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            [TEXT] => Лечение базалиомы или базальноклеточного рака
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    [25] => 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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    [29] => Array
        (
            [TEXT] => Антивозрастная физиотерапия
            [LINK] => /services/antivozrastnaya-fizioterapiya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [FROM_IBLOCK] => 1
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                    [0] => Антивозрастная физиотерапия
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            [DEPTH_LEVEL] => 1
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    [30] => Array
        (
            [TEXT] => Поверхностная шлифовка лица
            [LINK] => /services/antivozrastnaya-fizioterapiya/shlifovka/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/shlifovka/
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 30
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
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            [CHAIN] => Array
                (
                    [0] => Поверхностная шлифовка лица
                )

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

    [31] => Array
        (
            [TEXT] => Плазмолифтинг
            [LINK] => /services/antivozrastnaya-fizioterapiya/plazmolifting/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/plazmolifting/
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 31
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
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            [CHAIN] => Array
                (
                    [0] => Плазмолифтинг
                )

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

    [32] => Array
        (
            [TEXT] => Устранение мимических морщин
            [LINK] => /services/antivozrastnaya-fizioterapiya/morshhiny/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/morshhiny/
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 32
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
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            [CHAIN] => Array
                (
                    [0] => Устранение мимических морщин
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            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

    [33] => Array
        (
            [TEXT] => Механическая алмазная микродермабразия
            [LINK] => /services/antivozrastnaya-fizioterapiya/mikrodermabraziya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/mikrodermabraziya/
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 33
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
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            [CHAIN] => Array
                (
                    [0] => Механическая алмазная микродермабразия
                )

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

    [34] => Array
        (
            [TEXT] => Мезотерапия
            [LINK] => /services/antivozrastnaya-fizioterapiya/mezoterapiya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/antivozrastnaya-fizioterapiya/mezoterapiya/
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 34
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
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            [CHAIN] => Array
                (
                    [0] => Мезотерапия
                )

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    [40] => 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] => 40
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
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            [CHAIN] => Array
                (
                    [0] => Безинъекционная мезотерапия
                )

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

    [41] => Array
        (
            [TEXT] => Восстановление иммунитета
            [LINK] => /services/vosstanovlenie-immuniteta/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/vosstanovlenie-immuniteta/
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 41
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
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                    [DEPTH_LEVEL] => 1
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            [CHAIN] => Array
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                    [0] => Восстановление иммунитета
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            [DEPTH_LEVEL] => 1
            [IS_PARENT] => 1
        )

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

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 42
            [PARAMS] => Array
                (
                    [SHITTY] => 1
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Аллергический ринит
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            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

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

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 43
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 1
                    [DEPTH_LEVEL] => 1
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            [CHAIN] => Array
                (
                    [0] => Гинекология
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            [DEPTH_LEVEL] => 1
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    [44] => Array
        (
            [TEXT] => Лечение вульвовагинита
            [LINK] => /services/ginekologiya/vulvovaginit/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/ginekologiya/vulvovaginit/
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 44
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
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            [CHAIN] => Array
                (
                    [0] => Лечение вульвовагинита
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            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

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

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

            [CHAIN] => Array
                (
                    [0] => Лечение вульвита
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            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

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

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

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

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

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

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

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

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

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

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

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

            [CHAIN] => Array
                (
                    [0] => Плазмолифтинг в гинекологии
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            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
        )

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

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

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

    [51] => 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] => 51
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 3
                )

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

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

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

            [CHAIN] => Array
                (
                    [0] => Фотодинамическая терапия вульвы
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            [DEPTH_LEVEL] => 3
            [IS_PARENT] => 
        )

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

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

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

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

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 54
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

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

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

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

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

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

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

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

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

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

    [57] => 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] => 57
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 3
                )

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

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

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

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

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

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

            [ITEM_TYPE] => D
            [ITEM_INDEX] => 59
            [PARAMS] => Array
                (
                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
                )

