => Array
                (
                    [0] => Лечение лейкоплакии вульвы и шейки матки
                )

            [DEPTH_LEVEL] => 3
            [IS_PARENT] => 
        )

    [53] => Array
        (
            [TEXT] => Фотодинамическая терапия вульвы
            [LINK] => /services/ginekologiya/fotodinamicheskaya-terapiya-v-ginekologii/fotodinamicheskaya-terapiya-vulvy/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/fotodinamicheskaya-terapiya-v-ginekologii/fotodinamicheskaya-terapiya-vulvy/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 53
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 3
                )

            [CHAIN] => Array
                (
                    [0] => Фотодинамическая терапия вульвы
                )

            [DEPTH_LEVEL] => 3
            [IS_PARENT] => 
        )

    [54] => Array
        (
            [TEXT] => Фотодинамическая терапия шейки матки
            [LINK] => /services/ginekologiya/fotodinamicheskaya-terapiya-v-ginekologii/fotodinamicheskaya-terapiya-sheyki-matki/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/fotodinamicheskaya-terapiya-v-ginekologii/fotodinamicheskaya-terapiya-sheyki-matki/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 54
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 3
                )

            [CHAIN] => Array
                (
                    [0] => Фотодинамическая терапия шейки матки
                )

            [DEPTH_LEVEL] => 3
            [IS_PARENT] => 
        )

    [55] => Array
        (
            [TEXT] => Лечение оофорита
            [LINK] => /services/ginekologiya/ooforit/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/ooforit/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 55
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Лечение оофорита
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [56] => Array
        (
            [TEXT] => Лечение миомы матки
            [LINK] => /services/ginekologiya/mioma-matki/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/mioma-matki/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 56
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Лечение миомы матки
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [57] => Array
        (
            [TEXT] => Лечение лейкоплакии
            [LINK] => /services/ginekologiya/lejkoplakiya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/lejkoplakiya/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 57
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 1
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Лечение лейкоплакии
                )

            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 1
        )

    [58] => Array
        (
            [TEXT] => Лейкоплакия вульвы
            [LINK] => /services/ginekologiya/lejkoplakiya/leykoplakiya-vulvy/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/lejkoplakiya/leykoplakiya-vulvy/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 58
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 3
                )

            [CHAIN] => Array
                (
                    [0] => Лейкоплакия вульвы
                )

            [DEPTH_LEVEL] => 3
            [IS_PARENT] => 
        )

    [59] => Array
        (
            [TEXT] => Лейкоплакия шейки матки
            [LINK] => /services/ginekologiya/lejkoplakiya/leykoplakiya-sheyki-matki/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/lejkoplakiya/leykoplakiya-sheyki-matki/
                )

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 59
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 3
                )

            [CHAIN] => Array
                (
                    [0] => Лейкоплакия шейки матки
                )

            [DEPTH_LEVEL] => 3
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        )

