妇产科学课件-byzh7年制.ppt

生殖免疫学检查 检测抗精子抗体 性交后精子穿透力试验(Post-coital Exam) ：夫妇双方经检查均未发现异常时行此试验。在排卵期进行，性交后2~8小时内检查，精子数>20/HP正常。否则疑有免疫问题。 治 疗treatment 增强体质和增进健康， 纠正营养不良和贫血；戒烟、 不酗洒；积极治疗内科疾病； 掌握性知识，学会预测排卵。 1、输卵管性不孕的治疗 Microsurgical relief of tubal obstruction due to salpingitis or tubal ligation will reestablish fertility in a significant number of cases. 1）双侧输卵管阻塞的治疗 ①输卵管粘连分解术 ②输卵管远端阻塞行输卵管造口术 ③输卵管近段阻塞采用输卵管子宫植入术 ④输卵管中段阻塞行吻合术 2）输卵管通而不畅者 ①输卵管通液术 ②手术治疗 3）输卵管慢性炎症的治疗 ①输卵管通液术 ②理疗 ③中医中药 不孕症 INFERTITY 定义Definition 凡婚后未避孕、有正常性生活，同居1年而未妊娠者A couple is said to be infertile if pregnancy does not result after 1 years of normal sexual activity without contraceptives. 原发性不孕(primary infertility) 继发性不孕(secondary infertility ) Etiologies Female Factor 40%-55% Male Factor 25-40% Couple’s Problem 30% Unexplained 10% causes of infertility Anovulation Quality and quantity of semen and sperm abnormalities Egg and sperm can not become fertilized in the fallopian tube The fertilized egg into the uterine cavity can not be normal implantation （一）输卵管因素(tubal factor) 输卵管机械性梗阻、伞端拾卵功能及输卵管蠕动功能异常 Tubal mechanical obstruction, umbrella side pick up eggs function and tubal motility dysfunction 女性不孕的因素 （二）排卵障碍(anovulation) 1.Central nervous system and hypothalamic dysfunction leading to anovulation 2. pituitary anovulation 3. ovarian factors leading to anovulation 4.Polycystic ovary syndrome 5.Other factors （三）子宫因素(uterus factor) ①子宫发育异常 Uterine abnormalities ②子宫内膜异常 abnormal endometrial ③子宫肿瘤 uterine tumors （四）宫颈因素(cervix factor) ①宫颈炎症 cervical inflammation ②宫颈发育异常 cervical dysplasia ③宫颈肿物 cervical tumor （五）外阴、阴道因素(vulvae and vagina factor) ①外阴、阴道发育异常 Vulva, vaginal dysplasia ② 炎症 inflammation （1）精子生成障碍：If there is no sperm or s