Drug treatment of indications:
1, young people desire to keep the reproductive function. Child-bearing age as a result of fibroids or infertility caused by abortion, drug therapy to shrink fibroids so that after the pregnancy, fetal survival.
2, pre-menopausal women, fibroids are not great, the symptoms are mild drug application, so that post-menopausal uterine contraction, and fibroids shrink from surgery.
3, there are indications for surgery, but there is contraindication need treatment before surgery.
4, patients with internal medicine, surgery or illness are not competent enough for surgery who do not want surgery.
5, the choice of drug treatment are advised to be done curettage diagnosis of endometrial biopsy to exclude malignant change, particularly on the amount of menstrual disorders or more persons. Curettage role in both diagnosis and stop bleeding.
According to the medication is for uterine fibroids sex hormone-dependent tumors, the use of hormone antagonist drugs for the treatment. The new application is the temporary suppression of ovarian drugs. Danazol,
Gossypol for the domestic drug commonly used. Other androgen, progesterone and vitamin drugs are also used. Since 1983, studies reported that the application of gonadotropin-releasing hormone analogue (GnRHa) success
Reduced leiomyoma. Research proves GnRHa indirectly reduce the level of pituitary gonadotropin secretion in order to effectively suppress ovarian function, the so-called "down regulation" (downregulation) Phenomenon.
Saturday, November 22, 2008
Friday, November 21, 2008
Fetal deformities caused by congenital hydrocephalus What are the characteristics of the performance?
Q: fetal deformities caused by congenital hydrocephalus What are the characteristics of the performance?
A: congenital hydrocephalus caused by fetal malformation. There were common:
1. Midbrain deformities are divided into: ① aqueduct bifurcation malformation; ② aqueduct stenosis or atresia; ③ divide aqueduct.
2. Chiari malformation is due to the tonsils, medulla and spinal canal to the fourth ventricle hernia, the change strip of the fourth ventricle, the middle of the hole and the hole-side down, so that the cycle of CSF obstruction. The deformity can be alone, but with the majority associated with meningomyelocele, or depressed skull base and with the same disease.
3. The middle of the fourth ventricle and the side of the hole-hole rare congenital atresia, and the need to post-secondary intracranial infection caused by adhesion to identify with.
4. Considerable part of the congenital hydrocephalus can be due to infants and young children caused by posterior fossa tumor.
5. Some other congenital diseases, such as achondroplasia, the cranio-cervical junction malformation, spina bifida, stains hamartoma disease, Dandy-Walker syndrome, the absence of the corpus callosum, back to the cerebellum, and other deformities may be associated with brain plot.
A: congenital hydrocephalus caused by fetal malformation. There were common:
1. Midbrain deformities are divided into: ① aqueduct bifurcation malformation; ② aqueduct stenosis or atresia; ③ divide aqueduct.
2. Chiari malformation is due to the tonsils, medulla and spinal canal to the fourth ventricle hernia, the change strip of the fourth ventricle, the middle of the hole and the hole-side down, so that the cycle of CSF obstruction. The deformity can be alone, but with the majority associated with meningomyelocele, or depressed skull base and with the same disease.
3. The middle of the fourth ventricle and the side of the hole-hole rare congenital atresia, and the need to post-secondary intracranial infection caused by adhesion to identify with.
4. Considerable part of the congenital hydrocephalus can be due to infants and young children caused by posterior fossa tumor.
5. Some other congenital diseases, such as achondroplasia, the cranio-cervical junction malformation, spina bifida, stains hamartoma disease, Dandy-Walker syndrome, the absence of the corpus callosum, back to the cerebellum, and other deformities may be associated with brain plot.
Congenital hydrocephalus of the main features of what?
Q: congenital hydrocephalus of the main features of what?
A: As the brain caused by congenital abnormalities of the brain known as congenital hydrocephalus water. The formation of hydrocephalus may be due to the secretion of cerebrospinal fluid between the absorption and loss of balance, that is, cerebrospinal fluid or have too many obstacles to absorb. In addition, the cerebrospinal fluid circulation pathway obstruction caused by congenital hydrocephalus is also an important reason.
Congenital hydrocephalus are the main features of head circumference was increased to carry out. Head circumference at birth after more than a few weeks or months to start increasing as well as birth than normal. Head circumference increased, relatively small face, prominent forehead forward, thinning scalp tension, the two eyes, or strabismus, or turning tremor, fontanelle (including the skull before and after the top of head) to open, the separation of the skull bone joints. In severe cases, patients have frequent vomiting, irritability and poor eating. Early no effect on intelligence, advanced cases may appear dull expression, mental retardation, vision loss, paralysis of limbs. Finally, more as a result of malnutrition, bed sores and the occurrence of complications such as respiratory tract infections and deaths. A small number of cases of the disease on its own will to ease or stop the development.
