《婦科陰道流血》ppt課件-文庫吧
2024-12-24 04:40 本頁面
【正文】 ? Intrauterine Device (IUD) ? Fallopian dysplasia or dysfunction, affect the transmigration of fertilized ovum. ? Others： surrounding oncothlipsis, EMs Gestational Trophoblastic Disease Trophohyper plasiacyte, erosin and destroy surrounding blood vessel. ? Hydatidiform mole (葡萄胎 ) ? Invasive hydatidiform mole(侵蝕性葡萄胎 ) ? Chorionic carcinoma(絨毛膜癌 ) 3. Genitals inflammation ? Vulvovaginitis(外陰陰道炎 )： disorder of vaginal ecological balance or exogenous pathogen invasion ? Cervicitis(宮頸炎 ) ? Cervical polyp(宮頸息肉 ): longterm chronic inflammation stimulation ? Endometritis (子宮內(nèi)膜炎 )： mon in after abortion, parturition, postmenopause women and IUD 4. Genitals tumor （ 1） Tumor erosion the vessel wall, cause cellular necrosis, ulcer. （ 2） Tumor cause steroid hormone disorder. （ 3） Myoma enlarged endometrial area, interfere uterine contraction and blood sinus shut. ? Vulovaginal tumor, cervix cancer, myoma, endometrial carcinoma, sara of uterus, ovarian cancer, oviduct cancer 5. Genitals damage, extraneous material and exogenous hormone ? Genitals damage: vulovaginal straddle injury (外陰陰道騎跨傷 ) ? Sexual intercause cause hymen and vaginal injury and bleeding. ? IUD: hard and large area IUD oppress cause local endometrium necrosis and ulcer ? E2 /P misapply. 6. Bleeding due to systemic diseases ? Purpura haemorragica (血小板減少性紫癜 ) ? Aplastic anemia(再生障礙性貧血 ) ? Leukemia (白血病 ) ? Hepatic function damage disturbances of blood coagulation(凝血機(jī)制障礙 ) thrombocytopenia (血小板減少 ) increased capillary permeability (毛細(xì)血管通透性增加 ) some liver disorder hormone change. 7. Others ? Pelvic inflammation： congestion (充血 ), vessel wall brittleness (脆性 ) increased ? Endometrial polyps ? EMs： steroid hormone disorder Part II Patterns of Abnormal Uterine Bleeding(陰道流血特點(diǎn)與相關(guān)疾病的聯(lián)系 ) ? Age factors ? Regulation of period or not ? Pregnancy or not 1. menorragia/ hypermenorrhea (經(jīng)量增多 ) Heavy (80ml) or prolonged （ 7d） menstrual flow. ? Submucous myomas (子宮粘膜下肌瘤 ) ? Complications of pregnancy ? Endometrial hyperplasias ? Malignant tumors ? Endometrial polyps (子宮內(nèi)膜息肉 ) ? Adenomyosis (子宮腺肌病 ) ? Dysfunctional bleeding (排卵性月經(jīng)失調(diào) ) ? IUDs (放置宮內(nèi)節(jié)育器 ) Myomas Symptoms： 1. Abnormal uterine bleeding： 30%, prolonged and heavy menses， irregular uterine bleeding often in submucous myomas 2. Abdominal mass (腹塊 ) 3. Leucorrhea (白帶 ) increased 4. Pain or sore waist (腰酸 ) 5. Pressure effects 6. Infertility, spontaneous abortion, malposition (胎位不正等 ) 7. Secondary anemia (繼發(fā)貧血 ) 8. B type ultrasound, CT, MRI help to diagnosis Endometrial polyps ? Spotting or irregular uterine bleeding ? Ultrasound help to diagnosis ? Diagnosis curettage(診斷性刮宮 ), hysteroscope (宮腔鏡檢查 ) and pathology examination help final diagnosis Adenomyosis ? Menstruation change: 50% hypermenorrhea ? Menalgia (痛經(jīng) )， increasingly severe ? Enlarged uterus, hard ? Ultrasound, MRI help to diagnosis Ovulatory menstrual dysfunction ? Luteal phase defe
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