子宫肌瘤ppt课件_1.pptVIP

What we have talked about? High risk factors Classification Pathology Degeneration of myoma Clinical manifestation Diagnosis and differential diagnosis Management Summary Women at age of 30 ～50 Abnormal vaginal bleeding Enlargement of uterus with smooth, spherical, solid mass Pelvic ultrasonography generally assists in establishing diagnosis Medical therapy and surgical treatment * Metrorrhagia: Uterine bleeding,usually irregular or acyclic,between periods. Best wishes for you all Symptoms –  Abnormal vaginal bleeding (2) Mechanisms for increased bleeding: Alteration of normal myometrial contractile function Inability of the overlying endometrium to respond to the normal E/P menstrual phases. Pressure necrosis of the overlying endometrial bed. Symptoms –  abdominal mass Sometimes the first thing that the patient notices. Asymptomatic: not tender and rarely gives rise to pain. Symptoms – Pelvic pressure Against bladder (frequency and retention of urine) Against rectum（constipation） Against parauterine tissues: pain or discomfort Symptoms –  abnormal Vaginal discharge 42% ↑Area of uterine cavity Pelvic congestion Complications of submucous myoma Symptoms –  Pain not a common symptom, when it occurs: Some complication of myoma such as, degeneration or torsion Endometriosis Pelvic inflammatory disease Symptoms – others Infertility: 30％patients with myoma Spontaneous abortion: 4 ：1 Anemia: Signs Vary with the size，site (region/ location), number, and complication of myomas. abdominal examination pelvic examination Signs - Abdominal mass ﹤3 months gestational age：not palpable ＞ 3 months gestational age： In the middle of the lower abdomen, irregular, hard, nodular Signs - Pelvic mass Intramural：enlargement of uterus; irregular, single or multiple nodules on the surface Subserous：spherical, nodular masses Submucous： symmetrical enl