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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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            [PERMISSION] => R
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    [94] => Array
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 94
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                    [0] =>  Лечение рака легких
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    [95] => Array
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            [TEXT] =>  Лечение рака поджелудочной железы
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            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [ITEM_TYPE] => D
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            [PERMISSION] => R
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                    [0] => /services/onkologiya/rak-pochki/
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            [CHAIN] => Array
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                    [0] =>  Лечение рака почки
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            [DEPTH_LEVEL] => 2
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    [97] => Array
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            [TEXT] =>  Лечение рака толстого кишечника
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => /services/onkologiya/rak-tolstogo-kishechnika/
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            [ITEM_INDEX] => 97
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            [DEPTH_LEVEL] => 2
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    [98] => Array
        (
            [TEXT] =>  Лечение рака шейки и тела матки, опухоли яичников
            [LINK] => /services/onkologiya/rak-sheyki-i-tela-matki-opukholi-yaichnikov/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => /services/onkologiya/rak-sheyki-i-tela-matki-opukholi-yaichnikov/
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            [ITEM_INDEX] => 98
            [PARAMS] => Array
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                    [FROM_IBLOCK] => 1
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    [99] => Array
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            [PERMISSION] => R
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 99
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    [100] => Array
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            [PERMISSION] => R
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    [101] => Array
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            [TEXT] => Лечение рака пищевода
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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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    [102] => Array
        (
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
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            [ITEM_TYPE] => D
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            [PARAMS] => Array
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            [CHAIN] => Array
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    [103] => Array
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            [TEXT] => Лечение плоскоклеточного рака
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    [104] => Array
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    [105] => Array
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            [LINK] => /services/onkologiya/rak-predstatelnoy-zhelezy/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [ITEM_TYPE] => D
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    [106] => Array
        (
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 106
            [PARAMS] => Array
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            [DEPTH_LEVEL] => 3
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    [107] => Array
        (
            [TEXT] => Базалиома. Базальноклеточный рак
            [LINK] => /services/onkologiya/fotodinamicheskaya-terapiya/bazalioma-bazalnokletochnyy-rak/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/onkologiya/fotodinamicheskaya-terapiya/bazalioma-bazalnokletochnyy-rak/
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            [ITEM_INDEX] => 107
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                (
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            [DEPTH_LEVEL] => 3
            [IS_PARENT] => 
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    [108] => Array
        (
            [TEXT] => Лечение табакокурения у женщин
            [LINK] => /services/lechenie-ot-kureniya/lechenie-tabakokureniya-u-zhenshchin/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/lechenie-ot-kureniya/lechenie-tabakokureniya-u-zhenshchin/
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            [DEPTH_LEVEL] => 2
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    [109] => Array
        (
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            [LINK] => /services/onkologiya/bazalioma-bazalnokletochnyy-rak/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [ITEM_TYPE] => D
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            [CHAIN] => Array
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            [DEPTH_LEVEL] => 2
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    [110] => Array
        (
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            [LINK] => /services/onkologiya/rak-pecheni/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/onkologiya/rak-pecheni/
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    [111] => Array
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            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /services/onkologiya/rak-pishchevoda/
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 111
            [PARAMS] => Array
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                    [FROM_IBLOCK] => 1
                    [IS_PARENT] => 
                    [DEPTH_LEVEL] => 2
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            [CHAIN] => Array
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                    [0] => Лечение рака пищевода
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            [DEPTH_LEVEL] => 2
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    [112] => Array
        (
            [TEXT] => Онкоиммунология
            [LINK] => /services/onkologiya/onkoimmunologiya/
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            [PERMISSION] => R
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    [113] => Array
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            [LINK] => /services/onkologiya/fotodinamicheskaya-terapiya/rak-kozhi/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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    [114] => Array
        (
            [TEXT] => Hidden
            [LINK] => /services/
            [SELECTED] => 1
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
                (
                    [0] => /hidden/
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            [ITEM_TYPE] => D
            [ITEM_INDEX] => 114
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                    [HIDDEN] => 1
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            [CHAIN] => Array
                (
                    [0] => Hidden
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            [DEPTH_LEVEL] => 3
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        )

    [115] => Array
        (
            [TEXT] => Лечение позвоночника и суставов
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [DEPTH_LEVEL] => 1
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    [116] => Array
        (
            [TEXT] => Лечение позвоночника и суставов
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            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [DEPTH_LEVEL] => 2
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    [117] => Array
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            [TEXT] => Лечение артроза
            [LINK] => /services/lechenie-pozvonochnika-i-sustavov/oporno-dvigatelnyj-apparat/lechenie-artroza/
            [SELECTED] => 
            [PERMISSION] => R
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            [DEPTH_LEVEL] => 3
            [IS_PARENT] => 
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    [118] => Array
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            [TEXT] => Лечение пяточной шпоры
            [LINK] => /services/lechenie-pozvonochnika-i-sustavov/lechenie-pyatochnoy-shpory/
            [SELECTED] => 
            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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                    [0] => /services/lechenie-pozvonochnika-i-sustavov/lechenie-pyatochnoy-shpory/
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            [PERMISSION] => R
            [ADDITIONAL_LINKS] => Array
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            [DEPTH_LEVEL] => 2
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)

Лечение рака толстого кишечника

Понятие рак кишечника объединяет группу различных онкологических заболеваний, локализованных в области толстого кишечника - т.е., в сигмовидной, слепой, толстой, ободочной или прямой кишке.

