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婦科陰道流血ppt課件(編輯修改稿)

2025-02-04 04:40 本頁面
 

【文章內(nèi)容簡(jiǎn)介】 ct (LPD) (黃體功能不全 ) ( 1) shorten cycle,luteal phase 11d,frequently cycle ( 2) infertility ( 3) repeating spontaneous abortion ( 4) D amp。 C: luteal phase endometrium defected and backward 2d to standard phase ? Irregular shedding of endometrium(子宮內(nèi)膜不規(guī)則脫落 ) ( 1) prolonged and heavy menses ( 2) D amp。 C: proliferative and secretary endometrium coexist in cycle d5 ( 3) BBT high temperature phase prolonged to next menstruation (4) Serum E2,P and BBT,Damp。G, cervix mucus score help to diagnosis 2. Menometrorrhagia (周期不規(guī)則的陰道流血 ) ? Bleeding occurs at irregular intervals. ? Amount and duration of bleeding also vary. ? Anovulatory dysfunctional uterine bleeding ? Exclude early endometrial cancer ? Complications of pregnancy Anovulatory dysfunctional uterine bleeding ? Irregular uterus bleeding ? Characteristic of bleeding: ( 1) irregular cycle and duration ( 2) not stop by oneself ( 3) irregular amount ( 4) no menalgia (痛經(jīng) ) ( 5) anaemia Endometrial cancer 1. Irregular bleeding: Postmenopause bleeding: middle or less amount, durative(持續(xù)性 ) or intermittence(間歇性 ); Childbearing age women: prolonged and heavy menses or intermenstrual bleeding 2. Vaginal apocenosis (排液 ) 3. pain 4. General symptom 5. Enlarged uterus, tender, tissue emersion in advanced stage( 組織物脫出 )。 6. Segmenting diagnosis curettage(分段診刮 ) help to diagnose lesions whether involve cervix canal. 7. Hysteroscope, ultrasound, CT、 MRI help to diagnosis. 3. Last and durative uterine bleeding (長(zhǎng)期持續(xù)陰道流血 ) ? Often happen in reproductive malignant tumor ? Need exclude carcinoma of cervix uteri and corpus uteri Cervix cancer 1. Contact bleeding (接觸性出血 ): after sex intercross or pelvic examination young: prolonged and heavy menses, short cycle old: postmenopause irregular bleeding 2. Vagina apocenosis (流液 ): white or uprightness(血性 )、 smell of fish(腥臭 ) or foul smell (惡臭 ) 3. Often early onset of sexual activity or marriage and child bear, multiple sexual partner(多個(gè)性伙伴 ). 4. Pelvic examination 5. Special examination: cervical cytology, HPV testing, iodine test, colposcopy(陰道鏡 ), biopsy, endocervical curettage, cone biopsy(宮頸錐切 ) 4. Bleeding after menelipsis (停經(jīng)后陰道流血 ) ? Childbearing age: first consider pregnancyrelated disease Abortion Ectopic pregnancy Gestational trophoblastic disease (GTD) ? Perimenopause period: Anovulatory dysfunctional uterine bleeding Exclude genital malignant tumor Abortion ? Bleeding and pelvic pain after menelipsis (停經(jīng) ). ? Clinic types and feature: amount pelvic pain tissue discharge cervix uterus zise Threatened ~ less no or light no close match Inevitable ~ middle to heavy severe no expand match/ small Inplete~ less to heavy light part discharge expand
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