A: As the brain caused by congenital abnormalities of the brain known as congenital hydrocephalus water. The formation of hydrocephalus may be due to the secretion of cerebrospinal fluid between the absorption and loss of balance, that is, cerebrospinal fluid or have too many obstacles to absorb. In addition, the cerebrospinal fluid circulation pathway obstruction caused by congenital hydrocephalus is also an important reason.
Congenital hydrocephalus are the main features of head circumference was increased to carry out. Head circumference at birth after more than a few weeks or months to start increasing as well as birth than normal. Head circumference increased, relatively small face, prominent forehead forward, thinning scalp tension, the two eyes, or strabismus, or turning tremor, fontanelle (including the skull before and after the top of head) to open, the separation of the skull bone joints. In severe cases, patients have frequent vomiting, irritability and poor eating. Early no effect on intelligence, advanced cases may appear dull expression, mental retardation, vision loss, paralysis of limbs. Finally, more as a result of malnutrition, bed sores and the occurrence of complications such as respiratory tract infections and deaths. A small number of cases of the disease on its own will to ease or stop the development.
Wednesday, November 19, 2008
Pelvic inflammatory disease will affect the reproductive right?
The female pelvis and reproductive organs (including the uterus, fallopian tubes and ovaries), uterine and pelvic peritoneum around the connective tissue inflammation, etc., collectively referred to as pelvic inflammatory disease. Pelvic inflammatory disease is a relatively common gynecological diseases, in some sexual disorders, the spread of sexually transmitted disease is particularly common in the country. In my pelvic inflammatory disease caused by sexually transmitted diseases, although rare, but the following factors and the incidence of pelvic inflammatory disease: (L) poor personal hygiene. (2) the wider use of intrauterine devices. (3) post-natal infections and post-abortion infection. (4) to the minor gynecological some of the preoperative surgery and the lack of attention to aseptic operation. (5) unclean sexual intercourse or menstruation, and so on. Pelvic inflammatory disease often caused by more than one pathogen of mixed infections. Although the pathogen can be spread through blood or lymphatic, sometimes from nearby tissues or organs directly from the spread, but the vast majority of pelvic inflammatory disease pathogens are inside the vagina mucous membrane along the surface of the pelvic line tat-induced organ. And genital inflammation of the surrounding tissue is often not isolated, but interact at the same time inflammation. Pelvic inflammatory disease, tubal If you are going to feel the impact, resulting in adhesion lumen, complete obstruction, can affect the future of the pregnancy, causing infertility; if limited to pelvic inflammation of connective tissue, fallopian tube is not involved, do not affect reproductive function.
Diarrhea can also lead to pelvic inflammatory disease it?
Although the majority of diarrhea and gastrointestinal diseases are directly related to diarrhea but also by some other organ of the spread of gastrointestinal illness caused. For example, some women in the menstrual period, menstrual period, the net after two weeks of pregnancy, as well as 40 days or so with the early response to the emergence and occurrence of diarrhea, this time taking antidiarrheal drugs are often ineffective.
Diarrhea caused by pelvic inflammatory disease may be the reason why is because of the uterus is located in front of the rectum, pelvic inflammatory disease, uterine posterior pelvic congestion (as before the pelvic serious congestive heart), congestive heart soften the uterus, will be closer to the rectum, sacral nerve compression arising from fall Sense of uterine extrusion rectum to stimulate the Mucosal straight contraction caused defecation. If pregnant women suffering from pelvic inflammatory disease, uterine and pelvic congestive heart even more obvious that the spread of rectal inflammation, it will stimulate the rectum and diarrhea occurred.
This type of diarrhea should be into the gynecological examination, pelvic inflammatory disease diagnosed after active treatment is necessary to pay attention to correct the position after the uterus (can be reset, knee-chest position, etc.). Patients taking the right side of the prone position can alleviate the symptoms. Suspicious or diarrhea diagnosed with early pregnancy, drug use caution when, in order to prevent fetal malformation. At the same time, pay attention to nutrition during pregnancy to strengthen in order to avoid non-nutritional anemia and abortion, preterm labor, and so on.
Diarrhea caused by pelvic inflammatory disease may be the reason why is because of the uterus is located in front of the rectum, pelvic inflammatory disease, uterine posterior pelvic congestion (as before the pelvic serious congestive heart), congestive heart soften the uterus, will be closer to the rectum, sacral nerve compression arising from fall Sense of uterine extrusion rectum to stimulate the Mucosal straight contraction caused defecation. If pregnant women suffering from pelvic inflammatory disease, uterine and pelvic congestive heart even more obvious that the spread of rectal inflammation, it will stimulate the rectum and diarrhea occurred.
This type of diarrhea should be into the gynecological examination, pelvic inflammatory disease diagnosed after active treatment is necessary to pay attention to correct the position after the uterus (can be reset, knee-chest position, etc.). Patients taking the right side of the prone position can alleviate the symptoms. Suspicious or diarrhea diagnosed with early pregnancy, drug use caution when, in order to prevent fetal malformation. At the same time, pay attention to nutrition during pregnancy to strengthen in order to avoid non-nutritional anemia and abortion, preterm labor, and so on.
