卵巢巧克力囊腫概要課件

CLOIG/O卵巢巧克力囊腫金凡汪玲Evaluadononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyLCLOIG/O1概論定義:子宮內(nèi)膜異位癥(內(nèi)異癥)是指子宮內(nèi)膜在子宮腔以外的部位出現(xiàn)生長、侵潤、反復(fù)出血,或者引發(fā)疼痛、不育及結(jié)節(jié)包塊內(nèi)異癥是育齡婦女最常見的疾病之一(以25-45歲多見)發(fā)病率呈明顯上升趨勢,可達(dá)10%~15組織學(xué)上為良性,卻有增生、浸潤、轉(zhuǎn)移及復(fù)發(fā)等惡性行為Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL概論2病因●子宮內(nèi)膜異位癥是良性病變,但具有惡性腫瘤的遠(yuǎn)處轉(zhuǎn)移及種植生長能力,病因至今尚未闡明,有如下學(xué)說●種植學(xué)說:經(jīng)血逆流、淋巴及靜脈播散、醫(yī)源性種植體腔上皮化生●誘導(dǎo)學(xué)說:遺傳因素、免疫因素、炎癥Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL病因3病理特點(diǎn)卵巢型子宮內(nèi)膜異位癥約80%患者病變累及一側(cè)卵巢50%患者同時(shí)波及雙側(cè)卵巢。卵巢的異位內(nèi)膜病灶分為兩種類型微小病變型為位于卵巢淺表層的紅色、藍(lán)色或棕色等斑點(diǎn)或小囊病灶只有數(shù)亳米大小典型病變型又稱囊腫型。異位內(nèi)膜在卵巢皮質(zhì)內(nèi)生長周期性出血以至形成單個(gè)或多個(gè)囊腫,典型情況下,陳舊性血液聚集在囊內(nèi)形成咖啡色粘稠液體,似巧克力樣故俗稱卵巢“巧克力囊腫”Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL病理特點(diǎn)4靜EvaluauononrchAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL靜5巧克力囊腫子宮肌腺痼輸卵管粘連子宮內(nèi)膜異位病灶Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL巧克力囊腫6Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyLEvaluauononr.7臨床表現(xiàn)痛經(jīng)及慢性盆腔痛●性交痛月經(jīng)異常不孕急腹痛Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL臨床表現(xiàn)8痛經(jīng)及慢性盆腔痛●繼發(fā)性,進(jìn)行性加重●首日最劇●持續(xù)整個(gè)經(jīng)期下腹深部和腰骶部痛●疼痛可向會(huì)陰、肛門、大腿放射●可有直腸刺激癥Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL痛經(jīng)及慢性盆腔痛9性交痛●發(fā)生率30%●深部痛●見于子宮直腸陷凹有病灶及子宮后傾固定者●月經(jīng)來潮前更顯著性交時(shí)碰撞及子宮收縮、提升造成Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL性交痛10卵巢巧克力囊腫概要課件11卵巢巧克力囊腫概要課件12卵巢巧克力囊腫概要課件13卵巢巧克力囊腫概要課件14卵巢巧克力囊腫概要課件15卵巢巧克力囊腫概要課件16卵巢巧克力囊腫概要課件17卵巢巧克力囊腫概要課件18卵巢巧克力囊腫概要課件19卵巢巧克力囊腫概要課件20卵巢巧克力囊腫概要課件21卵巢巧克力囊腫概要課件22卵巢巧克力囊腫概要課件23CLOIG/O卵巢巧克力囊腫金凡汪玲Evaluadononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyLCLOIG/O24概論定義:子宮內(nèi)膜異位癥(內(nèi)異癥)是指子宮內(nèi)膜在子宮腔以外的部位出現(xiàn)生長、侵潤、反復(fù)出血,或者引發(fā)疼痛、不育及結(jié)節(jié)包塊內(nèi)異癥是育齡婦女最常見的疾病之一(以25-45歲多見)發(fā)病率呈明顯上升趨勢,可達(dá)10%~15組織學(xué)上為良性,卻有增生、浸潤、轉(zhuǎn)移及復(fù)發(fā)等惡性行為Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL概論25病因●子宮內(nèi)膜異位癥是良性病變,但具有惡性腫瘤的遠(yuǎn)處轉(zhuǎn)移及種植生長能力,病因至今尚未闡明,有如下學(xué)說●種植學(xué)說:經(jīng)血逆流、淋巴及靜脈播散、醫(yī)源性種植體腔上皮化生●誘導(dǎo)學(xué)說:遺傳因素、免疫因素、炎癥Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL病因26病理特點(diǎn)卵巢型子宮內(nèi)膜異位癥約80%患者病變累及一側(cè)卵巢50%患者同時(shí)波及雙側(cè)卵巢。卵巢的異位內(nèi)膜病灶分為兩種類型微小病變型為位于卵巢淺表層的紅色、藍(lán)色或棕色等斑點(diǎn)或小囊病灶只有數(shù)亳米大小典型病變型又稱囊腫型。異位內(nèi)膜在卵巢皮質(zhì)內(nèi)生長周期性出血以至形成單個(gè)或多個(gè)囊腫,典型情況下,陳舊性血液聚集在囊內(nèi)形成咖啡色粘稠液體,似巧克力樣故俗稱卵巢“巧克力囊腫”Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL病理特點(diǎn)27靜EvaluauononrchAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL靜28巧克力囊腫子宮肌腺痼輸卵管粘連子宮內(nèi)膜異位病灶Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL巧克力囊腫29Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyLEvaluauononr.30臨床表現(xiàn)痛經(jīng)及慢性盆腔痛●性交痛月經(jīng)異常不孕急腹痛Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL臨床表現(xiàn)31痛經(jīng)及慢性盆腔痛●繼發(fā)性,進(jìn)行性加重●首日最劇●持續(xù)整個(gè)經(jīng)期下腹深部和腰骶部痛●疼痛可向會(huì)陰、肛門、大腿放射●可有直腸刺激癥Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL痛經(jīng)及慢性盆腔痛32性交痛●發(fā)生率30%●深部痛●見于子宮直腸陷凹有病灶及子宮后傾固定者●月經(jīng)來潮前更顯著性交時(shí)碰撞及子宮收縮、提升造成Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dien