【妇产科护理课件】子宫肌瘤病人的护理

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1、Nursingcareforuterinemyoma子宫肌瘤病人的护理Introduction(概述)Leiomyoma,fibromyomaorfibroidsThemostcommonbenign(良性的)tumorsofthefemalegenitaltract（女性生殖系统）Affect1/4ofchild-bearingagewomen30-to50-yearsEtiology(病因)Hormone-dependent(激素依赖性肿瘤)Femalehormones(estrogen,progesterone)女性激素雌激素孕激素Eviden

2、cesoccursinreproductiveageincreaseinsizeduringpregnancydecreaseinsizeaftermenopause★Classification(分类)SubserousMyomaIntramuralMyomaSubmucousMyomaMultipleMyomas:Classification(分类)SingleMultiplePathology(病理)VaryinsizeHardPseudocapsule(假包膜）Whorledstructure(螺旋状结构)Secondarychange(变性

3、)hyalinedegeneration玻璃样变cysticdegeneration囊性变reddegeneration红色样变malignantdegeneration肉瘤样变(0.4~0.8%.)★Clinicalmanifestations(临床表现)SymptomsSignsDependonitssize,location,thepresenceofdegenerationsornot★Clinicalmanifestations(临床表现)Symptoms(1)Abnormaluterinebleeding(2)Abdominallump腹

4、部包块(3)Pressuresymptoms压迫症状★Clinicalmanifestations(临床表现)⑴abnormaluterinebleedingThetypicalchangeistheheavierflowandprolongationoftheperiods.Mostcausedbyintramuralmyomasandsubmucousmyomas.★Clinicalmanifestations(临床表现)(2)Abdominallump(s)腹部包块Resultfromamyomaofconsiderablesize,mostf

5、requentlyofthesubserousmyomasStructureoffemalepelvis★Clinicalmanifestations(临床表现)⑸Pressuresymptoms压迫症状PressureonbladderUrinaryfrequency(尿频)Pressureonrectumincompletedefecation(排便不尽)Constipation(便秘)Signs(体征)PelvicsignsUterusfeellargerthannormalAnirregularuterusmasswithoutpainDia

6、gnosticTests(诊疗方法)（1）B-modeUltrasonagraphyB超（2）Hysteroscopy宫腔镜检查（3）MagneticResonanceImaging(RMI)核磁共振Treatments(治疗)TheseverityofsymptomsTheageandgeneralconditionsThetypesoftumorpresentThedesiretobearchildrenThepresenceofsecondarychangesornotTreatments(治疗)Options：Conservativemana

7、gement保守治疗Surgicalmanagement手术治疗Others:HighIntensityFocusedUltrasoun-d，etc(HIFU)海扶刀治疗Treatments(治疗)Conservativemanagement保守治疗Follow-up随访观察Appropriateforthosewhohavesmall,asymptomatic(无症状的)myomas,especiallythosewhoareclosetomenopauseTakeexaminationat3to6monthintervalsMedicalmana

8、gement药物治疗Androgen(雄激素)，GnRHagonist(激动剂)Sideeffects(副作