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子宫内膜异位症(Endometriosis).ppt

文档分类：医学/心理学 | 页数：约47页举报非法文档有奖

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EndometriosisDefinitionEndometriosisisusuallydefinedasthepresenceofendometrial-liketissue,thatis,glandsandstroma,monsites:uterosacralligamentrectouterinepouchovaryOthers:uterineserosafallopiantubesigmoidcolon(乙状结肠)outsideofthepelvis:Umbilicus(脐),bladder,kidneyPrevalencepresentin10%-15%ofwomeninreproductiveagegroup,especiallyfromage25to45normallynotseenbeforeage15oraftermenopauseearlyandmorechildbearinglateststudy:morefrequentmenses(cyclelength≤27days)andprolongedmenstrualflow(≥1week)2timesriskPathogenesisTheoriesofsourcesofectopicendometriumEndometrialimplantingtheory(种植学说)——Sampson1921endometriumtransfer→implant→grow⒈retrogrademenstruation(经血逆流)theory⒉transportbylymphandvein⒊iatrogenic(医源性的)implantationPathogenesisTheoriesofsourceofectopicendometriummetaplasiatheory(化生学说)inducementtheory(诱导学说)icAbnormalities:highriskinfirst-degreerelativesImmunologicFactors:increasedconcentrationsofwhitebloodcells,cytokines,andgrowthfactors——IL-6、IL-8、TNF-α、MCP-1inflammation:EMslesions→chronicpelvicinflammationPathologyectopicendometrium↓hemorrhage↓proliferationoffibroustissue&adhesions↓darkblueordarkbrownspots↓scarringnodulesorcystsGrossappearance:ovarianendometriosisred,blue,orbrownspotsendometriomas——chocolatecystsGrossappearance:monsites:uterosacralligament、rectouterinepouchpurplespotsdarkbrownspotsredlesionswhitelesionsperitoneumlack

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