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《互联网药品信息服务资格证书》编号:(苏)-非经营性-2018-0040

Uterine fibroids

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[Abstract]:
Uterine fibroids are the most common benign tumors in female reproductive organs and one of the most common tumors in the human body, also known as fibroids and uterine fibroids. Because uterine fibroids are mainly caused by the proliferation of uterine smooth muscle cells, and a small amount of fibrous connective tissue exists as a supporting tissue, it is called uterine leiomyoma. Referred to as uterine fibroids.
【Uterine fibroids are the most common benign tumors in female reproductive organs and one of the most common tumors in the human body, also known as fibroids and uterine fibroids. Because uterine fibroids are mainly caused by the proliferation of uterine smooth muscle cells, and a small amount of fibrous connective tissue exists as a supporting tissue, it is called uterine leiomyoma. Referred to as uterine fibroids.】
 
【According to a large number of clinical observations and experimental results, uterine fibroids are a hormone-dependent tumor. Estrogen is the main factor in promoting the growth of fibroids. Some scholars believe that growth hormone (GH) is also involved in the growth of fibroids. GH can synergize with estrogen to promote mitosis and promote the growth of fibroids, and speculate that human placental lactogen (HPL) also It can synergize with estrogen to promote mitosis. It is believed that the growth of uterine fibroids during pregnancy is related to the high hormonal environment during pregnancy. HPL may also participate.】
 
【In addition, ovarian function and hormone metabolism are regulated by the high-level nerve center, so the central nervous activity may play an important role in the pathogenesis of fibroids. Factor uterine fibroids are more common in women of childbearing age, widowhood and sexual life. Chronic congestion of the pelvis caused by long-term sexual disorders may also be one of the causes of uterine fibroids.】
 
【In a word, the occurrence and development of uterine fibroids may be the result of multiple factors.】
 
Clinical manifestation
 
1. Symptom
 
1.1 【Most patients are asymptomatic and are only found during pelvic or ultrasound examinations. If there are symptoms, it is closely related to the growth site, speed, presence or absence of degeneration and complications, but it is relatively small compared with the size and number of fibroids. People with multiple subserosal fibroids may not have symptoms, and a smaller submucosal fibroid can often cause irregular vaginal bleeding or menorrhagia. Common clinical symptoms are:】
 
1.2 【Uterine bleeding is the most common symptom of uterine fibroids, occurring in more than half of patients. Among them, periodic bleeding is more, which can be expressed as increased menstrual flow, prolonged menstruation or shortened cycle. It can also be expressed as irregular vaginal bleeding without menstrual periodicity. Uterine bleeding is more common in submucosal fibroids and intermuscular fibroids, while subserosal fibroids rarely cause uterine bleeding.】
 
1.3 【Abdominal mass and compression symptoms of fibroids gradually grow, when it makes the uterus more than 3 months pregnant uterus size or large subserosal fibroids located at the bottom of the palace, often can be found in the abdomen, early morning bladder It is more obvious when filling. The mass is solid, movable, and free of tenderness. When the fibroids grow to a certain size, it can cause symptoms of peripheral organs. The anterior wall of the uterine fibroids close to the bladder can produce frequent urination and urgency. The compression of the bladder by a large cervical fibroid can cause poor urination or even urinary retention. Is the isthmus or cervical posterior lip fibroids can compress the rectum, causing poor bowel movements, discomfort after defecation; huge wide ligament fibroids can compress the ureter, and even cause hydronephrosis】.
 
1.4 【Pain Under normal circumstances, uterine fibroids do not cause pain, but many patients can complain of lower abdominal bulge and low back pain. Acute subcutaneous pain can occur when the subserosal fibroids are reversed or the uterine fibroids are red-denatured. It is not uncommon for fibroids with endometriosis or adenomyosis to be dysmenorrhea.】
 
1.5 【Increased vaginal discharge The uterine cavity enlarges, the endometrial glands increase, and the pelvic congestion can increase the vaginal discharge. When the submucosal fibroids of the uterus or cervix develop ulcers, infections, and necrosis, bloody or purulent leucorrhea is produced.】
 
1.6 【Infertility and abortion Some uterine fibroids with infertility or prone to miscarriage, the impact on pregnancy and pregnancy outcome may be related to the growth site, size and number of fibroids. Giant uterine fibroids can cause uterine cavity deformation, hinder gestational sac implantation and embryo growth and development; fibroids pressing the fallopian tube can lead to patency of the lumen; submucosal fibroids can hinder the implantation of the gestational sac or affect sperm into the uterine cavity. The spontaneous abortion rate of patients with fibroids is higher than that of the normal population, and the ratio is about 4:1.】
 
1.7 【Anemia Due to long-term menorrhagia or irregular vaginal bleeding can cause hemorrhagic anemia, more severe anemia is more common in patients with submucosal fibroids.】
 
1.8 【Others Very few patients with uterine fibroids can develop polycythemia, hypoglycemia, which is generally thought to be related to the production of ectopic hormones in tumors.】
 
2. Signs
 
2.1 【Abdominal examination of the uterus increased more than 3 months of pregnancy size or larger subuterine subserosal fibroids, can be in the upper or lower abdomen of the pubic symphysis and mass, solid, no tenderness, if multiple uterus The fibroids are irregular in shape outside the mass.】
 
2.2 【pelvic examination Gynecological double-combination, triple-examination examination, the uterus is increased to varying degrees, less regular, irregular surface of the uterus, solid, if the denaturation is softer. The signs of uterine fibroids during gynecological examination vary according to their different types. If the pedicle subserosal fibroids are long, they can be paralyzed and substantively packed in the uterus, and the activity is free. This situation is easily confused with ovarian tumors. The submucosal fibroids descend to the cervical canal, and the cervix is loose. The examiner's fingers reach into the cervix to touch the smooth spherical tumor. If the cervix is removed, the tumor is visible, and the surface is dark red and sometimes ulcerated. Necrosis. Larger cervical fibroids can displace and deform the cervix, and the cervix can be flattened or moved up to the posterior pubic symphysis.】
Uterine fibroids
Endometrial polyps
Intrauterine adhesions (IUA)