妇科生殖系统炎症_精品.ppt

Differential Diagnosis Appendicitis Rupture or abortion of tubal pregnancy Torsion or rupture of an ovarian tumor * Treatment (1) 1. Systemic medication (Ideal) Based on drug sensitivity test (Empirical) Combination use of drugs Patient’s condition and possible pathogens 1) Oral: Ofloxacin (氧氟沙星) Metronidazole for 14 days 2) Intravenous: Penicillin or Erythromycin (红霉素) Gentamycin (庆大霉素) or Amikacin (阿米卡星/丁胺卡那霉素) Metronidazole for endogenous bacteria 3) Cefuroxime sodium (头孢呋辛钠/西力欣) for gonococcus 4) Doxycycline (多西环素/强力霉素) or Azithromycin (阿奇霉素) for chlamydia or mycoplasma 5) Clindamycin (克林/氯林/氯洁霉素) for anaerobic bacteria * Treatment (2) 2. Surgical treatment for TOA or peritoneal abscesses that can not be controlled by drugs (2-3 days) Indications: 1) Failure of drug therapy 2) Persistent existence of abscesses (2-3 weeks) 3) Rupture of the abscess 3. Traditional Chinese medicine * * Chronic PID * Etiology 1. Incomplete treatment of the acute PID 2. Infection from certain pathogens such as Chlamydia trachomatis 3. Residual lesions from previous acute PID Characteristics of chronic PID: 1. Persistence of the condition 2. Difficult to identify the pathogens * Pathology 1. Chronic endometritis 2. Chronic salpingitis and hydrosalpinx 3. Salpingo-oophoritis and tubo-ovarian cyst 4. Chronic inflammation of pelvic connective tissue * * Clinical Features 1. Chronic pelvic pain 2. Infertility (20-30%) and ectopic pregnancy 3. Abnormal menstrual cycle 4. Systemic symptoms 5. Signs * Pelvic congestion or varicosity (静脉曲张) Endometriosis Tumors Ultrasound and laparoscopic examination is helpful Diagnosis Based on history of acute PID, symptoms and signs Differential diagnosis * Treatment According to place of the lesion and t