婦科急腹癥ppt課件(已修改)
2025-01-20 05:03 本頁(yè)面
【正文】 婦科急腹癥 Gyneacologic Acute Abdomen 以腹部疼痛為主要癥狀的一組婦科急癥。 腹痛 是這三種疾病的主要癥狀 急： 發(fā)病突然，癥狀重，危及生命 ectopic pregnancy extrauterine pregnancy torsion of the ovarian pedicle twisted ovarian cysts acute pelvic inflammatory disease a ruptured ovarian lutia Endomitriosis s t o rystory ? Acute abdominal pain ? wanted to give bowels ? the abdomen rigidity and tenderness、rebound tenderness. ? pass water ? fainted on the spot ? blood presure was zero Diagnosis? ectopic pregnancy Ectopic Pregnancy Definition: ?Ectopic pregnancy is defined as pregnancy outsied the uterine cavity ?Most mon site of occurrence is the fallopian tube ? tubal pregnancy % ovarian pregnancy % cervical pregnancy % pregnancy in rudimentary horn % pregnancy in interstitial % abdominal pregnancy 4 7 8 6 3 1 2 5 ?the UK : % getting more mon. ?In Finland, tripled between 1966 and 1985 ?in the US , a fourfold rise between 1970 and 1983. ?In Jamaica, an unusually high rate of ectopic pregnancy (1 in 28 deliveries). etiology: 受精卵著床于子宮體腔以外?；蛞?yàn)?輸卵管結(jié)構(gòu)異常，或受精卵行走異常 。 FACTORS 輸卵管結(jié)構(gòu)異常 受精卵行走異常 Pelvic inflammatory disease Advancing age Tubal surgery DES exposure Previous ectopic， repeated IVF and ovulation induction Previous termination 經(jīng)宮腔或腹腔向?qū)?cè) of pregnancy 輸卵管移行 輸卵管發(fā)育不良或功能異常 smoke IUD Intrauterine device usage 肌瘤，卵巢腫物， EM Salpingitis→adhesions of the tubal wall, → retards the passage of the fertilized egg → Ectopic pregnancy。 輸卵管的變化 部位 壺腹部 峽部 間質(zhì)部 解剖 管腔寬 窄 較窄 肌層 較厚 薄 很厚 停經(jīng) 812周 6周 4個(gè)月 表現(xiàn) 流產(chǎn) 破裂 破裂 abdominal pain of ectopic pregnancy ? tubal rupture: sharp colicky pain ?tubal abortion:隱痛、脹痛 伴隨癥狀 ? Straining at stool ? faintness and shock ? amenorrhea or menstrual period delayed ? spotting type bleeding ? 掉出蛻膜管
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