女性生殖系统炎症及STD幻灯片.pptVIP

女性生殖系统炎症及STD 女性生殖系统炎症 妇科最常见的疾病之一。 生理防御机制被破坏，机体免疫功能降低、内分泌改变、内源性菌群失调或外源性致病菌侵入时，均可导致炎症发生。 病 理 Pathology 3.宫颈息肉 cervical polyp 慢性炎症→颈管粘膜增生→突出外口→息肉,恶变率1%,子宫腺肉瘤鉴别。 4.宫颈腺囊肿 Naboth cyst（宫颈腺管为新生的鳞状上皮等阻塞）:青白色小囊泡。 5.宫颈管粘膜炎 endocervicitis（颈管内粘膜及黏膜下组织炎症） 治疗: 宫颈息肉：摘除，病理； 宫颈管黏膜炎：抗感染药物全身治疗为主；增生严重者宫腔镜电切； 宫经腺囊肿：不处理；物理治疗；LEEP。 Summary Acute infection of the cervix may be Neisseria gonorrhoeae ，Chlamydia trachomatis，herpes simplex virus，human papilloma virus in origin.It may present with vaginal discharge,but also asymptomatic.Routine dual therapy for gonococcal and chlamydial infections is necessary.Chronic cervicitis causes a chronic persistent vaginal discharge.Cervical swabs,colposcopy and cervical biopsy are all helpful in diagnosis.Destruction of the inflamed columnar epithelium by cauterization or cryotherapy may produce a cure. 治疗： 一般治疗：休息、半卧位、支持治疗（饮食、补充液体、纠正电解质紊乱及酸碱失衡）、避免不必要的检查。 抗生素治疗：主要治疗手段；联合、足量、足疗程（14日以上）。 手术治疗：主要用于抗生素治疗无效的输卵管卵巢脓肿或盆腔脓肿；指征有：药物治疗无效、脓肿持续存在、脓肿破裂。 慢性盆腔炎 Frozen pelvis，冰冻骨盆：部分慢性盆腔炎患者盆腔粘连严重，盆腔脏器活动差。 Summary Pelvic inflammatory disease includes endometriosis，salpingitis，oophoritis，myometritis，parametritis and pelvic abscess Acute lower abdominal pain,vaginal discharge,fever,pelvic tenderness and adnexal mass are symptoms and signs of acute pelvic inflammatory disease.Hospital admission is required for severe cases,for bed rests,intravenous antibiotics and analgesia.Combination antibiotic therapy is started immediately and is reviewed when bacteriological culture results are available.Treatment is given at least for 14days.Chronic infection may be relatively asymptomatic or may provoke complaints of chronic pelvic pain and dyspareunia.There are three major sequelae of PID-ectopic pregnancies,chronic pain,and infertility.The majority of these infections require specific therapy. Summary Infection of the genital tract with Mycobacterium Tuberculosis is almost always secondary to a primary lesion elsewhere，usually in the lungs.The clinical symptoms and signs of