    [60] => Array
        (
            [TEXT] => Лазерная терапия в гинекологии
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            [PERMISSION] => R
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            [DEPTH_LEVEL] => 2
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [DEPTH_LEVEL] => 2
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    [62] => Array
        (
            [TEXT] => Лечение эрозия шейки матки
            [LINK] => /services/ginekologiya/eroziya-shejki-matki/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [ITEM_TYPE] => D
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                    [FROM_IBLOCK] => 1
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            [DEPTH_LEVEL] => 2
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    [63] => Array
        (
            [TEXT] => Лечение эндометрита
            [LINK] => /services/ginekologiya/endometrit/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/endometrit/
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 63
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                    [FROM_IBLOCK] => 1
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                    [0] => Лечение эндометрита
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    [64] => Array
        (
            [TEXT] => Лечение эндоцервицита (цервицита)
            [LINK] => /services/ginekologiya/endocervicit-cervicit/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [ITEM_TYPE] => D
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                    [FROM_IBLOCK] => 1
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        (
            [TEXT] => Лечение дисплазии шейки матки
            [LINK] => /services/ginekologiya/displaziya-shejki-matki/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [TEXT] => Лечение бартолинита
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            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [FROM_IBLOCK] => 1
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                    [0] => Лечение бартолинита
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            [DEPTH_LEVEL] => 2
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        (
            [TEXT] => Лечение бактериального вагиноза
            [LINK] => /services/ginekologiya/bakterialnyj-vaginoz/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                (
                    [FROM_IBLOCK] => 1
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                    [DEPTH_LEVEL] => 2
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                    [0] => Лечение бактериального вагиноза
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            [DEPTH_LEVEL] => 2
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        (
            [TEXT] => Диагностика аппаратная
            [LINK] => /services/diagnostika-apparatnaya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => Диагностика аппаратная
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    [69] => Array
        (
            [TEXT] => Видеокольпоскопия
            [LINK] => /services/diagnostika-apparatnaya/videokolposkopiya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [FROM_IBLOCK] => 1
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                    [0] => Видеокольпоскопия
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            [DEPTH_LEVEL] => 2
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        (
            [TEXT] => Спектрально-флюоресцентная диагностика
            [LINK] => /services/diagnostika-apparatnaya/spektralno-flyuorescentnaya-diagnostika/
            [SELECTED] => 
            [PERMISSION] => R
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            [DEPTH_LEVEL] => 2
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        (
            [TEXT] => Кардиовизор
            [LINK] => /services/diagnostika-apparatnaya/kardiovizor/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => /services/diagnostika-apparatnaya/kardiovizor/
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                    [0] => Кардиовизор
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            [DEPTH_LEVEL] => 2
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        (
            [TEXT] => Функциональная компьютерная диагностика
            [LINK] => /services/diagnostika-apparatnaya/funkcionalnaya-kompyuternaya-diagnostika/
            [SELECTED] => 
            [PERMISSION] => R
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            [DEPTH_LEVEL] => 2
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    [73] => Array
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            [TEXT] => Дерматоскопия
            [LINK] => /services/diagnostika-apparatnaya/dermatoskopiya/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [FROM_IBLOCK] => 1
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                    [0] => Дерматоскопия
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            [DEPTH_LEVEL] => 2
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    [74] => Array
        (
            [TEXT] => Избавление от татуировок и татуажа
            [LINK] => /services/izbavlenie-ot-tatuirovok-i-tatuazha/
            [SELECTED] => 
            [PERMISSION] => R
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                    [FROM_IBLOCK] => 1
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            [DEPTH_LEVEL] => 1
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    [75] => Array
        (
            [TEXT] => Реабилитация после травм и операций
            [LINK] => /services/reabilitaciya-posle-travm-i-operacij/
            [SELECTED] => 
            [PERMISSION] => R
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                    [0] => /services/reabilitaciya-posle-travm-i-operacij/
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                    [FROM_IBLOCK] => 1
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                    [0] => Реабилитация после травм и операций
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            [DEPTH_LEVEL] => 1
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    [76] => Array
        (
            [TEXT] => Фотодинамическая терапия
            [LINK] => /services/fotodinamicheskaya-terapiya/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => /services/fotodinamicheskaya-terapiya/
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                    [0] => Фотодинамическая терапия
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    [77] => Array
        (
            [TEXT] => Фотодинамическая терапия в онкологии
            [LINK] => /services/onkologiya/fotodinamicheskaya-terapiya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [SHITTY] => 1
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    [78] => Array
        (
            [TEXT] => Фотодинамическая терапия в гинекологии
            [LINK] => /services/ginekologiya/fotodinamicheskaya-terapiya-v-ginekologii/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
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                    [SHITTY] => 1
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            [CHAIN] => Array
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    [79] => Array
        (
            [TEXT] => Фотодинамическая терапия в стоматологии
            [LINK] => /services/fotodinamicheskaya-terapiya/fotodinamicheskaya-terapiya-v-stomatologii/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [FROM_IBLOCK] => 1
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                    [DEPTH_LEVEL] => 2
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                    [0] => Фотодинамическая терапия в стоматологии
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            [DEPTH_LEVEL] => 2
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            [TEXT] => Фотодинамическая терапия в дерматологии
            [LINK] => /services/fotodinamicheskaya-terapiya/fotodinamicheskaya-terapiya-v-dermatologii/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/fotodinamicheskaya-terapiya/fotodinamicheskaya-terapiya-v-dermatologii/
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            [ITEM_INDEX] => 80
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                    [FROM_IBLOCK] => 1
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                    [0] => Фотодинамическая терапия в дерматологии
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            [DEPTH_LEVEL] => 2
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    [81] => Array
        (
            [TEXT] => Неврология
            [LINK] => /services/nevrologiya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/nevrologiya/
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            [ITEM_TYPE] => D
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                    [FROM_IBLOCK] => 1
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            [CHAIN] => Array
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                    [0] => Неврология
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            [DEPTH_LEVEL] => 1
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    [82] => Array
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            [TEXT] => Озонотерапия
            [LINK] => /services/ozonoterapiya/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => /services/ozonoterapiya/
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            [ITEM_TYPE] => D
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                    [FROM_IBLOCK] => 1
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            [CHAIN] => Array
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                    [0] => Озонотерапия
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    [83] => Array
        (
            [TEXT] => Озонотерапия в гинекологии
            [LINK] => /services/ozonoterapiya/ozonoterapiya-v-ginekologii/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [FROM_IBLOCK] => 1
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            [CHAIN] => Array
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                    [0] => Озонотерапия в гинекологии
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            [DEPTH_LEVEL] => 2
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    [84] => Array
        (
            [TEXT] => Восстановление легких после Covid-19
            [LINK] => /services/ozonoterapiya/vosstanovlenie-legkikh-posle-covid-19/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => Восстановление легких после Covid-19
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            [LINK] => /services/ozonoterapiya/lechenie-legkikh-posle-pnevmonii/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => /services/ozonoterapiya/lechenie-legkikh-posle-pnevmonii/
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                    [FROM_IBLOCK] => 1
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                    [DEPTH_LEVEL] => 2
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            [CHAIN] => Array
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                    [0] => Лечение легких после пневмонии
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            [IS_PARENT] => 
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    [86] => Array
        (
            [TEXT] => Озонотерапия внутренних органов
            [LINK] => /services/ozonoterapiya/ozonoterapiya-vnutrennikh-organov/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ozonoterapiya/ozonoterapiya-vnutrennikh-organov/
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 86
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
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                    [DEPTH_LEVEL] => 2
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            [CHAIN] => Array
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                    [0] => Озонотерапия внутренних органов
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            [DEPTH_LEVEL] => 2
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    [87] => Array
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            [TEXT] => Кислородная терапия
            [LINK] => /services/kislorodnaya-terapiya/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/kislorodnaya-terapiya/
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            [DEPTH_LEVEL] => 1
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            [TEXT] => Комплексное лечение
            [LINK] => /services/kompleksnoe-lechenie/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => /services/kompleksnoe-lechenie/
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    [89] => Array
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            [TEXT] => Лазерная терапия
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            [PERMISSION] => R
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                (
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            [CHAIN] => Array
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            [TEXT] => Лечение аллергии
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => Лечение аллергии
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            [DEPTH_LEVEL] => 1
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    [91] => Array
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            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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    [96] => Array
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [ADDITIONAL_LINKS] => Array
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            [ADDITIONAL_LINKS] => Array
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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)

