acute endometritis
Introduction
Introduction to acute endometritis Uterine inflammation is one of the inflammations of the pelvic genital organs and is a common disease in women. Inflammation can be limited to one site, or several sites at the same time. Clinically, it is more common in the latter case. Acute inflammation may cause serious consequences such as diffuse peritonitis and sepsis to septic shock. Usually due to unsanitary menstruation, menstrual sexual intercourse or sexual life disorder will bring pathogens in the cervix in vitro or in the vagina into the uterine cavity. The mildly infected endometrium is only hyperemia, edema, polymorphonuclear leukocytes and round cell infiltration, infection. Severe, purulent, extensive necrosis, and can accumulate the muscle layer underneath to form acute uterine myositis. basic knowledge Probability ratio: female incidence rate is about 0.1%-0.2% Susceptible people: adult women Mode of infection: non-infectious Complications: peritonitis sepsis septic shock
Cause
Causes of acute endometritis
Cause
Menstrual unsanitary, menstrual sexual intercourse or sexual life disorder will bring pathogens in the cervix in vitro or in the vagina into the uterine cavity. The mildly infected endometrium is only hyperemia, edema, polymorphonuclear leukocytes and round cells infiltration, serious infection occurs. Suppurative, extensive necrosis, and can accumulate the muscle layer underneath to form acute uterine myositis.
Prevention
Acute endometritis prevention
Because acute endometritis occurs after abortion or after delivery, it is related to bacterial retrograde infection of uterine wounds. Therefore, prenatal treatment of genital tract inflammation, post-abortion and postpartum attention to personal hygiene, prevention of acute endometritis Play a role.
(1) Before the abortion, a comprehensive gynecological examination is performed before delivery, and the genital tract is urgently discovered, chronic inflammation is treated and treated to prevent the infection of the bacteria after abortion or postpartum.
(2), choose a regular hospital for abortion surgery or childbirth, surgery is not strict at the time of delivery is an important cause of acute endometritis, should be taken seriously.
(3) Pay attention to personal hygiene after postpartum or abortion surgery, do not use unclean sanitary napkins, replace sanitary napkins in time, and prohibit sexual intercourse.
(4) As a pregnant woman, it is necessary to go to the designated hospital for prenatal examination regularly, receive health guidance during pregnancy, actively treat chronic diseases such as malnutrition and anemia, enhance physical fitness, prohibit sexual life in late pregnancy, pay attention to diet after childbirth, and eat easily. Digest, nutritious food rich in protein and vitamins, maintain a good physical condition, take more than half position when the lochia is not discharged, in order to facilitate the discharge of lochia.
(5), ordinary women should also pay attention to personal hygiene, when the vaginal bleeding is absolutely prohibited.
Complication
Acute endometritis complications Complications peritonitis sepsis septic shock
May cause diffuse peritonitis, sepsis and septic shock and other serious consequences.
Symptom
Acute endometrial symptoms Common symptoms Bloody secretions Reactive cells change Anti-intimal antibody Positive backache Lower abdominal pain Malignant leucorrhea Increase aversion Cold Abdominal tenderness weakness
According to the medical history, clinical manifestations and signs are easy to diagnose. When the speculum is examined, the uterine cavity drainage should be taken as far as possible to send bacterial culture and drug sensitivity. At the same time, the smear test bacteria should be used as reference for the action drug, and repeated vaginal examination should be avoided to prevent the spread of infection. .
The onset is more urgent, there is chills and even chills, fever (38 ~ 40 ° C), pulse speed, body weakness, sweating, lower abdomen pain, drama, back pain, a lot of blood, purulent or watery vaginal discharge, and stink Flavor, postpartum infection, the lochia is earthy.
Signs: The patient has tenderness in the lower abdomen. The speculum examination shows that there is a large amount of purulent or septic bloody odor secretions in the uterus. The cervix is painful during double diagnosis. The uterus is swollen due to congestion and edema, soft and tender, and the test is obvious. Then the total number of white blood cells and neutrophils increased.
Examine
Examination of acute endometritis
Signs: The patient has tenderness in the lower abdomen. Speculum examination revealed a large amount of purulent or fouling bloody odor secretions in the uterus. Cervical pain during double consultation. The palace body is swollen due to congestion and edema, soft and tender. The test showed the total number of white blood cells and neutrophils.
According to medical history, clinical manifestations and signs are easy to diagnose. When the speculum is inspected, the uterine cavity drainage should be taken as far as possible to send the bacteria culture and drug sensitivity, and the smear test bacteria should be used as reference for the action drug. Repeated vaginal examinations should be avoided to prevent the spread of infection.
Diagnosis
Diagnosis and diagnosis of acute endometritis
diagnosis
Mildly infected endometrium is only hyperemia, edema, polymorphonuclear leukocytes and round cells infiltration, severe infection, suppuration, extensive necrosis, and can accumulate the muscle layer underneath to form acute uterine myositis.
The onset is more urgent, there is chills and even chills, fever (38 ~ 40 ° C), pulse speed, body weakness, sweating, lower abdomen pain, drama, back pain, a lot of blood, purulent or watery vaginal discharge, and stink Flavor, postpartum infection, the lochia is earthy.
Signs: The patient has tenderness in the lower abdomen. The speculum examination shows that there is a large amount of purulent or septic bloody odor secretions in the uterus. The cervix is painful during double diagnosis. The uterus is swollen due to congestion and edema, soft and tender, and the test is obvious. Then the total number of white blood cells and neutrophils increased.
According to the medical history, clinical manifestations and signs are easy to diagnose. When the speculum is examined, the uterine cavity drainage should be taken as far as possible to send bacterial culture and drug sensitivity. At the same time, the smear test bacteria should be used as reference for the action drug, and repeated vaginal examination should be avoided to prevent the spread of infection. .
Differential diagnosis
1. Acute appendicitis: abdominal pain begins in the stomach or total abdominal pain. Finally, the pain is fixed in the right lower abdomen McBurney's. The tender point is fixed at this point. The abdominal muscles are tense and may be accompanied by rebound pain. The fever is mostly between 38 °C and 38.5 °C. The blood sedimentation is normal. The pain of normal metritis is mostly the lower abdomen. Generally, there is no abdominal muscle tension and rebound tenderness. The body temperature is high and the blood sedimentation is fast.
2. Ectopic pregnancy: There is often a history of menopause, accompanied by vaginal bleeding, pregnancy test can be positive, no chills and high fever, occasionally low fever, pain and internal bleeding as the main features, can occur anemia or hemorrhagic shock.
3. Ovarian cysts are twisted or ruptured: the torsion or rupture is sudden, the pain is severe, and the sacral side is prominent. When the examination is performed, the occipital area of the diseased side can be covered with a mass, tenderness, and B-ultrasound is helpful for diagnosis.
