Overview: chronic pelvic inflammatory disease (chronic pelvic inflammatory disease) often acute pelvic Yan did not complete treatment, in patients with poor physical circumstances, due to prolonged course; but also no history of acute pelvic inflammatory disease processes, such as infections caused by Chlamydia trachomatis salpingitis. Chronic pelvic inflammatory disease more stubborn, when body resistance is poor, can still acute.[Cause]
chronic pelvic inflammatory disease is caused by what the?
get a thorough treatment of acute pelvic inflammatory disease without prolonged course and chronic pelvic inflammatory disease; When the natural defenses have been destroyed, or decreased immune function, endocrine changes or exogenous pathogens intrusion, can lead to inflammation. Some patients may be no history of acute pelvic inflammatory disease, caused by Chlamydia trachomatis infection. Part of the legacy of chronic pelvic inflammatory disease as the pathological changes of acute pelvic inflammatory disease, no pathogen is present.
previous pelvic inflammatory disease usually caused by post-natal, post-abortion and gynecological surgery pathogens into the wound and infection, lower genital tract infection in recent years, reproductive tract infections retrograde supremacy gradually increased.
1. intrauterine infection after surgical procedures such as dilatation and curettage, tubal surgery, hysterosalpingography, hysteroscopy, abortion, etc., caused due to surgery reproductive tract mucosal damage, hemorrhage, necrosis, resulting in lower genital tract pathogens endogenous flora ascending infection.
2. sexual activity with age, pelvic inflammatory disease occurred in sexually active women, especially younger first sexual intercourse, multiple sexual partners, frequency of sexual intercourse and sexual partner sexual transmitted diseases. According to U.S. data, a high incidence of pelvic inflammatory disease aged 15 to 25 years old. The young are prone to pelvic inflammatory disease may be associated with frequent sexual activity, cervical columnar epithelium outward shift of physiological, cervical mucus poorer mechanical defenses.
3. lower genital tract infections, lower genital tract of sexually transmitted diseases, such as Neisseria gonorrhoeae cervicitis, chlamydial cervicitis and bacterial vaginosis and PID is closely related.
4. poor sexual health sexual intercourse during menstruation, use of unclean menstrual pads, etc., can make the inflammation caused by invasive pathogens. In addition, pay attention to sexual health care, vaginal douching were the high incidence of pelvic inflammatory disease.
5. inflammation of the direct spread of adjacent organs such as appendicitis, peritonitis, etc. spread to the pelvic cavity, the main pathogens in Escherichia coli.
6.PID acute PID again due to extensive pelvic adhesions, tubal damage, tubal defenses down, could easily lead to re-infection, resulting in acute attacks.
(B) the pathogenesis
1. Chronic Endometritis chronic endometritis can occur in the postpartum, abortion or cesarean section, due to the placenta, fetal membranes or uterine involution remains poor vulnerable to infection; also found in postmenopausal elderly women with low estrogen due to endometrial thin, vulnerable to bacterial infection, severe cervical adhesion formation empyema cavity. Endometrial edema, interstitial infiltration of a large number of plasma cells or lymphocytes.
2. Chronic salpingitis and hydrosalpinx mostly bilateral chronic salpingitis, the fallopian tubes were mild or moderate swelling, fimbria can be partially or completely closed, and with the surrounding tissue adhesion. Sometimes isthmus epithelium and fibrous tissue adhesions, tubal showed multiple, nodular thickening, called the isthmus nodular salpingitis. Less tubal inflammation, the adhesion fimbria and isthmus atresia, the accumulation of serous exudate hydrosalpinx formation; sometimes becomes chronic tubal empyema, pus gradually absorbed, serous fluid filled the lumen continued oozing from the wall, also the formation of hydrosalpinx. Water tube surface smooth, wall very thin, due to tubal mesangial not increase with the water wall tube expansion is extended, so the water tube to the mesangial side of the curved shape was curved sausage or neck flask-shaped, curled back, can be free or membrane-like with the surrounding tissue adhesion.
3. tubal oophoritis and ovarian cysts tubal tubal inflammation spread to the ovaries, fallopian tubes and ovarian adhesion formation between inflammatory mass, or tubal fimbria and ovarian adhesions and through the liquid exudative form of tubal ovarian cysts, tubal ovarian abscess may also be pus exudate is absorbed instead by the formation (Figure 4).