            [CHAIN] => Array
                (
                    [0] => Лазерная терапия в гинекологии
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            [DEPTH_LEVEL] => 2
            [IS_PARENT] => 
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            [PERMISSION] => R
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            [DEPTH_LEVEL] => 2
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    [61] => 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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        )

    [62] => 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
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                    [FROM_IBLOCK] => 1
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                    [0] => Лечение эндометрита
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    [63] => 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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    [64] => Array
        (
            [TEXT] => Лечение дисплазии шейки матки
            [LINK] => /services/ginekologiya/displaziya-shejki-matki/
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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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                    [0] => Лечение дисплазии шейки матки
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        (
            [TEXT] => Лечение бартолинита
            [LINK] => /services/ginekologiya/bartolinit/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => /services/ginekologiya/bartolinit/
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            [ITEM_TYPE] => D
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                    [FROM_IBLOCK] => 1
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                    [0] => Лечение бартолинита
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    [66] => Array
        (
            [TEXT] => Лечение бактериального вагиноза
            [LINK] => /services/ginekologiya/bakterialnyj-vaginoz/
            [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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                    [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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                    [FROM_IBLOCK] => 1
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                    [0] => Диагностика аппаратная
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    [68] => 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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                    [FROM_IBLOCK] => 1
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                    [0] => Спектрально-флюоресцентная диагностика
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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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                    [FROM_IBLOCK] => 1
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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/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => 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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                    [0] => Дерматоскопия
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            [DEPTH_LEVEL] => 2
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    [73] => Array
        (
            [TEXT] => Избавление от татуировок и татуажа
            [LINK] => /services/izbavlenie-ot-tatuirovok-i-tatuazha/
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            [PERMISSION] => R
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                    [FROM_IBLOCK] => 1
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    [74] => 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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        (
            [TEXT] => Фотодинамическая терапия
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => Фотодинамическая терапия
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        (
            [TEXT] => Фотодинамическая терапия в онкологии
            [LINK] => /services/onkologiya/fotodinamicheskaya-terapiya/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [ITEM_TYPE] => D
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                    [SHITTY] => 1
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        (
            [TEXT] => Фотодинамическая терапия в гинекологии
            [LINK] => /services/ginekologiya/fotodinamicheskaya-terapiya-v-ginekologii/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
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            [ITEM_TYPE] => D
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                    [SHITTY] => 1
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    [78] => Array
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            [TEXT] => Фотодинамическая терапия в стоматологии
            [LINK] => /services/fotodinamicheskaya-terapiya/fotodinamicheskaya-terapiya-v-stomatologii/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => /services/fotodinamicheskaya-terapiya/fotodinamicheskaya-terapiya-v-stomatologii/
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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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            [TEXT] => Фотодинамическая терапия в дерматологии
            [LINK] => /services/fotodinamicheskaya-terapiya/fotodinamicheskaya-terapiya-v-dermatologii/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => /services/fotodinamicheskaya-terapiya/fotodinamicheskaya-terapiya-v-dermatologii/
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            [ITEM_INDEX] => 79
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                    [FROM_IBLOCK] => 1
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            [DEPTH_LEVEL] => 2
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        (
            [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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                    [0] => Неврология
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    [81] => 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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            [CHAIN] => Array
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                    [0] => Озонотерапия
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    [82] => Array
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            [TEXT] => Озонотерапия в гинекологии
            [LINK] => /services/ozonoterapiya/ozonoterapiya-v-ginekologii/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [PARAMS] => 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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    [83] => Array
        (
            [TEXT] => Восстановление легких после Covid-19
            [LINK] => /services/ozonoterapiya/vosstanovlenie-legkikh-posle-covid-19/
            [SELECTED] => 
            [PERMISSION] => R
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                    [0] => /services/ozonoterapiya/vosstanovlenie-legkikh-posle-covid-19/
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                    [0] => Восстановление легких после Covid-19
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            [TEXT] => Лечение легких после пневмонии
            [LINK] => /services/ozonoterapiya/lechenie-legkikh-posle-pnevmonii/
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            [PERMISSION] => R
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                    [0] => /services/ozonoterapiya/lechenie-legkikh-posle-pnevmonii/
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                    [FROM_IBLOCK] => 1
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    [85] => Array
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            [TEXT] => Озонотерапия внутренних органов
            [LINK] => /services/ozonoterapiya/ozonoterapiya-vnutrennikh-organov/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => /services/ozonoterapiya/ozonoterapiya-vnutrennikh-organov/
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 85
            [PARAMS] => Array
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                    [FROM_IBLOCK] => 1
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                    [DEPTH_LEVEL] => 2
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    [86] => Array
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            [TEXT] => Кислородная терапия
            [LINK] => /services/kislorodnaya-terapiya/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => /services/kislorodnaya-terapiya/
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                    [0] => Кислородная терапия
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    [87] => Array
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            [TEXT] => Комплексное лечение
            [LINK] => /services/kompleksnoe-lechenie/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/kompleksnoe-lechenie/
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    [88] => Array
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            [TEXT] => Лазерная терапия
            [LINK] => /services/lazernaya-terapiya/
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            [PERMISSION] => R
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                (
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    [89] => Array
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            [TEXT] => Лечение аллергии
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [CHAIN] => Array
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                    [0] => Лечение аллергии
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            [DEPTH_LEVEL] => 1
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    [90] => Array
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            [TEXT] => Аллергический ринит
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            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [FROM_IBLOCK] => 1
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            [CHAIN] => Array
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    [91] => Array
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                    [0] => /hidden/
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    [115] => Array
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Лечение рака шейки и тела матки, опухоли яичников

