内膜异位护理普本护理

ENDOMETRIOSIS.Aimsanddemands

Tomasterthedefinitionofendometriosisanditstypicalclinicalmanifestation.Toknowwellaboutthemaintreatmentsforendometriosisandthemainnursinginterventions.Tounderstandthepathologyofendometriosis..Whatisendometriosis?.DefinitionEndometriosisisadisorderinwhichabnormalgrowthsoftissue,histologicallyresemblingtheendometriumarepresentinlocationsoutsidetheuterinecavity..Whichlocations?Themostcommonlocationis___..Figure7.1showsthesitesatwhichendometriosismayoccur.

.Itisinfluncedbytheactionof

oovarionhormones.

Itisoftenfoundin25-45reproductiveagewomenandnormallynotseenbeforemenarcheoraftermenopause.

Theincidenceofitisabout10-15%.

.why?.Endometriosisisabenigndisease,thecauseofitisstilluncertain..Etiology1.ImplantationofviableEndometrialcellstheory(1)retrogrademenstruationtheory(2)implantationfrommedicalinfection2.lymphaticandvascularmetastasis3.Coelomicmetaplasiatheory4.Immunesystemmorbiditytheory.HowcanwerecogniazeEndometriosis?

.PathologyTherearetwobasicfeatures:1.cyclicbleedingintheendometrioticsite

accompaniedbytheovariancycle.2.surroundedbyazoneoffibrosisandcontractureor“puckering”.......Microscopicchanges:

Theclassicmicroscopicpictureofendometriosisconsistsof：endometrialglandsendometrialstromahemosiderin-ladenmacrophagessurroundinginflammatorycellsandfibrosis.diagnose?.history

generaldata,menstrualhistory,reproductivehistory,surgicalhistorycontraceptionhistory,abnormaldevelopmentofreproductiveorgans,thetreatment,theeffectandsoon..Clinicalmanifestation?.Physicalassessment1.Symptoms(1)painPainisthemostcommonsymptom.Itismostlycharacterizedbysecondaryandprogressivedysmenorrhea(痛经,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..2.SignsTheseimplantsusuallyarenodular,firm,fixed,anddiscreteandareespeciallysensitiveduringmenstruation.Whenweexamine,thepatientmaybefeeltenderness.However,manypatientshavenoabnormalfindingsonphysicalexamination.

.Diagnostictests?.Specialexaminations

1.ultrasonicscanning2.CA125measurement3.laparoscopy.Methods?Treatmentfocusonarrestingtheprogressionofthedisease,symptomcontrol,andpreservationoffertility(ifdesired)..Treatment

1.ExpectantmanagementIfthepatienthasnosymptom，thereisnoneedtoinsistonanytreatment,butthepatientshouldbeexaminedperiodically.

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

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

asanurse?.Psychosocialassessmentthepatient’sfeelingsocialsupportofthepatientthestresscopingstyle.NursingdiagnosisPainrelatedtotheabnormalendometriumreplantedKnowledgedeficitrelatedtoignoranceofthediseaseanditsmanagementSexfunctiondisturbancerelatedtotheintercoursepainSelf-esteemdisturbancerelatedtoinferti