4. chronic pelvic inflammation of connective tissue inflammation spread to the uterosacral ligament, the fibrous tissue, hardening . If the spread of the range, make the uterus fixed cervical tissue is thickened. Uterus often biased towards the ipsilateral pelvic connective tissue.[Sign]
What are the early symptoms of chronic pelvic inflammatory disease?
(1) chronic pelvic pain: chronic inflammation of the formation of scar adhesions and pelvic congestion, often caused by lower abdominal bulge, pain, and lumbosacral pain. Often tired, aggravated sexual intercourse before and after menstruation.
(2) infertility and ectopic pregnancy: tubal adhesions can cause obstruction infertility and ectopic pregnancy. Acute pelvic inflammatory disease after infertility was 20% to 30%.
(3) menstrual abnormalities: irregular menstruation often endometritis; pelvic congestion can be caused by increased volume; ovarian dysfunction can cause menstrual disorders.
(4) systemic symptoms: more obvious, and sometimes only a low heat, susceptibility to fatigue. As the course of a long time, some patients may be symptoms of neurasthenia, such as lack of energy, aches and discomfort, and insomnia. When the patient resistance is poor, tend to have acute or subacute onset.
2. If signs of endometritis, the uterus increases, tenderness; case of salpingitis, one or both sides in the womb was touched the cable strip tubal thickening, and mild tenderness. If the hydrosalpinx or tubal ovarian cysts, one or both sides in the pelvic cystic mass reach, activities and more limited. If the pelvic connective tissue inflammation, the uterus often has bent backward after, limited mobility or adhesion fixed, one or both sides of a sheet of uterine thickening, tenderness, uterosacral ligaments often thickening, hardening, and tenderness .
history of acute pelvic inflammatory disease, and with obvious signs and symptoms, diagnosis, and more in time. Patients with symptoms but sometimes more, without obvious signs of pelvic inflammatory disease and positive, then the diagnosis of chronic pelvic inflammatory disease should be cautious to avoid making rash caused by the diagnosis of patients thought the burden.[Aftertreat]
ate chronic pelvic inflammatory disease?
therapeutic side of chronic pelvic inflammatory disease (below information is for reference only, details need to consult a doctor)
1. qi stagnation of blood stasis
performance: lower abdomen tingling or pain, pain radiating to the lumbosacral region, lower abdominal mass, the pressure of pain, vaginal discharge volume, irregular menstruation, color There are dark block. Dark side of the tongue with petechia, thin white fur, wiry pulse.
diet: ① 30 grams of hawthorn, bergamot 15 grams, sonchifolia 60 grams, add water, Tong Jian, day 1 for 7 ~ 8. ② Patrinia 30 grams, bergamot, rose, 10 grams, decoction. Day one, even for 5 to 6 days.
2. liver and kidney
performance: lower abdomen dull pain, vaginal discharge volume, the color yellow sticky stench. With waist and knees, dizziness, or early menstruation, the color pink. Red tongue, little coating, rapid pulse.
diet: ① habitat 30 grams, rice 30 to 60 grams. The habitat slices, boiling with water two times, a total of juice 100 ml. The rice porridge, eight mature into the concoction, a total cook until cooked. Eating porridge, can even serve a few days. ② pigeon 5, gelatin 30 grams. First set gelatin bowl into some water, no fireworks on the baking of, into the pigeon and uniform Serve hot. Sooner or later be divided into 2 consumption, can be taken continuously to illness.
3. spleen deficiency
performance: abdominal bulge, pain, vaginal discharge volume, thin. With backache soft limbs, aversion to cold, swollen face. Pale tongue body fat, thin white fur, pulse.
diet: ① leek root 50 grams, 2 eggs, 50 grams of sugar, eat with the soup, and even served a few days. ② 20 grams of walnut, Gorgon 18 grams, lotus seeds 18 grams, 60 grams of rice, porridge eat it.
4, Material: soil Poria 50 grams, 30 grams Gorgon Fruit, mixed drink 15 grams, Shichangpu 12 grams, 100 grams of pork.
production: amount of water, simmered in soup, add salt, seasoning, Yin Tang meat.
Effect: This only spleen and kidney, detoxification dampness. Adapt to chronic pelvic inflammatory disease, vaginitis, cervicitis.
5, bitter herbs, radish soup
components: bitter herbs, 100 grams, 20 grams of honeysuckle, dandelion 25 grams, radish 200g (sliced).
