(妇产科学教材）12.3（参考翻译）Uterine myoma.pptVIP

Uterine Myoma子宫肌瘤;General Consideration;Pathogenesis ;Classification;Pathology ;2. Microscopical structure 显微结构;Degeneration 变性;Degeneration;2. Cystic degeneration 囊性变 liquefaction 溶解 of the areas of hyaline change, capsular 囊状的 space containing clear fluid ; Degeneration;4. Malignant transformation 恶变 (sarcomatous change 肉瘤样变) rare 0.4%～0.8% ;Degeneration;Clinical Findings;Symptoms ;1. Abnormal uterine bleeding menorrhagia 经量增多 (prolonged 延长, heavy menses) Where: large intramural myoma 大肌壁间肌瘤 submucous myoma 粘膜下肌瘤 Why: Endometrium 内膜 surface increases More blood surface Influence uterine contraction 收缩;irregular or increased menstrual 月经 bleeding;2. Lower abdominal mass hard mass no tenderness local discomfort 局部不适 ; 3. Pain rarely happen usually due to complications red degeneration torsion 扭转 of pedunculated 有蒂的 subserous myoma 浆膜下肌瘤 expelling 压榨 of submucous myoma 粘膜下肌瘤 ;4. Pressure effects cervical myoma 宫颈肌瘤 Urination 排尿 frequency and urgency of urination 尿频和尿急 difficulty in urination 排尿困难 retention of urine 尿潴留 Constipation 便秘; 5. Effects on pregnancy and childbearing submucous 粘膜下, intramural 肌壁间 infertility 不孕 (inability to conceive 怀孕) abortion 流产 obstruct birth canal 产道阻塞, difficult labor 难产;Clinical Findings;Diagnosis;Ultrasound detected an abnormal echo 回声 in the uterine cavity;Differential Diagnosis ;Treatment; every 3～6 months small myoma with no symptom close to menopause 更年期; pretreatment for surgery contraindicated for surgery;(1)? Heavy or prolonged 长时间 bleeding, especially causing anemia 贫血 (2)??Torsion 扭转 of subserous myoma (3)??Myoma with pressure effects (4) Myoma which cause infertility 不孕 and recurrent abortion 复发性流产 (5) Possible malignant change ;A. Myomectomy 肌瘤切除术 preserve fertility 生育能力 or uterus B. Hysterectomy 子宫切除术 subtotal ~ 次全子宫切除术 total ~ transabdominal 经腹, transv