Патологии шейки матки и рак тела матки входят в число самых опасных и распространенных онкологических заболеваний женской репродуктивной системы наряду с таким заболеванием, как рак яичников - после рака груди и рака эндометрия. По данным ВОЗ, ежегодно в мире заболевают свыше 500 тыс. женщин, а умирает 200 тыс. женщин.

При этом в последнее десятилетие отмечена такая негативная тенденция, как увеличение количества больных с раком матки на IV стадии. По самой неутешительной оценке, их количество составляет до 47,3 %. Также следует отметить возрастную специфику - чаще всего раком шейки матки страдают женщины от 35 до 55 лет, соответственно, 20% больных - женщины старше 65 лет. В возрасте до 35 лет рак шейки матки встречается значительно реже. Российские показатели для первичных больных: 15,8% - рак матки на начальных стадиях; 39,5% - запущенный рак матки стадий III–IV.

Некоторые ценные наблюдения по вопросам эпидемиологии рака шейки матки были сделаны еще в позапрошлом веке. Итальянский врач Ригони-Штерн еще в 1842 году опубликовал анализ статистики летальных исходов рак шейки матки в Вероне за период с 1760 по 1830 г. Статистика показала, что рак матки приводил к смерти только тех женщин, у которых была регулярная половая жизнь. Летальных исходов среди девственниц и монахинь зафиксировано не было. Тогда был сделан вывод об инфекционной природе рака шейки матки. Те же выводы сделал канадский исследователь Ф.Ганьон - он изучал истории болезней 13000 монахинь.

Факторы риска

Раннее начало половой жизни, ранние первые роды, частая смена половых партнеров. Имеются убедительные данные о повышении риска рака шейки матки у курящих женщин. В настоящее время неоспоримым фактором дисплазии и рака шейки матки считается генитальная папилломавирусная инфекция (16 и 18 серотипы ВПЧ).

Дополнительные факторы - такие фоновые процессы, как эрозия и псевдоэрозия шейки матки и лейкоплакия. А также такие предраковые состояния, как эпителиальные дисплазии трех степеней выраженности.

Диагностика

Прежде всего, для профилактики рака матки необходимо регулярно проходить полноценное профилактическое обследование не реже одного раза в год, а при частой смене половых партнеров чаще.