Usage: boiling on a total of four taste, eat carrot soup to medicine. Day one.
indications: pelvic inflammatory disease, is a type of heat Ecchymosis, fever, abdominal pain, abdominal pain on both sides refused to press, more than the amount taken off the color yellow, red tongue, yellow fur, slippery pulse.
Notes: honeysuckle on a variety of bacteria such as staphylococcus, streptococcus, pneumococcus, Escherichia coli, Pseudomonas aeruginosa and skin fungi have different degrees of inhibition.
6, Yin-hua Jen honey melon soup
consists of: melon seed kernel 20 grams of honeysuckle 20 grams, Coptis 2 grams, 50 grams of honey.
Usage: fry honeysuckle, to slag juice, fried melon seeds with a concoction Jen 15 minutes later generations berberine, honey can be. Daily l, with service for 1 week.
indications: pelvic inflammatory disease, is a damp heat toxin, both sides of lower abdomen and lower abdomen pain, refused to press, micro heat, spontaneous, more than the amount taken off the color yellow, the tongue red yellow fur.
7, peach pie
form: walnuts 20 grams flour, 200 grams, sesame oil 30 grams.
usage: peach research into a very fine powder and flour are fully mixed, add boiling water loo ml knead thoroughly after cooling, roll into a rectangular thin-skinned son, coated with sesame oil, roll into a cylinder shaped, with a knife cut each 30 grams, roll into a round cake, baked in a pan on the can. Breakfast and dinner are free to take the drugs several times a day, every two, warm water.
effect: qi and blood circulation, stasis pain.
indications: pelvic inflammatory disease, is blood stasis type, on both sides of the lower abdomen and abdominal pain such as acupuncture, lumbosacral pain, Purple tongue, pulse string .
8, peel red tea
components: Peel 10 grams, 10 grams of safflower.
Usage: Peel and air-dried, cut wire, and the saffron into the casserole, add water, soak for 30 minutes, boiling for 30 minutes, with a clean gauze filter, to the residue, juice Serve. When the frequent drinking of tea, or morning and evening 2 pm service.
effect: qi and blood circulation.
indications: pelvic inflammatory disease, is blood stasis type, on both sides of the lower abdomen and abdominal pain such as acupuncture, lumbar pain, Purple tongue, pulse string.
9, litchi honey drink
components: Litchi 30 grams, 20 grams of honey.
Usage: After Litchi crack into the casserole, add water, soak a while, boiling for 30 minutes, to slag juice, while hot and transferred to honey, mixing evenly, the be. Morning and evening 2 pm service.
effect: qi, dampness, pain.
Indications: all kinds of chronic pelvic inflammatory disease, on both sides of lower abdomen and lower abdomen pain, discomfort, depression, vaginal discharge volume.
chronic pelvic inflammatory disease who eat a body good?
1. Patients should eat high protein, high vitamin diet include lean meat, liver, tofu, chicken, fruits, vegetables and so on.
2, can eat lean meat, chicken, eggs, fish, turtles, cabbage, asparagus, celery, spinach, cucumber, melon, mushrooms, tofu, kelp, seaweed , and fruit.
3, pain Yichi horseshoe crab, red, lobster, mussels, sea cucumber, tiger fish, beets, green beans, carrots, chicken blood.
4, eat more fresh fruit, ready meal, more Shijun mushrooms, sunflower class, asparagus, tomatoes, carrots and so on.
chronic pelvic inflammatory disease is best not to eat those foods?
1, eat chili, Ma pepper, raw onions, garlic, white wine and spicy food and drinks.
2, fasting cold things such as cold drinks, fruits and so on.
3, Atsumi avoid sweet foods: too much sweet food such as candy, cake, rice pudding, rice Gaotuan, lard and pork fat, suet, egg yolk, the role of these foods will help wet, will reduce the efficacy results, the persistent disease refractory.
4, should not eat fatty foods cold viscosity. Such as fat, crab, snail, cured products.