Tuesday, November 18, 2008
Cervical erosion and pregnancy related
With regard to cervical erosion:
In fact on the cervical erosion, cervical erosion is not an independent disease, but rather a manifestation of chronic cervicitis form. In addition, cervical erosion does not actually belong to the real erosion. When
Foreign epidermal mouth of the cervix off, I was another kind of cervical epithelial tissue replaced, as a result of new coverage on Pifei thin, or even see the bottom of the blood vessels and red, looks on
As a true erosion, so called cervical erosion, and in fact, this is not a true erosion.
The incidence of cervical erosion and usually give birth abortion, puerperal infection or surgical operation or mechanical stimulation, such as sex cervical injury, caused by invasive pathogens as a result of the infection. Although cervical Mi
Black is commonly found in married women, unmarried women does not mean that there will be no possibility of the emergence of cervical erosion.
Cervical erosion occurred, they would often make leucorrhea more viscous, and may occasionally appear purulent, bloody leucorrhea, waist acid, abdominal pain and severe fall in the lower abdomen often accompanied by flu, when the love
May cause further contact bleeding, the emergence of smell is very possible.
With regard to pregnancy and cervical erosion:
In general, cervical secretions will be increased than before, and viscous texture, as containing a large number of white blood, sperm through the cervix, the environment will reduce the inflammation of the vitality of the sperm, sticky
The thick secretions also make it difficult for sperm. Will swallow a large number of inflammatory cells, sperm, the rest of the sperm would also like to be part of the bacterial toxins and destruction. If there is E. coli infection, but also
So that sperm have a strong role in agglutination, so that the loss of sperm vitality. All of the above on the sperm of the sperm so that the poisoning effect of excessive energy consumption, shorter life expectancy, so that both the activity of sperm produced a
Will be affected, and at the same time prevent sperm into the uterine cavity, and eventually reduce sperm and egg. As a result, in general, the crowd of cervical erosion fertility generally lower than normal crowd
. However, after the occurrence of cervical erosion will certainly lead to infertility it? Of course not, in fact, will lead to infertility and your specific situation.
Cervical erosion in the absence of positive treatment in the future associated with cancer will also increase opportunities. So the discovery of cervical erosion must adopt a positive treatment. At present, the most common rule
Treatment of cervical erosion is local treatment, such as laser therapy, microwave therapy, and so have a higher cure rate. However, you must pay attention to health is very concerned about this kind of treatment is after the impact of pregnancy
Pregnant. Although no treatment will have a certain amount of physical damage, but if the operation of skilled doctors action, the scope of the operation of the breadth and depth are appropriate controlling, laser or microwave therapy
The impact on children are negligible, but also apply equally to unmarried women.
The need to remind you that on the cervical erosion through a variety of physical therapy, there will be increased vaginal discharge, a large number of yellow liquid discharged may also have a small amount of bleeding. By
In one month after treatment, sex should be avoided, bath and wash the vagina, or else they will greatly increase the chance of infection.
In fact on the cervical erosion, cervical erosion is not an independent disease, but rather a manifestation of chronic cervicitis form. In addition, cervical erosion does not actually belong to the real erosion. When
Foreign epidermal mouth of the cervix off, I was another kind of cervical epithelial tissue replaced, as a result of new coverage on Pifei thin, or even see the bottom of the blood vessels and red, looks on
As a true erosion, so called cervical erosion, and in fact, this is not a true erosion.
The incidence of cervical erosion and usually give birth abortion, puerperal infection or surgical operation or mechanical stimulation, such as sex cervical injury, caused by invasive pathogens as a result of the infection. Although cervical Mi
Black is commonly found in married women, unmarried women does not mean that there will be no possibility of the emergence of cervical erosion.
Cervical erosion occurred, they would often make leucorrhea more viscous, and may occasionally appear purulent, bloody leucorrhea, waist acid, abdominal pain and severe fall in the lower abdomen often accompanied by flu, when the love
May cause further contact bleeding, the emergence of smell is very possible.
With regard to pregnancy and cervical erosion:
In general, cervical secretions will be increased than before, and viscous texture, as containing a large number of white blood, sperm through the cervix, the environment will reduce the inflammation of the vitality of the sperm, sticky
The thick secretions also make it difficult for sperm. Will swallow a large number of inflammatory cells, sperm, the rest of the sperm would also like to be part of the bacterial toxins and destruction. If there is E. coli infection, but also
So that sperm have a strong role in agglutination, so that the loss of sperm vitality. All of the above on the sperm of the sperm so that the poisoning effect of excessive energy consumption, shorter life expectancy, so that both the activity of sperm produced a
Will be affected, and at the same time prevent sperm into the uterine cavity, and eventually reduce sperm and egg. As a result, in general, the crowd of cervical erosion fertility generally lower than normal crowd
. However, after the occurrence of cervical erosion will certainly lead to infertility it? Of course not, in fact, will lead to infertility and your specific situation.