Характерные для рака матки симптомы могут проявиться достаточно поздно, поэтому при выявлении любого фонового и, тем более, предракового заболевания, его необходимо, не откладывая, лечить и приходить на профилактические осмотры не реже 1 раза в 6 месяцев или как того потребует конкретная клиническая ситуация. При необходимости набор исследований увеличивается.

!!! ВАЖНО: Чтобы обезопасить себя от рака шейки матки, каждая женщина должна не менее 1 раза в год проходить профилактическое обследование с расширенной кольпоскопией и исследованием на инфекции (а при выявлении каких-либо изменений слизистой – мазки на онкоцитологию вплоть до выскабливания и биопсии всех подозрительных участков).

Кольпоскопическое исследование для определения состояния шейки матки и назначения соответствующего лечения рака матки впервые предложил в 1924 г. Х. Хинсельман. Эта процедура предполагала осмотр слизистой при помощи бинокулярной лупы. Лупа была оснащена осветительной системой и цветными фильтрами. Сегодня применяются различные реактивы для окрашивания подозрительных участков - это позволяет выявить границы пораженных участков и предварительно определить характер патологии.

Важным показателем для диагностики (опухолевым маркёром) является уровень специфического SCC в сыворотке крови. В 60% случаев при плоскоклеточном раке шейки матки он превышает норму -1,5 нг/мл. Исходно повышенный SCC означает увеличение риска рецидива в 3 раза. Точно установить стадию заболевания позволяет комплекс процедур, включающий в себя УЗИ, рентгенографию лёгких, цистоскопию, ирригоскопию, а также КТ и МРТ по показаниям.

Помните – лишних обследований не бывает! Часто от них зависит Ваше будущее.

Признаки рака шейки матки

Системные признаки рака шейки матки - это:

- повышенная утомляемость и общая слабость;

- потеря веса;

- стабильные показатели субфебрильной температуры - не выше 37,5° С;

- повышение СОЭ, анемия.

Также в случае значительного местно-регионарного распространения опухолевого процесса отмечаются такие симптомы, как боли, а также затруднения при дефекации и дизурия. При раке шейки матки преобладает лимфогенный путь метастазирования, регионарные зоны метастазирования: наружные и внутренние подвздошные, обтураторные, общие подвздошные, поясничные парааортальные лимфатические узлы.

Лечение

Комплексное лечение рака шейки матки предполагает использование разнообразных методов, выбор которых напрямую зависит от состояния пациентки. Раньше традиционными вариантами лечения являлись хирургический и лучевой методы.

Однако в настоящее время с хорошей эффективностью также используется химиотерапия, фотодинамическая терапия и цитокинотерапия последнего поколения. При этом цитокинотерапия последнего поколения значительно повышает эффективность лечения в сочетанном применении с фотодинамической, химио- или лучевой терапией. Благодаря внедрению в схемы химиотерапии цитокинов удалось увеличить эффективность лечения пациентов на 30-40%. У пациентов с диссименированным, распространенным опухолевым процессом удается достигать длительных ремиссий. При диагнозе рак шейки матки лечение с использованием цитокинов последнего поколения позволяет эффективнее устранять метастазы и, что особенно важно, существенно снизить риск рецидива в большинстве клинических случаев.

! Знайте - Все предраковые и фоновые заболевания шейки матки успешно излечиваются

Стоит помнить о том, что риск летального исхода напрямую зависит от стадии рака матки - соответственно, на стадии I 5-летние показатели смертности составляют 21,8%, на II стадии - 43%, III — 69,0%, IV — 92,2 8%. При эффективном комбинированном лечении можно существенно снизить эти показатели. Однако первостепенное значение сохраняет своевременная диагностика - по статистике, улучшение общих показателей достигается, главным образом, за счет прогресса в лечении пациенток на стадиях I и II, в то время как показатели в тех случаях, когда рак по статистике, на стадии III, остаются стабильными.

! ВАЖНО: МИЛЫЕ ДАМЫ – 60 МИНУТ В ГОД СОХРАНЯТ ВАШЕ ЖЕНСКОЕ ЗДОРОВЬЕ НА ДОЛГИЕ ЛЕТА


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