5, tobacco, alcohol, tea and other hot spicy food, food should be strictly prohibited.[Prevent]
chronic pelvic inflammatory disease should be how to prevent?
chronic pelvic inflammatory disease are mostly secondary to acute pelvic inflammatory disease, due to inadequate treatment, persistent disease walls. Or patients with poor physical fitness, pathogen virulence is weak, since the beginning is the chronic, is a common gynecological diseases. Pelvic inflammatory disease include pelvic reproductive organs (uterine body, fallopian tubes, ovaries), and pelvic inflammation of connective tissue around the uterus. How the treatment of chronic pelvic inflammatory disease? Clinical common types are: chronic salpingitis and hydrosalpinx, tubal ovarian inflammation and tubal ovarian cysts, pelvic connective tissue inflammation. Disease is more stubborn and difficult to completely cure, easy to repeated acute attacks, to bring a lot of women troubled.
prognosis: chronic pelvic inflammatory disease, often prolonged healing, and repeated attacks, not only seriously affect women's health, life and work, also contributed to the family and social burden.[Treat]
treatment of chronic pelvic inflammatory disease precautions?
1) nursing should pay attention to diet, nutrition.
2) adult women should pay attention to contraception, to avoid or reduce abortion, the surgery must be strictly aseptic technique to avoid the bacteria invade the pelvis.
3) try to avoid douching, pay attention to post-natal health, prevent postpartum infection.
1. 3 days before treatment prohibition of sex.
2. treatment 3 days ago: eat light low residue diet: such as rice, noodles, the right amount of meat, potatoes and cucumbers, pumpkin, gourd, bitter gourd, melon, etc., and various types of fruit (Shensi beans and vegetables, leafy green vegetables etc. with fiber-rich dishes, do not eat too much greasy food). 2 days before treatment: eating liquid diet such as rice, millet gruel, mountain ones, mushy noodles, oatmeal soup, lotus root starch, Egg Foo Yung, a variety of soups (no residue) and so on. (Fasting with sugar water or soup and a variety of beverages). 1 day before treatment: eat no residue diet such as rice soup, a variety of soups (no residue) and glucose water.
Chinese medicine treatment of chronic pelvic inflammatory disease
1. in order to heat traditional Chinese medicine treatment of chronic pelvic inflammatory disease type of majority, rule places dampness, blood circulation. Recipe by: RSM 18g, red peony root 15g, woody 12g, peach kernel 9g, honeysuckle 30g, dandelion 30g, Poria 12g, paeonol 9g, rehmannia 9g. When the pain re-added fumarate 9g. Some patients Hanning Qi stagnation, rule, compared with warm and cold, qi and blood, commonly used Guizhifuling decoction. Qi are Codonopsis 15g, Atractylodes 9g, Astragalus 15g. Chinese medicine can be taken orally or enema.
The main point: the sea air, in a very, return.
Points: colon Yu, times[Examine]
chronic pelvic inflammatory disease should be how?
blood tests, vaginal examination, tumor marker examination, polymerase chain reaction.
B-mode ultrasound, colposcopy, laparoscopy, histopathological examination.[Diff]
chronic pelvic inflammatory diseases easily confused?
1. endometriosis, endometriosis, dysmenorrhea was secondary, progressive increase if they can reach the typical tenderness nodules help diagnostics. B-mode ultrasound examination can help identify. Difficult to distinguish when laparoscopy.
2. tubal ovarian cysts and ovarian cysts ovarian cysts need to identify. Apart from ovarian cysts tubal pelvic inflammatory disease, the tumor showed a sausage-shaped, thin wall, surrounded by adhesions; and ovarian cysts generally more round or oval, surrounded by non-adhesion, easily.
3. ovarian cancer attachment and adhesions around the inflammatory mass, inactive, and sometimes easy to be confused with ovarian cancer, chronic inflammatory mostly cystic mass; and ovarian mass, mostly solid, hard, irregular surface of the uterus and rectal fossa palpable hard nodules, often ascites, poor general condition of patients, B-mode ultrasound examination can help identify. Diagnosis difficult, it can by means of laparoscopy or pathological biopsy.
4. old ectopic pregnancy more than a history of amenorrhea and vaginal bleeding, lower abdominal pain are somewhat affected, gynecological examination the uterus next to the adhesion of the mass, tenderness, laparoscopy has help diagnosis.
5. tuberculous pelvic inflammatory disease is chronic disease, more than a history of tuberculosis of other organs, abdominal pain, often persistent, sometimes the history of amenorrhea, endometrial tuberculosis often , bloating, occasional abdominal mass, X-ray examination shows calcification in the lower abdomen, pelvic inflammatory mass in the high position slowly, laparoscopy biopsy can confirm the diagnosis.
sometimes congestion or pelvic varicose veins, within the broad ligament can produce similar symptoms of chronic pelvic inflammatory disease should also be noted that identification.[Disease]
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