Cervical erosion in the absence of positive treatment in the future associated with cancer will also increase opportunities. So the discovery of cervical erosion must adopt a positive treatment. At present, the most common rule
Treatment of cervical erosion is local treatment, such as laser therapy, microwave therapy, and so have a higher cure rate. However, you must pay attention to health is very concerned about this kind of treatment is after the impact of pregnancy
Pregnant. Although no treatment will have a certain amount of physical damage, but if the operation of skilled doctors action, the scope of the operation of the breadth and depth are appropriate controlling, laser or microwave therapy
The impact on children are negligible, but also apply equally to unmarried women.
The need to remind you that on the cervical erosion through a variety of physical therapy, there will be increased vaginal discharge, a large number of yellow liquid discharged may also have a small amount of bleeding. By
In one month after treatment, sex should be avoided, bath and wash the vagina, or else they will greatly increase the chance of infection.
Which method of treatment of uterine fibroids safe
People in the evaluation of uterine fibroids treatment efficacy, it is usually in order to improve the symptoms of an index, but the Monterey Peninsula of California Institute of Surgery Dr. Lee and others in their research
, With symptoms completely disappear as an index to evaluate the radio-frequency ablation (RFA) treatment.
The 58 cases included in the study (average age 46.9 years) for women suffering from uterine fibroids, which are usually women who want to retain the uterus or willing to accept out-patient surgery cases, their symptoms, including blood
Too much, dysmenorrhea, sexual difficulties, pelvic pressure, urinary frequency, pain and sleep disorders, uterine fibroids the size of 1 ~ 11 cm.
Researchers from the use of a RITA Medical Systems to expand the system implementation of needle electrodes RFA. After 1,3,6,9 and 12 months for patients with ultrasound and clinical assessment
. At present, 67% of patients received at least 6 months of follow-up, 46% of the patients received 1-year follow-up.
12 months, patients with too much blood, dysmenorrhea, sexual difficulties, pelvic pressure, urinary frequency of complete remission rates were 94%, 93%, 100%, 100% and 100%, In addition, local pain
Pain and sleep disorders of the complete remission rates were 50% and 94%.
For the equivalent of the size of the uterus before 10 weeks gestation or more women, RFA and reduce uterine volume related. The women's uterus in volume after 3 months to reduce the average 36% (P <0.
0001); 6 months to reduce the average 41% (P <0. 0001). No cases of relapse after treatment.
In early studies, 2 cases occurred in parts of the liner scalded skin, 1 case of umbilical trauma patients.
, With symptoms completely disappear as an index to evaluate the radio-frequency ablation (RFA) treatment.
The 58 cases included in the study (average age 46.9 years) for women suffering from uterine fibroids, which are usually women who want to retain the uterus or willing to accept out-patient surgery cases, their symptoms, including blood
Too much, dysmenorrhea, sexual difficulties, pelvic pressure, urinary frequency, pain and sleep disorders, uterine fibroids the size of 1 ~ 11 cm.
Researchers from the use of a RITA Medical Systems to expand the system implementation of needle electrodes RFA. After 1,3,6,9 and 12 months for patients with ultrasound and clinical assessment
. At present, 67% of patients received at least 6 months of follow-up, 46% of the patients received 1-year follow-up.
12 months, patients with too much blood, dysmenorrhea, sexual difficulties, pelvic pressure, urinary frequency of complete remission rates were 94%, 93%, 100%, 100% and 100%, In addition, local pain
Pain and sleep disorders of the complete remission rates were 50% and 94%.
For the equivalent of the size of the uterus before 10 weeks gestation or more women, RFA and reduce uterine volume related. The women's uterus in volume after 3 months to reduce the average 36% (P <0.
0001); 6 months to reduce the average 41% (P <0. 0001). No cases of relapse after treatment.
In early studies, 2 cases occurred in parts of the liner scalded skin, 1 case of umbilical trauma patients.
Uterine fibroids and uterine prolapse of the identification
Uterus from the vagina along the normal location of the decline in population outside the reach of cervical spine ischial level, or even all of uterine prolapse in the mouth outside of the vagina, known as uterine prolapse (uterine prolapse). Uterine
There are often associated with vaginal prolapse anterior and posterior wall bulging.
【Etiology】
Delivery caused by cervical, uterine and cervical main ligaments injury and sacral ligament after delivery organizations in support of the main reasons for the failure to return to normal. Jinan City, according to 2504 cases of uterine prolapse patients, 1 to 3 fat production
Health accounted for 58.21 percent. In addition, the number of maternal postpartum sit-hi, and easy to complicated chronic urinary retention, easily into the uterus after, the uterus and vagina axle shaft in the same direction, the case of abdominal pressure increases, that is, along the vaginal hysterectomy
The decline occurred in the direction of prolapse.
