内膜异位护理2008普本护理.ppt

ENDOMETRIOSIS Aims and demands To master the definition of endometriosis and its typical clinical manifestation. To know well about the main treatments for endometriosis and the main nursing interventions . To understand the pathology of endometriosis . What is endometriosis? Definition Endometriosis is a disorder in which abnormal growths of tissue ,histologically resembling the endometrium are present in locations outside the uterine cavity . Which locations ? The most common location is ___. Figure 7.1 shows the sites at which endometriosis may occur. It is influnced by the action of oovarion hormones.It is often found in 25-45 reproductive age women and normally not seen before menarche or after menopause . The incidence of it is about 10-15%. why? Endometriosis is a benign disease ,the cause of it is still uncertain . Etiology 1.Implantation of viable Endometrial cells theory (1)retrograde menstruation theory (2)implantation from medical infection 2. lymphatic and vascular metastasis 3.Coelomic metaplasia theory 4.Immune system morbidity theory How can we recogniaze Endometriosis? Pathology There are two basic features: 1.cyclic bleeding in the endometriotic site accompanied by the ovarian cycle. 2.surrounded by a zone of fibrosis and contracture or “puckering” . Microscopic changes :  The classic microscopic picture of endometriosis consists of ： endometrial glands endometrial stroma hemosiderin-laden macrophages surrounding inflammatory cells and fibrosis diagnose ? history general data , menstrual history , reproductive history ,surgical history contraception history , abnormal development of reproductive organs, the treatment , the effect and so on . Clinical manifestation ? Physical assessment 1.Symptoms (1)pain Pain is the most common symptom. It is mostly characterized by secondary and progressive dysmenorrhea(痛经,cyclic pain in phase with menses ). It can also cause dyspareunia ( 性交痛，pain during or following int