Uterine fibroid

Uterine fibroids are formed by the proliferation of uterine smooth muscle cells and a small amount of fibrous connective tissue.Uterine fibroids are the most common benign tumors for women’s genitals. They are also the most common tumors in the human body. They are more common in women aged aged 30 to 50. They are most commonly seen in the age of 40 to 50 and are rare under 20.About 20%of women over the age of 35 have uterine fibroids. Because many patients have no symptoms, or if the fibroids are small, the incidence of clinical reporting is far lower than that.

The exact cause is not clear.Because fibroids are good at fertility, it is rare before adolescence, and atrophy or retreat after menopause may be related to female hormones.The concentration of estrogen receptor in fibroids is significantly higher than peripheral muscle tissue. Therefore, it is believed that the high -sensitivity of the local fibroid tissue to estrogen is one of the important factors for the occurrence of fibroids.In addition, progestin has the effect of stimulating fibroid growth.

Different from the parts of fibroid growth are divided into the following three types

(1) Intramural myoma: 60%to 70%, fibroids are located between the uterine muscle wall and surrounded by muscle layers.

(2) Subserous myoma: About 20%, fibroids grow to the plasma surface of the outer uterine.If the tumor continues to grow towards the plasma surface, only one is connected to the uterus.If the blood supply is inadequate, fibroids can be degenerated.If the tire is twisted, the fibroids fall off to form free fibroids.

(3) Submucous myoma: account for 10%to 15%.The fibroids grow in the direction of the uterine cavity, highlighting in the uterine cavity, and the surface is only covered with endometrium.Subciders are prone to formation, growing like foreign objects in the uterine cavity, often causing uterine contraction. The fibroids can be squeezed out of the cervix outer mouth and burst into the vagina.

Uterine fibroids are often multiple, and various types of fibroids can occur in the same uterus, called multiple uterine fibroids.

(1) Clinical manifestations

1. Menstruation abnormalities

It is the most common symptoms of uterine fibroids, which are manifested as more menstruation, extended menstrual periods, shortening cycles, or irregular vaginal bleeding.Menstrual abnormalities are closely related to the growth of fibroids. Subcidial fibroids are most likely to cause increased menstrual flow and prolonged menstrual period, and the chance of occurring is close to 100%.The incidence of menstrual abnormalities of fibroids and submissions of the muscle wall is 74%and 36%, respectively.The cause of menstrual abnormalities is that the tumor deforms the uterine cavity and increases the area; fibroids hinder the contraction of the uterus during menstrual period; the hyperplasia of the endometrium and the formation of polyps; necrotic infection of fibroids; fibroid compression causedCluster blood recharge and expansion.

2. The fibroids with large symptoms of symptoms are located on the anterior wall of the uterus to compress the bladder to cause frequent urination, urgency, or difficulty in urination, and urinary retention. Located on the back wall can compress the rectum and cause constipation.When the cervical fibroids increase, the ureteral pelvis may be compressed and the pyelone is accumulated.

3. Increased vaginal discharge due to increased uterine cavity, increased endometrium glandular secretion leads to an increase in leucorrhea. If submucosal fibroids are infected by necrosis, it can produce a large amount of bloody and purulent secretions.

4. Patients with uterine fibroids in the pain have lower abdomen pain and falling feeling, accompanied by back pain and back pain.Sub -membrane fibroids can cause acute abdominal pain when the fibroids are transformed, and acute abdominal pain can be treated in a timely manner.

5. After a long time and extension of the anemia, the period of time is prolonged, and the irregular vaginal bleeding time can lead to varying degrees of anemia.

6. Infertility, an increased uterine fibroids can change the location of the fallopian tube, or cause tubal obstruction. The submucosal fibroids can affect the bed in the uterus and affect the conception.abortion.

7. Patients with weight loss in the abdominal block, or when the fibroids increase by more than 3 months, can be in the abdominal wall and hard mass.

(2) Gynecological examination

(1) Betal fibroids: The uterus increases, the texture is hardened, the original normal shape is lost, and the surface is irregular.(2) Mulbulosal fibroids: The lumps can be connected to the palace body to promote the movement of the lump with the palace body during the uterus.Pattius’s subdivic fibroids often have pain when they move or press the lump.

(3) Subcidial fibroids: The uterine is enlarged, and the shape is still regular. When the submucosal fibroids are protruding in the vagina, the surface of the surface is congested, and there is a pyotic secretion when the surface is infected.Bleeding.

(4) During the degeneration of fibroids, such as cystic changes, mucus changes, etc., the uterine texture becomes soft during examination, like a pregnancy uterus.

2. Auxiliary inspection

(1) B -ultrasound: The most commonly used and simple way to diagnose uterine fibroids.It is characterized by the increase in the volume of the uterus, the fibroids cannot be separated from the uterus, and the uterine shape is irregular.The fibroids are located in a strong echo, the group and dot -shaped echo appear, and the echo gradually weakens.

The uniformity of uterine myotomas increases.It rarely exceeds uterine adenomia.Uterine adenomy disease may have increased uterus and increased menstruation.Limited uterine adenomy disease is similar to the uterine muscle wall fibroids, which is hard.However, the secondary dysmenorrhea in the uterine adenocular disease is obvious, and the uterus is mostly increased, and the uterine size is less than 3 months.Ultrasonic examination and peripheral blood CA125 detection can help diagnosis.But sometimes the two can coexist.

Patients with uterine fibroids should be followed up regularly and 1 test 2 to 3 months, including gynecological examinations and B -ultrasound diagnosis.Actively follow up before and after menopause to prevent bad changes.

Patients with uterine fibroids should not be placed in the intrauterine condiments, especially fibroids and submucosal fibroids in the muscle wall, so as not to cause more menstruation and prolonged menstruation, and it is not appropriate to take contraceptives. It is best to use contraceptive measures.For young fibroid patients who want to have childbirth, fibroids can be performed through the abdomen.Pattius’s submucosal fibroids are removed from vaginal removal.If the fibroids increase, the entire uterus is more than 3 months of pregnancy uterine size, or the fibroids have increased significantly in the near future, or too much menstrual flow.

For multiple uterine fibroids, surgery can be used. For small uterine fibroids, traditional Chinese medicine can be used to promote blood circulation and blood stasis, qi dispersing node treatment or acupuncture points for acupuncture points: Foot triple, Kuyu, Hegu, Taichong, etc.For the purpose of the treatment of childbearing age, the patient infertility is solved.

【Prevention and protection】

(1) Qi stagnation is one of the factors of uterine fibroids. Smoothing is an important aspect of preventing and nursing patients with uterine fibroids.You can usually take a small amount of roses, and rose drinks can lighten the stains.However, it is not recommended to drink roses for adolescents and children, because rose flowers are warm, floating, and it is easy to disturb blood sea uterus, affect menstruation, and cause children to puberty.

(2) Patients with uterine fibroids often lead to anemia due to a long time, and nutrition should be strengthened. Multi -iron content and high protein content should be strengthened.Such as fish, beef, mutton, seafood, etc. high protein, low -fat diet, take a pork liver with iron -high internal organs diet once a week if necessary

(3) Patients with uterine fibroids are often extended during menstruation and are prone to infection. The vulva should be kept clean and infection.It is particularly emphasized here: any gynecological inflammation is strictly forbidden to rinse vagina, which will lead to reverse upward infection.

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