Customary post-squat-style labor (such as washing diapers, vegetables, etc.), so that the abdominal pressure can be increased to uterine prolapse. Maternal uterine prolapse did not occur, due to support for the Organization of genital dysplasia by
Letter.
【Clinical】
Uterine prolapse uterus to the vagina along the downward shift, according to the degree of prolapse can be divided into 3:
Ⅱ: cervical means I have vaginal prolapse, the uterus and the uterine body or body parts are still inside the vagina. However, including the scope is too large, light only extraoral cervical vaginal prolapse, can be re-extended as a result of cervical
Long, resulting in the extension of the cervical and vaginal prolapse vaginal wall all extraoral. Ⅱ degree of uterine prolapse was divided into light and heavy-two. Light Ⅱ degrees part of the vagina and cervix anterior vaginal prolapse face-up. Ⅱ weight degree Palace
Palace part of the neck and body, as well as most or all of the anterior vaginal are turned face-vaginal prolapse. Ⅲ: refers to the entire body of uterus and cervix, as well as all of the vagina and the anterior part of the posterior wall of the vagina are turned face-vaginal prolapse.
】 【Diagnosis
According to the main signs. In addition, should also do some checking. Zhu Huanzhe not understand at an early age, the cut check bladder-stone surgery. Check to make patients cough or gas burst forth in order to increase abdominal pressure, to observe whether the urine from
Overflow urethra, in order to ascertain whether there is stress urinary incontinence, and then emptying the bladder, gynecological examinations.
First of all, pay attention to chronic urinary retention in the non-force cases, the vaginal wall prolapse and uterine prolapse. And attention to the vulva and the extent of the breakdown of the perineum. Vaginal speculum to observe whether or not the cervix and vagina wall
Fester, whether or not the uterus Waterloo rectal hernia. Vagina patient should pay attention to both sides of the levator, to determine the anal fissure width of the muscle, the location of the cervix, uterus and then clear the size of the pelvic position and accessories
Whether or not the tumor or inflammation. Finally, Zhu Huanzhe use of abdominal pressure and, if necessary, desirable Dunwei so palpable uterine prolapse further consultation to determine the degree of uterine prolapse.
【Differential diagnosis】
First, submucosal fibroid-emerge in the palace I can not find, before and after vaginal wall prolapse do not hand can be inserted inside the vagina touched the cervix.
Second, the extension of cervical disease were not maternal. Before and after the vaginal wall does not emerge, before and after high Qionglong Bu, uterine body was still inside the pelvic cavity of only the cervix such as the extreme extension of the column, I highlighted in the vagina
Outside.
Third, intra-uterine chronic disease over the last mass I can not find the uterus, fallopian tube but can be found on both sides of the entrance to the sunken, red mucosal surface, easy bleeding, the attending San uncle empty cavity, can not touch son
Palace.
Fourth, vaginal wall cyst or fibroids often mistaken for bladder prolapse, or uterine prolapse, the check still in the normal uterus location of the tumor or the top of Jixiang, and the tumor has nothing to do with the cervix.
【Treatment】
Have been of prolapse of the uterus occurred in the patient should adopt the traditional Chinese and western medicine and treatment, nutrition, rest a combination of comprehensive measures. In the treatment can be divided into: the use of uterine care, internal medicine, acupuncture,
Fumigation and other non-surgical therapy and surgery to repair. As a result of post-operative vaginal delivery once again have a certain influence, the operation applies only to serious cases of women and children no longer.
There are often associated with vaginal prolapse anterior and posterior wall bulging.
【Etiology】
Delivery caused by cervical, uterine and cervical main ligaments injury and sacral ligament after delivery organizations in support of the main reasons for the failure to return to normal. Jinan City, according to 2504 cases of uterine prolapse patients, 1 to 3 fat production
Health accounted for 58.21 percent. In addition, the number of maternal postpartum sit-hi, and easy to complicated chronic urinary retention, easily into the uterus after, the uterus and vagina axle shaft in the same direction, the case of abdominal pressure increases, that is, along the vaginal hysterectomy
The decline occurred in the direction of prolapse.
Customary post-squat-style labor (such as washing diapers, vegetables, etc.), so that the abdominal pressure can be increased to uterine prolapse. Maternal uterine prolapse did not occur, due to support for the Organization of genital dysplasia by
Letter.
