[outline]
??Womb large sickness (hypertrophy of uterus), is refers to the womb to increase evenly, myo- level thickness surpasses above 2.5cm, is accompanied by does not wait for the degree uterine hemorrhage one kind of disease.
[diagnosis]
??Multiparous woman, menstruation many, but the womb uniformity increases, endometrium normal or accumulation, assumes the polyp shape individually, but pathology inspection most normal, minority demonstration proliferation, then may diagnose largely for the womb sickness. Should pay attention to and the fibroid distinguishes, especially myo- nucleus for sole intermural or mucous membrane, when its palace body increases evenly, often not easily with the womb large sickness distinction, through examines blows the investigation palace cavity and the ultrasound inspection may assist to diagnose. But still had at the minority case to have when cuts open the belly the investigation the side can diagnose.
??In addition, but should also pay attention to and the uterine gland myopathy, diseases and so on endometrium cancer distinguishes.
[remedial measure]
The traditional Chinese medicine treatment may control the excessive menstruation, and improves the whole body situation; The androgen treatment may reduce the bleeding quantity. Conservative treatment invalid, may consider the entire womb excision method. below 50 years old, the ovary normal person, should give the retention.
[etiology]
(1) multiparous woman chronic involution of uterus not entire: In multiparous woman’s myometrium the elastic fibers organization in the smooth intermuscular and the perivascular proliferation, causes the womb to be large.
(2) ovarian function barrier: The estrogen stimulates continually, may cause the myometrium to be plump. On the clinical common functionality uterine hemorrhage patient, the course compares the elder especially, has the varying degree womb to increase.
(3) inflammation causes: The chronic adnexitis, the pelvic cavity knot contract the organization inflammation and the womb chronic myositis, causes in the myometrium the collagenous fibre proliferation, causes the womb fibrosis.
(4) pelvic cavity ecchymosis, causes the womb knot to contract the organization proliferation, may also send the womb to be large.
(5) myometrium angiosclerosis: Primary womb blood vessel pathological change and so on.
[pathology change]
??This sickness’s basic pathology change is in the myometrium the smooth muscle cell and the blood vessel wall change.
??(1) sees roughly: The womb assumes increases evenly, the myo- level reaches 2.5~3.2cm plump. Cuts the delivering in person iron grey or the pink, degree of hardness increases, the fibrous bundle assumes the knitting shape arrangement. Outside 1/3 myo- in blood vessel prosperous suddenly, internal membrane normal or accumulation, sometimes obviously merges the small myoma levicellulare (diameter is smaller than 1cm) or the internal membrane polyp.
??(2) microscopic exam: The image sees not consistently, has the following several kind of shapes:?The pure smooth muscle cell is large. Under the mirror the observation and the normal myometrium are the same, the non-collagenous fibre proliferation, the blood vessel wall also not obviously changes;?In the myometrium the collagenous fibre proliferation, forms the womb fibrosis;?In myo- level blood vessel wall change: Moves the vein obvious expansion, has the agglomerate elastic fibers proliferation in the newborn perivascular.
[clinical manifestation]
??The cardinal symptoms are excessively many for the volume of menstrual flow, continue the number of days extension; Also has the performance to reduce for the cycle to 20 days about, and continues the number of days after the quantity to change not obviously; Or the performance lengthens for the monthly period, but are not many after the quantity.
??The patient many to pass through the parturient woman, and above most is 3 produces. The sick time is long, bleeding quantity many assumes anemia appearance. The gynecological examination womb increases evenly, generally is 6 week pregnancy size, minority surpasses 8 week pregnancy size, the quality of material is tenacious. The two-sided ovary may increase slightly, has the multiple follicle cyst.
[prevention]
??Because the aetiological agent is various, some may prevent its occurrence, if completes the birth control, the prevention post-natal infection, the post-natal uterus contraction undesirability should give the uterus contraction medicine promptly. Pays attention post-natal lies face downward suitably or the knee chest decubitus and the post-natal movement, after against womb but actually, reduces the pelvic cavity extravasated blood. Active treatment ovarian function being out of balance, avoids the estrogen the continually stimulation and so on.
