子宫内膜异位症英语课件VIP免费

子宫内膜异位症和子宫腺肌病（endometriosisandadenomyosis）Objectives（教学目标）1.Familiarizetheprevailingtheoriesonpossiblecausesandpathogenesisofendometriosis。（熟悉子宫内膜异位症可能的病因和发病机制）2.Mastertheclinicalfeatures,diagnosisanddifferentialdiagnosisofendometriosis（掌握子宫内膜异位症的临床特点、诊断及鉴别诊断）Objectives（教学目标）3.Understandtheprinciplesofthetreatmentstrategyofendometriosis。（了解子宫内膜异位症治疗策略的原则）主要内容MaincontentPathogenesis病因和发病机制Pathologicalfeatures病理特点Clinicalfindings临床表现Diagnosis诊断Differentialdiagnosis鉴别诊断Treatment治疗子宫内膜异位性疾病：子宫内膜异位症（endometriosis，EM）子宫腺肌病(adenomyosis)定义：DefinitionAgynecologicalconditioninwhichendometrialcellsappearandgrowoutsidetheuterinecavity。（endometriosis,EM）具有生长功能的子宫内膜出现在子宫体以外身体其他部位，生长、侵蚀、周期性出血称子宫内膜异位症，简称内异症发生部位发生部位ovarian（卵巢）peritonea（腹膜）deepinfiltratingendometriosis(DIE)异位子宫内膜可以侵犯全身任何部位，绝大多数位于盆腔脏器和腹膜。最常见的被侵犯部位是子宫骶韧带及卵巢IncidencerateTheendometriosisincidenceofFertilewomenis76%，Hormonedependentdisease，生育年龄妇女是内异症高发人群约占76%，是一种激素依赖性疾病。Incidencerate1.Recurringpelvicpain，20%-90%慢性盆腔疼痛及痛经，2.Infertility，40%，不孕3.dyspareunia，pain，性交不适，疼痛4.Menstrualdisturbances，月经紊乱15%-30%Thecharacteristicsofendometriosis子宫内膜异位症特点子宫内膜异位症特点Diverseclinicalmanifestations临床表现多样Histologicallybenign组织学上良性Buthyperplasia,infiltration,metastasisandrecurrenceof"malignant"behavior,causingextensiveadhesion“”但有增生、浸润、转移及复发等恶性行为，引起广泛粘连Growthishormonallydependent生长的激素依赖性11EtiologyandpathogenesisEtiologyandpathogenesis一、病因和发病机制一、病因和发病机制Nosingletheoryexplainsallcasesofendometriosis.发病机制不清，提出了各种学说MechanismsummoryEndometrialimplantationtheoryhasbeenrecognizedSampson'stheoryofhemorhedraltransplantingandtranscoelomicmetaplasiaistheleadingtheory以sampson的经血逆流种植及体腔上皮化生学说为主导理论.Endomyelitisdeterminism在位内膜决定论.EMRetrogrademenstruation种植学说Coelomicmetaplasia体腔上皮化生Inductiontheory诱导学说Geneticfactors遗传因素Immuneandinflammatory免疫与炎症因素Endomyelitisdeterminism在位内膜决定论Etiology:theoriesEtiologicalstudyEtiologicalstudy病因学研究病因学研究种植学说：Sampsonfirstputforwardthetheoryofmenstrualbloodrefluflowin19211921年Sampson最早提出经血逆流学说Endometrialimplantationtheoryhasbeenrecognized种植学说种植学说种植学说种植学说内膜种植学说已为人们所公认内膜种植学说已为人们所公认Etiologicalstudy病因学研究1.Endometrialglandularepitheliumandstromalcellsmayreverseflowduringmenstruation2.Throughthetubalintothepelviccavity,implantedintheovaryandadjacentpelvicperitoneumandcontinuetogrow,spread,theformationofpelvicdysplasia经期时子宫内膜腺上皮和间质细胞可随经血逆流，经输卵管进入盆腔，种植于卵巢和邻近的盆腔腹膜并在该处继续生长、蔓延，形成盆腔内异症TheBasicpathologicalchangesofendometriosisTheBasicpathologicalchangesofendometriosis基本病理变化基本病理变化Implantationofendometrialcellstotheperitonealsurfacecanleadtoaspectrumofdiseaseseveritywiththemostseverecausingextensivepelvicadhesionsandanatomicdistortion.将子宫内膜细胞移植到腹膜表面...