【Clinical】
Uterine prolapse uterus to the vagina along the downward shift, according to the degree of prolapse can be divided into 3:
Ⅱ: cervical means I have vaginal prolapse, the uterus and the uterine body or body parts are still inside the vagina. However, including the scope is too large, light only extraoral cervical vaginal prolapse, can be re-extended as a result of cervical
Long, resulting in the extension of the cervical and vaginal prolapse vaginal wall all extraoral. Ⅱ degree of uterine prolapse was divided into light and heavy-two. Light Ⅱ degrees part of the vagina and cervix anterior vaginal prolapse face-up. Ⅱ weight degree Palace
Palace part of the neck and body, as well as most or all of the anterior vaginal are turned face-vaginal prolapse. Ⅲ: refers to the entire body of uterus and cervix, as well as all of the vagina and the anterior part of the posterior wall of the vagina are turned face-vaginal prolapse.
】 【Diagnosis
According to the main signs. In addition, should also do some checking. Zhu Huanzhe not understand at an early age, the cut check bladder-stone surgery. Check to make patients cough or gas burst forth in order to increase abdominal pressure, to observe whether the urine from
Overflow urethra, in order to ascertain whether there is stress urinary incontinence, and then emptying the bladder, gynecological examinations.
First of all, pay attention to chronic urinary retention in the non-force cases, the vaginal wall prolapse and uterine prolapse. And attention to the vulva and the extent of the breakdown of the perineum. Vaginal speculum to observe whether or not the cervix and vagina wall
Fester, whether or not the uterus Waterloo rectal hernia. Vagina patient should pay attention to both sides of the levator, to determine the anal fissure width of the muscle, the location of the cervix, uterus and then clear the size of the pelvic position and accessories
Whether or not the tumor or inflammation. Finally, Zhu Huanzhe use of abdominal pressure and, if necessary, desirable Dunwei so palpable uterine prolapse further consultation to determine the degree of uterine prolapse.
【Differential diagnosis】
First, submucosal fibroid-emerge in the palace I can not find, before and after vaginal wall prolapse do not hand can be inserted inside the vagina touched the cervix.
Second, the extension of cervical disease were not maternal. Before and after the vaginal wall does not emerge, before and after high Qionglong Bu, uterine body was still inside the pelvic cavity of only the cervix such as the extreme extension of the column, I highlighted in the vagina
Outside.
Third, intra-uterine chronic disease over the last mass I can not find the uterus, fallopian tube but can be found on both sides of the entrance to the sunken, red mucosal surface, easy bleeding, the attending San uncle empty cavity, can not touch son
Palace.
Fourth, vaginal wall cyst or fibroids often mistaken for bladder prolapse, or uterine prolapse, the check still in the normal uterus location of the tumor or the top of Jixiang, and the tumor has nothing to do with the cervix.
【Treatment】
Have been of prolapse of the uterus occurred in the patient should adopt the traditional Chinese and western medicine and treatment, nutrition, rest a combination of comprehensive measures. In the treatment can be divided into: the use of uterine care, internal medicine, acupuncture,
Fumigation and other non-surgical therapy and surgery to repair. As a result of post-operative vaginal delivery once again have a certain influence, the operation applies only to serious cases of women and children no longer.
Monday, November 10, 2008
Nephritis and the factors related to prognosis?
Although chronic nephritis has yet to effect therapy, but in recent years due to its pathogenesis of the study of the great progress in treatment has also been a significant improvement, combined with traditional Chinese and western medicine, treatment approaches more than ever before, Its prevention is also much better than it is. To determine the prognosis of chronic nephritis, first of all need to understand the nature of their primary disease and type of current clinical performance of any activity, the type of renal pathology of renal function impairment, and so on, and then a comprehensive analysis in order to draw the right conclusions . Nephritis and prognosis of the following factors: 1) clinical performance: a simple microscopic hematuria or proteinuria, and no other symptoms associated with, in general a better prognosis; chronic nephritis sustained hypertension than those without high blood pressure in patients with poor prognosis. Although high blood pressure, blood pressure medication in general can or slightly higher than normal blood pressure down to normal levels, the better the prognosis, on the contrary poor prognosis. There are persistent anemia can improve the prognosis poor. 2) caused by renal disease or a precursor of the foundation is closely related to disease and prognosis: tonsillitis, flu, such as those caused by hemolytic streptococcus better prognosis; secondary to systemic causes of disease are difficult to remove poor prognosis. 3) the type of pathology: as mild or minimal change focal nephritis can be cured by treatment; membrane and proliferative glomerulonephritis are relatively poor prognosis; if small kidney cyst formation or a crescent glomerulosclerosis Those who show severe disease, poor prognosis. 4) renal function: a serious impaired renal function, serum creatinine and blood urea nitrogen increased, creatinine clearance rate, a serious prognosis; normal renal function or renal damage though, the positive treatment of a return to normal, the prognosis Relatively good; On the other hand, if the development of chronic renal failure or uremia, the prognosis is poor. In addition, the prognosis of patients with nephritis patients and also the state of mind, diet control, whether early aggressive treatment, whether or not formal treatment and other factors.
