子宫肌瘤英语查房.ppt

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1、子宫肌瘤护理NursingofuterinemyomaNursingroundstarget查房目标1、Mastertheclassificationandclinicalmanifestationofmyoma掌握子宫肌瘤分类、临床表现2、Masterthenursingmeasuresanddischargeguidance掌握护理措施及出院指导3、withtheprincipleoftreatmentandsurgicalindicationsBefamiliar熟悉治疗原则及手术适应症4、Tounderstandthesecondarydegener

2、ationofuterinefibroids了解子宫肌瘤的继发变性一、Outline概述1、Themostcommonbenigntumoroffemalegenitaliafromuterinesmoothmuscle女性生殖器最常见的良性肿瘤来源于子宫平滑肌2、Morecommoninwomenaged30to50多见于30～50岁的妇女3、Andchangesrelatedtoestrogen与体内雌激素的变化有关子宫肌瘤二、PATHOGENESIS发病机制Feature特点：1．Afterpubertyoccurs,postmenopausalatr

3、ophy青春期后发生，绝经后萎缩2、Pregnancyorestrogenincreases妊娠或应用雌激素增大3、Multicoexistwithendometrialhyperplasia多与子宫内膜增生过长并存4、Tumorestrogenreceptorlevelsincreased,andestradiolbindingforceincreasedby20%瘤组织中雌激素受体含量增高，与雌二醇的结合力增加20％。三、CLASSIFICATION分类Palacefibroidsandcervicalfibroids宫体肌瘤和宫颈肌瘤。１、intram

4、uralmyoma（肌壁间肌瘤）60％～70％２、subserousmyoma（浆膜下肌瘤）20％３、Submucosalmyoma（粘膜下肌瘤）10％～15％，子宫肌瘤的分类宫体肌瘤宫颈肌瘤四、病理subserousmyoma四、Pathology病理Degenerationofmyoma：（肌瘤变性）Fibroidslosingitstypicalstructure肌瘤失去其原有典型结构hyalinedegeneration（玻璃样变）Themostcommon最多见。cysticdegeneration：（囊性变）Secondarytohyaliniz

5、ation继发于玻璃样变。reddegeneration：（红色变）Morecommoninpregnancyorpostpartum多见于妊娠期或产褥期。sarcomatouschange（肉瘤变）degenerationwithcalcification：（钙化）ReddegenerationSarcomatouschange钙化脂肪变五、ClinicalManifestation临床表现SYMPTOM（症状）1、Changeofmenorrhea（月经改变）2、Bellytumor（腹块）3、Moreleucorrhea(白带增多)4、Infertil

6、ity（不孕）20％～40％5、Abdominalpain,backache,abdominalbulge,compressionsymptoms（腹痛、腰酸、下腹坠胀、压迫症状）6、Secondaryanemia(继发性贫血)五、ClinicalManifestation临床表现1、Changeofmenorrhea月经改变：Theamountoftheincrease,theperiodisprolonged,thecycleisshort,thetypicalsymptoms经量增多、经期延长、周期缩短是典型症状Mostvulnerabletoblee

7、dingsubmucosalfibroidsandintramuralfibroids,subserosalless最易出血者为粘膜下肌瘤和壁间肌瘤，浆膜下较少Menstrualchangesandnotproportionaltothesizeoffibroids月经改变和肌瘤大小不成正比五、ClinicalManifestation临床表现2、Bellytumor（腹块）Moreintheventralmidline多位于下腹正中Earlyinthemorningwhenthebladderfillingandeasypalpable清晨膀胱充盈时易扪及

8、Hardtexture,irregularshape