Статистика и факторы риска

В последние годы колоректальный рак является серьезной проблемой, главным образом, для экономически развитых стран - наиболее часто признаки рака кишечника обнаруживаются в США, Канаде и в ряде европейских стран, в то время как в африканских странах заболеваемость минимальная. При этом среди всех заболевших все больше страдает раком ободочной (главным образом, сигмовидной) кишки, который по статистике преобладает над заболеваемостью раком прямой кишки. Риск развития рака толстой кишки повышается с возрастом, а также повышением уровня жизни. Большинство пациентов с онкологией - городские жители старше 65 лет.

Для таких заболеваний, как рак сигмовидной кишки и толстой кишки, а также рак слепой кишки и других разновидностей рака кишечника симптомы и факторы риска во многом схожи. Спровоцировать развитие кишечного рака могут:

- неправильное питание (в т.ч. избыточное употребление в пищу мяса и животного жира);
- курение и систематическое употребление алкоголя;
- генетическая предрасположенность.

Влияние промышленной загрязненности среды, инфекций и ультрафиолетового излучения на развитие кишечного рака не установлено. Таким образом, к средствам профилактики заболевания можно отнести соблюдение здорового пищевого рациона, содержащего в большом количестве растительную клетчатку, а также малорафинированные углеводы. Это позволяет ускорить работу кишечника и снизить концентрацию желчных кислот, поражающих стенки кишечника.

Симптоматика

Чаще всего злокачественные новообразования поражают прямую кишку. При подозрении на рак прямой кишки симптомы могут иметь следующие проявления:

  • ощущение, что при дефекации кишечник опорожняется не полностью;

  • боль в животе - наиболее частый и один из относительно ранних признаков развивающегося стеноза кишки;

  • кишечные расстройства - запоры, поносы, вздутие живота;

  • кишечные дискомфорты - чувство тяжести, отрыжка, тошнота и рвота, потеря аппетита;

  • примеси крови и слизи в кале (характерно для левостороннего поражения);

  • нарушение общего состояния (слабость, потеря веса, анемия - характерно для правостороннего поражения);

  • заметная пальпируемая опухоль в животе.

Диагностика

Комплексная диагностика включает в себя разнообразные методы исследования, основными среди которых являются:

  • пальпация - широко применяется при диагностике поражений ободочной кишки, дает хорошие результаты при обследовании поперечной, слепой и сигмовидной кишок; позволяет определить локализацию и оценить состояние опухоли, а также составить представление о степени вовлеченности периферических лимфоузлов;

  • перкуссия - используется для обнаружения в брюшной полости жидкости;
  • аускультация - позволяет установить степень непроходимости толстой кишки по таким показателям, как шум плеска и усиленная перистальтика;

  • пальцевое исследование - исследование прямой кишки, проводится при подозрении на колоректальный рак; с его помощью у пациентов с раком ободочной кишки удается определить наличие (отсутствие) метастазов и синхронной опухоли (в прямой кишке); у пациентов с раком прямой кишки опухоль может быть выявлена данным методом в 80-85% случаев; у женщин исследование прямой кишки может быть дополнено у женщин влагалищным исследованием - для оценки распространения поражения;

  • ректороманоскопия - визуальная оценка состояния опухоли и ее расположения, биопсия тканей опухоли; в обязательном порядке проводится при подозрении на рак прямой кишки, при подозрении на рак сигмовидной кишки в ее дистальной части;

  • ирригоскопия - метод диагностики рака толстой кишки; позволяет оценить размеры, состояние, локализацию опухоли; Противопоказана при перфорации стенки кишки, а также в случае токсического расширения толстой кишки в острой форме;

  • колоноскопия - проводится после ирригоскопического обследования для осуществления визуальной оценки опухоли ободочной кишки, сопровождается биопсией; показана при недостаточности данных рентгенологического исследования, при полипозе толстой кишки, а также при наличии сопутствующих, не онкологических заболеваний толстой кишки; имеются множественные противопоказания к использованию колоноскопии;

  • рентгенологическое исследование - используется для дифференциальной диагностики рака, служит для выявления сопутствующих патологий;

  • ультразвуковое исследование - используется для оценки распространенности поражения в сочетании с рентгенологическим исследованием, лапороскопией, компьютерной томографией и цитоскопией.

Лечение

Каждый год в мире выявляется более 600 тысяч новых случаев рака толстой кишки. В России заболеваемость составляет около 50 тысяч новых случаев в год. Далеко не все случаи колоректального рака выявляются даже на поздней стадии, показатель составляет не более 70 %.

По причине поздней диагностики, летальность от этого заболевания довольно высока и достигает 40 % в течение года с момента выявления болезни.

Наиболее частым органом, в который метастазирует колоректальный рак, является печень. Это обусловлено особенностями венозного оттока от кишечника, который осуществляется через систему воротной вены. По данным некоторых авторов, наличие метастазов в печени при колоректальном раке достигает 50 %.

В настоящее время эффективность лечения рака толстого кишечника значительно выросла за счет комплексного лечения данного заболевания. Для повышения эффективности лечения, особенно при III и IY стадии наша Клиника проводит специализированную иммунокорректирующую терапия. Эффективность такого лечения 40-45%. При сочетанном применении цитокинов и химиотерапии эффективность лечения можно повысить до 65-70%.


Работаем только по предварительной записи