Glomerulonephritis lead to recurrence of kidney failure
Australia's Monash University Medical Center and an expert in a recent study found that the recurrence of glomerulonephritis is the allogeneic transplant of kidney failure and an important cause. The study report recently published in the "New England Journal of Medicine." Analysis of data relating to Australia and New Zealand accepted the 1505 case of dialysis and transplantation in the treatment of the medical records of patients who were suffering from advanced biopsy confirmed glomerulonephritis, and in the period from 1988 to 1997, accepted the kidney transplant. Nephritis continues to be adopted by the recurrence of the biopsy confirmed that the use of Kaplan-Meier method for its recurrence led to the allogeneic transplant of kidney failure in 10 years the incidence of measured and with Determination of the outcome of acute and chronic rejection, such as the incidence of Comparison. The results show that lead to kidney failure of allogeneic transplant of 10-year rate of glomerulonephritis recurrence was 8.4%. Experts therefore believe that glomerulonephritis is the cause of relapse in patients 10 years of such third largest cause of kidney failure.
What is the primary glomerular disease classification?
Is the primary glomerular disease or glomerular lesions confined mainly to the glomerular damaging a group of kidney disease. Primary glomerular diseases are idiopathic (that is, cause unknown), a small number of bacterial infections or induced by drugs. Primary glomerular diseases can be classified in two ways, that is, clinical and pathological types.
Reference to the 1992 primary glomerular disease clinical classification standards can be divided into:
(1) acute onset of acute glomerulonephritis as to hematuria, proteinuria, edema and hypertension as the main performance, and a transient azotemia a group of diseases. Streptococcus infection found in other bacteria, viruses and parasites can also cause infection.
(2) rapidly progressive glomerulonephritis and the clinical course of the performance of similar onset of acute glomerulonephritis, but turn bad Renal rapid, early oliguria of acute renal failure is characterized as a large number of pathological crescentic The formation of a group of diseases.
(3) chronic glomerulonephritis for the protracted illness, the slow pace of changes will eventually develop into chronic renal failure of a group of glomerular disease. Clinical to edema, high blood pressure, proteinuria, hematuria and renal damage to the basic performance, but because of the type of disease pathology and disease period, the performance of their major differences can be, was to diversify.
(4) nephrotic syndrome mainly of the "three high and one low", that is a high degree of edema, a large number of proteinuria (≥ 3.5 g / day), hyperlipidemia and hypoproteinemia (plasma albumin ≤ 30 g / l ). As long as a large number of proteinuria and hypoproteinemia diagnosis can be set up.
(5) occult renal disease is asymptomatic proteinuria (protein in urine volume of <1 g / day, mainly to albumin), and (or) simple hematuria (continuous or intermittent microscopic hematuria, and occasionally the naked eye Hematuria, the nature of endogenous glomerular) for the clinical manifestations of a group of glomerular disease. Patients without edema, hypertension and renal dysfunction.
According to the 1982 World Health Organization on primary pathology Glomerular disease of the ladder, can be divided into:
① minor glomerular lesions;
② focal segmental lesions;
③ diffuse glomerulonephritis: membranous nephropathy, proliferative glomerulonephritis (the latter can be divided into: MsPGN, capillary glomerulonephritis, capillary mesangial glomerulonephritis, dense Nephritis and sediment crescentic glomerulonephritis) and sclerosing glomerulonephritis.
④ unclassified glomerulonephritis.
Some glomerular diseases can, in accordance with its immunofluorescence and (or) immunohistochemistry test results to make the immune pathology, such as kidney disease IgA nephropathy and IgM.
Reference to the 1992 primary glomerular disease clinical classification standards can be divided into:
(1) acute onset of acute glomerulonephritis as to hematuria, proteinuria, edema and hypertension as the main performance, and a transient azotemia a group of diseases. Streptococcus infection found in other bacteria, viruses and parasites can also cause infection.
(2) rapidly progressive glomerulonephritis and the clinical course of the performance of similar onset of acute glomerulonephritis, but turn bad Renal rapid, early oliguria of acute renal failure is characterized as a large number of pathological crescentic The formation of a group of diseases.
(3) chronic glomerulonephritis for the protracted illness, the slow pace of changes will eventually develop into chronic renal failure of a group of glomerular disease. Clinical to edema, high blood pressure, proteinuria, hematuria and renal damage to the basic performance, but because of the type of disease pathology and disease period, the performance of their major differences can be, was to diversify.
(4) nephrotic syndrome mainly of the "three high and one low", that is a high degree of edema, a large number of proteinuria (≥ 3.5 g / day), hyperlipidemia and hypoproteinemia (plasma albumin ≤ 30 g / l ). As long as a large number of proteinuria and hypoproteinemia diagnosis can be set up.
(5) occult renal disease is asymptomatic proteinuria (protein in urine volume of <1 g / day, mainly to albumin), and (or) simple hematuria (continuous or intermittent microscopic hematuria, and occasionally the naked eye Hematuria, the nature of endogenous glomerular) for the clinical manifestations of a group of glomerular disease. Patients without edema, hypertension and renal dysfunction.