Лечение пяточной шпоры

лечение пяточной шпоры

Отложение солей кальция на нижней части пяточной кости является причиной формирования пяточной шпоры. Новообразование представляет собой остроконечный шип, который вырастает до 1 см и более. Он сдавливает окружающие ткани и причиняет боль. Патология носит самостоятельный характер, а также может проявляться на фоне других заболеваний (артриты).

Заболевание возникает на месте крепления связки к пяточной кости. Из-за частых микротравм, воспаления или чрезмерных нагрузок на пяточную кость на этом месте начинают откладываться соли кальция и образуется остеофит.

Пяточная шпора регистрируется в 10% случаев заболеваний опорно-двигательного аппарата. Наблюдается в любом возрасте, но характерно для лиц старше 40, особенно женщин в климактерическом периоде.

Поводом обращения к врачу служит боль. Она сначала присутствует при ходьбе или вставании, а затем и в состоянии покоя.

Причины

Отложение солей на месте крепления связки к пяточной кости — процесс долгий и протекает в течение нескольких месяцев. Развивается оно на фоне различных заболеваний, таких как:

  • Плоскостопие (встречается у пациентов в 90% случаев). При этом меняется распределение нагрузки на стопу - оно переключается на пятку. В результате происходит перенатяжение сухожилия и его воспаление. Возможны даже травмы и разрывы.

  • Атеросклероз сосудов нижних конечностей. Плохая проходимость сосудов ног приводит к нарушению кровоснабжения в них.

  • Подагра (как следствие нарушения обмена веществ).

  • Воспалительные заболевания суставов: артриты, полиартриты, болезнь Бехтерева и др.

  • Сахарный диабет.

Что может привести к отложению солей:

  • Неудобная и узкая обувь.

