ENDOMETRIOSIS1精選ppt課件Aimsanddemands

Tomasterthedefinitionofendometriosisanditstypicalclinicalmanifestation.Toknowwellaboutthemaintreatmentsforendometriosisandthemainnursinginterventions.Tounderstandthepathologyofendometriosis.2精選ppt課件Whatisendometriosis?3精選ppt課件DefinitionEndometriosisisadisorderinwhichabnormalgrowthsoftissue,histologicallyresemblingtheendometriumarepresentinlocationsoutsidetheuterinecavity.4精選ppt課件Whichlocations?Themostcommonlocationis___.5精選ppt課件Figure7.1showsthesitesatwhichendometriosismayoccur.

6精選ppt課件Itisinfluncedbytheactionof

oovarionhormones.

Itisoftenfoundin25-45reproductiveagewomenandnormallynotseenbeforemenarcheoraftermenopause.

Theincidenceofitisabout10-15%.

7精選ppt課件why?8精選ppt課件Endometriosisisabenigndisease,thecauseofitisstilluncertain.9精選ppt課件Etiology1.ImplantationofviableEndometrialcellstheory(1)retrogrademenstruationtheory(2)implantationfrommedicalinfection2.lymphaticandvascularmetastasis3.Coelomicmetaplasiatheory4.Immunesystemmorbiditytheory10精選ppt課件HowcanwerecogniazeEndometriosis?

11精選ppt課件PathologyTherearetwobasicfeatures:1.cyclicbleedingintheendometrioticsite

accompaniedbytheovariancycle.2.surroundedbyazoneoffibrosisandcontractureor“puckering”.12精選ppt課件13精選ppt課件14精選ppt課件15精選ppt課件16精選ppt課件17精選ppt課件Microscopicchanges:

Theclassicmicroscopicpictureofendometriosisconsistsof：endometrialglandsendometrialstromahemosiderin-ladenmacrophagessurroundinginflammatorycellsandfibrosis18精選ppt課件diagnose?19精選ppt課件history

generaldata,menstrualhistory,reproductivehistory,surgicalhistorycontraceptionhistory,abnormaldevelopmentofreproductiveorgans,thetreatment,theeffectandsoon.20精選ppt課件Clinicalmanifestation?21精選ppt課件Physicalassessment1.Symptoms(1)painPainisthemostcommonsymptom.Itismostlycharacterizedbysecondaryandprogressivedysmenorrhea(痛經,cyclicpaininphasewithmenses).Itcanalsocausedyspareunia(性交痛，painduringorfollowinginterourse),chronicpelvicpain(慢性盆腔痛)andlowbackpain(腰背部痛).anacuteabdominalemergency?(2)dysfunctionalmenstruationAbout15-30%ofpatientsmanifestasexcessivemenstruation,premenstrualspotting,orprolongedmenses.(3)infertilityovarianadhesionsmaypreventreleaseoftheovumfromthefolliclepelvicadhesionsmaypreventtheovumfromenteringthefallopiantube;(4)otherspecialsymptomspainfulurination,bloodyurineorbloodystools.22精選ppt課件2.SignsTheseimplantsusuallyarenodular,firm,fixed,anddiscreteandareespeciallysensitiveduringmenstruation.Whenweexamine,thepatientmaybefeeltenderness.However,manypatientshavenoabnormalfindingsonphysicalexamination.

23精選ppt課件Diagnostictests?24精選ppt課件Specialexaminations

1.ultrasonicscanning2.CA125measurement3.laparoscopy25精選ppt課件Methods?Treatmentfocusonarrestingtheprogressionofthedisease,symptomcontrol,andpreservationoffertility(ifdesired).26精選ppt課件Treatment

1.ExpectantmanagementIfthepatienthasnosymptom，thereisnoneedtoinsistonanytreatment,butthepatientshouldbeexaminedperiodically.

2.HormonaltherapyThebasisofhormonalmethodstreatingendometriosisisthesuppressionofcyclicalovarianfunctionandavoidingmenstruation.(progestins,androgen-danazol,Gonadotropin-releasinghormone-Diphereline

)(1)Pseudopregnancy(2)Pseudomenopause3.SurgicaltreatmentAccordingtotheoperationrange,itcanbedividedintoconservativesurgeryandcurativesurgery.Atthesametime,medicationmaybeused2-3monthsbeforeoraftertheoperationtoimprovethetherapyeffect.27精選ppt課件Howcanwedo

asanurse?28精選ppt課件Psychosocialassessmentthepatient’sfeelingsocialsupportofthepatientthestresscopingstyle29精選ppt課件NursingdiagnosisPainrelatedtotheabnormalendometriumreplantedKnowledgedeficitrelatedtoignoranceofthediseaseanditsmanagementSexfunctiondisturbancerelatedtotheintercoursepainSelf-esteemdisturbancerelatedtoinfertilityFearrel