According to the 1982 World Health Organization on primary pathology Glomerular disease of the ladder, can be divided into:
① minor glomerular lesions;
② focal segmental lesions;
③ diffuse glomerulonephritis: membranous nephropathy, proliferative glomerulonephritis (the latter can be divided into: MsPGN, capillary glomerulonephritis, capillary mesangial glomerulonephritis, dense Nephritis and sediment crescentic glomerulonephritis) and sclerosing glomerulonephritis.
④ unclassified glomerulonephritis.
Some glomerular diseases can, in accordance with its immunofluorescence and (or) immunohistochemistry test results to make the immune pathology, such as kidney disease IgA nephropathy and IgM.
Pyelonephritis on patients confused
Patients with chronic pyelonephritis more often. Such patients may be due to a variety of incentives to attack again, there frequency, urgency, Niaotong, hematuria, and symptoms such as heartburn. Abnormal urine checks, urine culture can be found disease-causing bacteria. However, some patients with severe symptoms though, but the urine culture was not found. Clinically, this case is not uncommon, especially in healing or focal pyelonephritis, routine urine was sterile or low number of bacteria. Pyelonephritis when bacteria-free urine may be caused by:
① the most common causes for the anti-inflammatory drugs and the use of chemotherapy inhibited the activity of bacteria.
② side of the ureter obstruction, so that bacteria can not be discharged as urine.
③ urine acidity (pH value) of 5.0 or below a high degree of diluted urine (1.003 specific gravity in the following) is not conducive to the growth of bacteria.
④ rapid flow so that the bacteria have no chance to reproduce or slow the growth of bacteria or breeding is not easy.
⑤ there is a theory that chronic pyelonephritis as a aseptic disease, caused by the bacterial infection, after the disappearance of bacteria, and infected by bacteria or toxins continue to maintain the autoimmune mechanism.
① the most common causes for the anti-inflammatory drugs and the use of chemotherapy inhibited the activity of bacteria.
② side of the ureter obstruction, so that bacteria can not be discharged as urine.
③ urine acidity (pH value) of 5.0 or below a high degree of diluted urine (1.003 specific gravity in the following) is not conducive to the growth of bacteria.
④ rapid flow so that the bacteria have no chance to reproduce or slow the growth of bacteria or breeding is not easy.
⑤ there is a theory that chronic pyelonephritis as a aseptic disease, caused by the bacterial infection, after the disappearance of bacteria, and infected by bacteria or toxins continue to maintain the autoimmune mechanism.
APN how severe the treatment
Pyelonephritis light to the normal anti-bacterial treatment and after treatment to more than symptoms disappear, negative bacterial culture. However, serious or light pyelonephritis pyelonephritis handled fever and chills, low back pain, blood, as there are significantly higher white blood poisoning symptoms, such as whole body, muscle or can be given intravenous antibiotics. 80,000 units, such as gentamicin or tobramycin 1.5mg / kg, once every 8 hours; ampicillin 3.0 g or 3.0 g cefotaxime, 2 times a day; a Norfloxacin 400mg, twice daily . Can also be used to ampicillin, gentamicin, if necessary, added that if the treatment effect can not be based on the results of drug susceptibility to replace antibiotics. If not effect that consideration should be given concurrent renal or kidney abscess around, take line B, or super-CT examination in order to clear the development of inflammation, the choice of effective antibiotics, to be controlling symptoms in patients with 2 days after the effective use of oral antimicrobial drugs, Such as cotrimoxazole, norfloxacin, I furans Dan acid, and so on, 2 weeks to complete course of treatment. Severe acute pyelonephritis, such as the use of such conventional antibiotic treatment of 3 to 4 days, the urine can not be negative bacteria, and increase the clinical symptoms, severe shivering, suspected bacteremia, or even low blood pressure, respiratory alkalosis, Gram-negative bacteria are suspected sepsis, pyelonephritis is a complex, often multi-drug resistant pathogens of the gram-negative bacteria, the choice of semi-synthetic broad-spectrum penicillin, aminoglycosides, third-generation cephalosporin bacteria -Like, single-ring β-lactam antibiotics combined. In the condition allows, to determine whether there should be as soon as possible urinary tract obstruction, and so on. For urinary tract obstruction, urinary tract should be corrected in a timely manner poor drainage, otherwise the complexity of urinary tract infections difficult to cure. Some patients in the treatment process, the primary bacteria disappeared after treatment, but a new bacteria, or bacteria mutate itself, is the application of anti-bacterial drug resistance, so the need for repeated bacterial culture and drug sensitivity tests , According to the results of the examination and re-adjusting the antibiotics until the temperature is normal, the symptoms disappear, culture negative until after 2 weeks.
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