  • Бег на твердой поверхности или прыжки.

  • Лишний вес.

  • Возраст.

  • Беременность.

Подвержены этому заболеванию люди, которые по роду своей деятельности вынуждены большее количество времени проводить стоя. Особенно это касается женщин, которые носят узкие туфли на высоком каблуке.

причины появления пяточной шпоры

Симптомы

Главные клинический признак болезни — боль, не всегда может проявляться, а лишь в 5% случаев. Также следует отметить, что симптомы часто обусловлены не наличием шпоры как таковой, а изменениями в мягких тканях.

Клиническая картина:

  • Боль в пятке, которая постепенно проходит при ходьбе. Она возникает при вставании после сна или долгого отдыха. Локализуется она либо в одном месте, либо ощущается по всей пятке.

  • Боли после физической активности.

  • Чувство гвоздя или булавки в пятке.

  • Болезненность при прощупывании.

  • Отёк пяточной области.

  • Ограничение подвижности стопы.

  • Наличие мозолей.

Неприятные ощущения возникают при травмировании прилежащих тканей и от величины шпоры не зависят. Характер боли может быть разным. Сначала она бывает острой, внезапной; затем становится хронической, постепенно нарастающей и тупой.

Диагностика

Диагноз устанавливается по данным анамнеза и клинических признаков болезни, а также при осмотре врачом. Назначают такие методы исследования:

  • Рентгенография. Шпора на снимке хорошо визуализируется. Это даёт возможность отличить её от перелома и артроза.

  • МРТ дает представление о состоянии не только пяточной кости, но и окружающих мягких тканей.

  • УЗИ в отличие от предыдущего метода может проводиться часто, особенно при оценке эффективности лечения. Показывает состояние не только пяточной шпоры, но и окружающих мягких тканей.

  • Назначаются также общий и биохимический анализ крови и анализ мочи.

При игнорировании лечения развиваются осложнения в виде нарушения походки и развития плоскостопия.

диагностика пяточной шпоры

Лечение

Для успешного выздоровления нужно создать разгрузку пораженной области. Для этого используются специальные ортопедические стельки. Терапия зависит от причины и стадии развития патологии. Так, если шпора развивается на фоне какого-либо заболевания, то надо в первую очередь лечить его, а затем заниматься пяткой.

Назначаются нестероидные противовоспалительные препараты, а также медикаменты для местного применения, хондропротекторы. Это могут быть гели, мази, кремы с обезболивающим, противовоспалительным эффектом.

Проводят комплекс мероприятий, направленных на улучшение кровоснабжения пораженной области:

  • Массажи.

  • Грязелечение.

  • Лечебная гимнастика.

  • Минеральные ванны.

Для того чтобы лекарственные препараты лучше усвоились назначают такие процедуры:

  • Электрофорез (воздействие электрического тока).

  • Ультразвуковая терапия.

После затухания воспаления назначают УВТ (ударно-волновая терапия). Суть лечения в том, что под воздействием ультразвуковых импульсов кальциевые наросты разбиваются и выводятся из места поражения вместе с кровотоком. Процедура эффективна вместе с проведением инъекций лекарственных веществ. Есть некоторые противопоказания:

  • Беременность.

  • Низкое АД.

  • Инфекционные болезни.

  • Отравление и интоксикация.

  • Болезни сердца.

  • Нарушение свертываемости крови.

  • Злокачественные опухоли.

  • Тромбофлебит в пораженной области.

противопоказания к лечению пяточной шпоры

В настоящее время доказана эффективность магнито-лазерной терапии, которая

проводится в нашей клинике. Уже через 1 курс лечения пациенты на длительное время избавляются от боли и воспаления. Лечение такими лазерами безболезненно, не вызывает дискомфорта и практически лишено противопоказаний. Оно особенно показано лицам, страдающим аллергическими реакциями на медикаменты.

В сильно запущенных случаях, когда консервативное лечение не помогает, прибегают к оперативному удалению шпоры и окружающих пораженных тканей.

Чтобы не допустить развитие заболевания, нужно избегать воздействия неблагоприятных факторов. Для начала нужно организовать полноценное питание, сбалансированное по витаминам и минералам. Использовать только удобную и комфортную обувь. Заниматься профилактикой болезней, которые вызывают образование пяточных шпор. Снизить нагрузку на пятки и минимизировать травмы.

Имеются противопоказания. Необходима консультация специалиста.

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