女性生殖系统炎症 (2).ppt

又称结核盆腔炎，好发于输卵管（90%~100%）,近年发病率呈上升趋势，常继发于其他部位的结核，约10%的肺结核患者伴有生殖结核，潜伏期一般为1~10年。 生殖器结核 Genital tuberculosis 第23页，共50页，编辑于2022年，星期日 病 理 输卵管结核 子宫内膜结核、宫颈结核 卵巢结核 盆腔腹膜结核 第24页，共50页，编辑于2022年，星期日 临床表现 月经失调 menstrual dysfunction 下腹坠痛 全身症状 不孕 infertility 第25页，共50页，编辑于2022年，星期日 诊断：需详细病史、症状、体征；辅助检查：子宫内膜活检，X-ray（胸、腹、输卵管造影），腹腔镜，细菌培养等。 注意：鉴别肿瘤等 治疗：1、抗结核治疗； 2、手术。 诊断及治疗 第26页，共50页，编辑于2022年，星期日 Summary Infection of the genital tract with Mycobacterium Tuberculosis is almost always secondary to a primary lesion elsewhere，usually in the lungs.The clinical symptoms and signs of pelvic tuberculosis are similar to the chronic sequence of nontuberculous acute pelvic inflammatory disease.The fallopian tube is the most commonly affected site in the pelvis.The diagnosis may be established by specimen which may be from menstrual discharge,from curetage or biopsy.The therapy of genital tuberculosis, with or without extragenital lesions,is primarily that of continuous,long-term,combined drug therapy for 6 to 9 months.General therapeutic measures, including adequate diet and rest,should not be neglected.If surgery is necessary,patients older than 40 years should have a total hysterectomy with bilateral salpingo-oophorectomy. 第27页，共50页，编辑于2022年，星期日 Non-specific vulvitis 非特异性外阴炎 Non-specific vulvitis will occur if there is sufficient vaginal discharge，feces or urine from any cause to keep the vulval skin continually moist.In vulval dermatitis of long standing there may be some thickening and pigmentation of the skin,but the skin soon recovers when the cause is removed. 第28页，共50页，编辑于2022年，星期日 Bartholinitis 前庭大腺炎Abscess of Bartholin gland The most common cause of enlargement of Bartholin glands is csytic dilation of Bartholin duct.Subsequently,symptomatic enlargement of Bartholin glands may be related to adenitis of abscess formation.Bartholin abscess is treated by marsupialization which involves eversion and suturing of the cyst wall,so allowing it to drain. 第29页，共5