子宫肌瘤（uterine_myoma）双语教学张喜课件

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1、UterineMyomaWomen’sHospital,SchoolofMedicineZhejiangUniversityProf.LinJunIntroductionMostcommonbenigntumoroffemalereproductivesystemBenignneoplasmcomposedprimarilyofsmoothmuscleCommoninwomen30-50yUsuallyasymptomaticEtiologyNotdetectablebeforepubertyandaftermenopauseProbablyrelatestofema

2、lehormonesEstrogenandER↑Progestinmaypromotemitosis（有丝分裂）ofmyomaClassificationAccordingtothelocation：Uterinebodymyoma90%Cervicalmyoma10%ClassificationAccordingtotherelationshipbetweenmyomaanduterinemyometrium：intramuralmyoma60%-70%subserousmyoma20%submucousmyoma10%-15%ClassificationClass

3、ificationmultiplemyomaPathologyGrossAppearance：round,smooth,andusuallyfirmfalsecapsularcovering——pseudocapsulecanbeclearlydemarcatedfromthesurroundingmyometriumPathologyGrossAppearance：Transversesection:lightgrayawhorl-likearrangementoranintertwiningpatternPathologyMicroscopicexaminatio

4、n：composedofsmoothmusclecellsandvaryingamountsofconnectivestissueIndividualcellsarequiteuniforminsize,spindleshaped,haveelongatednuclei.Nonstriatedmusclefibers（平滑肌纤维）arearrangedininterlacingbundlesofvaryingsizerunningindifferentdirections.DegenerationHyalinedegenerationCysticdegeneratio

5、nReddegenerationSarcomatouschangeDegenerationwithcalcificationDegenerationReddegenerationmostcommonduringpregnancyandpuerperiumvenousthrombosisandcongestionwithinterstitialhemorrhageDegeneration←Reddegeneration←HyalinedegenerationDegenerationSarcomatouschangemalignantrare,0.4-0.8%oldwom

6、enenlargerapidlywithirregularvaginalbleedingDegenerationSarcomatouschangeSymptomsUsuallynosymptomsAssociatewithlocation,anddegenerationsNotassociatewiththesizeandthenumberSymptoms1.menorrhagiaandprolongedmenseslargeintramuralmyomasubmucousmyoma2.abdominalmass3.leukorrhagiaSymptoms4.pres

7、sureeffectspressurebladderorrectum→urinaryfrequency,constipation（便秘）intraligamentousmyomaandlargecervicalmyoma→obstructureter5.othersinfertilityspontaneousabortionabdominalpainSignassociatedwith：sizelocationnumberdegenerationlargemyoma→palpableabdominalmassPelvicexamination：ute