医学资料痛经之谜课件.ppt

痛经之谜 Monthly period——Menstrual cycle 子宫内膜自主增厚、血管增生 腺体生长分泌 子宫内膜崩溃脱落 原发性痛经(功能性痛经) 原发性痛经是普通痛经 疼痛开始于1~2年后 下腹部或者背痛，中度至重度 随着年龄增大，减弱 生育后可能完全缓解 继发性痛经 生殖器病变有关 子宫内膜异位、内生殖器畸形、盆腔炎、肿瘤 早于月经便出现，比原发性持续时间 疼痛分类 病因 伤害性疼痛 神经病理性疼痛 发病部位 躯体痛 内脏痛 疼痛持续时间 急性痛、慢性痛 病理生理 前列腺素 生理作用 维持平滑肌张力 粘膜保护、肾小球血流 大量分泌引起平滑肌收缩 病理生理 子宫异常收缩是由于化学物质——前列腺素、花生四烯酸失平衡有关 病理生理 前列腺素 卵巢排卵后分泌 (1 year later) 引起子宫收缩，导致痉挛和疼痛 子宫痉挛，压迫血管、切断血供，缺血性痛 引起背痛、头痛、恶心呕吐、发冷、嗜睡、腹泻 有痛经的妇女经期血液、体液内前列腺素浓度高 异常情况：子宫内膜异位等 谢 谢 Dysmenorrhea (Menstrual Cramps) Dysmenorrhea is the medical name for the pain of severe and disabling menstrual cramps. Approximately 52% of women are affected by dysmenorrhea and about 10% of these are incapacitated each month for up to three days. The pain usually starts as menstruation starts, but mild cramping or lower abdominal pain may begin 24 to 48 hours before the flow begins. It may last only a few hours until the flow is well-established, but some women are troubled for several days.  There are two types of dysmenorrhea - primary and secondary dysmenorrhea. Primary dysmenorrhea is severe, disabling cramps without underlying illness. Symptoms may include backache, leg pain, nausea, vomiting, diarrhea, headache, and dizziness. This kind of dysmenorrhea usually affects young woman within two years of the onset of menstruation and lasts one or two days each month. Secondary dysmenorrhea is cramps caused by another medical problem(s) such as endometriosis (abnormalities in the lining of the uterus), adenomyosis (nonmalignant growth of the endometrium into the muscular layer of the uterus), pelvic inflammatory disease, uterine fibroids, cervical narrowing, uterine malposition, pelvic tumors or an IUD (intra-uterine device). This condition usually occurs in older women. Cramps When the menstrual cycle begins, prostaglandins (chemical substances that are made by cells in the lining of the uterus) are released by the endometrial cells as they are shed from the uterine lining, causing the uterine muscles to contract. If