Cause of disease
The endometriosis sickness is the benign pathological change, has the distant place shift and planter ability. Sends in the cause of disease, at present mostly believed that endometriosis’s sickness organization occurs explained very difficultly with the sole theory, possibly is the multi-ways causes. And pelvic cavity internal membrane dystopia sickness by endometrium planter and coelomic epithelium metaplasia primarily; But outside pelvic cavity’s sub-official internal membrane dystopia sickness by passes through the possibility which the lymph spreads to be big.
Clinical manifestation
The approximately 20% patient not subjective symptom, have the symptom patient multi-performance is the periodic outbreak, may different have the different symptom because of pathological change’s spot.
?Painful menstruation: Take the secondary, the gradual painful menstruation as the characteristic, the ache spot are located at the underbelly and the waist bottle pre-, may emit to the vagina, the perineum, the anus, the thigh. Starts the pain time and the duration, so that many for the premenstrual 1~2 days, the menstrual period first day of most play, after the menstruation clean, ache alleviates vanishes. If after the dystopia internal membrane implicates the womb rectum, when falls concave and the sub-official indignant bone ligament, has the sexual intercourse pain and the anus falls the bulge feeling, the menstrual period much worse. If the intestines line official internal membrane dystopia sickness has the diarrhea or the constipation, even has periodic having blood in stool.
?Abnormal menstruation: Sometimes passes through the quantity to increase or the menstrual period lengthens, also has the premenstrual intravenous drip bleeder.
?Sterile: The internal membrane dystopia patient sterile rate reaches 40%, normal woman sterile rate high more than 2 times.
Diagnosis
Gynecological examination: The sub-official multi-casters are fixed, the huge mythical bird is big, the womb one side salty two-sided appendix place penetrating and connected does not move the pouch block with the womb, has the tenderness, the womb sacrum ligament, after the womb behind or, falls the depression to have the grain of rice to the broad bean size anomalous tubercle, touches a sore spot obviously, if the vagina rectum separates exhausts oneself, may after the vagina the curved board of trade penetrating and even sees the prominent indigo blue tubercle.
Prevention
1. prevents the menstruation to flow backwards?The menstrual period does not make the pelvic cavity inspection generally. If has the necessity, the operation should avoid extruding the womb gently.?When has the genital tract abnormal result menstruation outflow is blocked should the prompt surgery treat.
2. avoids endometrium planter which the surgery operates causes?Avoids splitting the palace in the gestation period interplanting to take the embryo technique, if really has the essential surgery, protects around the good child official margin using the gauze the technique to be wild, overflows into the abdominal cavity by against bureaucratic way of talking contents or the abdominal wall margin.?Before the menstruation, endures performs each kind of oviduct unobstructed experiment, in order to avoid the internal membrane detritus enters the abdominal cavity.
3 cervixes of the uterus freeze, the electricity ball, the awl to cut with orthopedics not suitably in the premenstrual single line, otherwise has causes the child official internal membrane planter in the surgery injured area danger. When the induced abortion attracts the palace, in the bureaucratic way of talking the negative pressure not suitable high suddenly has then drawn out the sucker, like this will cause the ship membrane fragment along with the palace cavity blood inflow abdominal cavity.
3. the marriage of age nurtures with the medicine contraception, because the pregnancy may delay this sickness the occurrence development. To married is pregnant the age or after marriage painful menstruation woman should breed promptly. Had the children, may take the contraceptive medicines to suppress the ovulation for a long time, causes the endometrium atrophy and reduces after the quantity.
Treatment
Should according to the patient age, the symptom, the pathological change spot and the scope as well as makes the comprehensive consideration to the birth request.
1. the non-surgery treats
?Observation: Is suitable is not serious in the pelvic cavity pathological change, the symptomless or symptom slight, every 6 month pelvic cavity inspects one time generally. If the menstrual period has time the slight ache may give the sterilization to contract and so on medicines just right for the illness.
?Sex hormone treatment: Highly effective progestogen cycle therapy commonly used medicine quick Ce (woman Kang piece). The armor smelts is pregnant clarifies (woman rather piece). The armor is pregnant the restroom (peaceful official plastid Li), daily 4~8mg, 5~26th date takes medicine from the menstrual cycle, suppresses the ovulation, may take medicine 3~6 cyclical I androgen methyl cold pill element 5mg hypoglossis to contain the clothing continuously, daily 1 time, including takes for 3~6 months, every month the total quantity do not surpass 300mg, the small dosage original medicine may slow relieve pain, does not suppress the ovulation; The false menopause therapy takes orally Dan that zuo, is suitable in the pathological change lightly to moderate, painful menstruation obvious or sterile patient, before may also take the conservative surgery’s medicine preparation, reduces the surgery scope, the dosage: 400~800mg, the menstruation 1st date starts to continue to break differently takes for 6 months. Stops in the clothing Dan that zuo latter 4~6 weeks the menstruation to restore, after taking medicine, the conception rate approximately 50%.
2. the surgery treats divides the retention birth function, the retention ovarian function and the radical cure surgery three groups:
(1) retains the birth function surgery: When technique cuts only the infection as far as possible, but retains the sub-official ovary (two-sided to become a person, or partial ovaries) promote to become pregnant, is suitable the young birth’s woman, after the surgery, the symptom many can vanish, 215% women after the technique has possibly becomes pregnant.
(2) half radical operation: Is suitable in the age below 35 years old, but the non-birth requests patient, line of entire womb or inferior womb excision and sickness side appendix excision method. But retention one side or the partial ovaries maintain the patient internal secretion’s function.
(3) radical cure surgery: Line of entire womb and two-sided appendix excision method. Although is suitable in near menopause or young, but pathological change serious patient.
