In this issue, we talk about the examination and treatment of pelvic inflammatory disease, which is a major concern for many pelvic inflammatory disease patients.
Let’s talk about the tests that are usually needed for pelvic inflammatory disease.
1. Gynecological examination: the vagina is usually congested with a large amount of purulent discharge; the cervix is congested and edematous, often accompanied by painful lifting, the uterine body may be slightly enlarged, with pressure pain and limited activity; the uterus may have significant pressure pain on one or both sides, or even a painful, inactive mass may be palpated; in severe cases, there may be pelvic abscess formation, and if the location is low, a mass may be palpated at the posterior fornix with a fluctuating sensation, or on one side of the uterine body In severe cases, pelvic abscesses may form. Sometimes thickening and stiffening of the uterosacral ligament with tenderness is seen.
2. Vaginal, pelvic and uterine secretions: During the gynecological examination, vaginal, pelvic and uterine secretions are taken to check whether there are white blood cells or whether pathogenic bacteria are cultured, and to find out the type of antibiotic drugs that are sensitive to the pathogenic bacteria.
3. Posterior fornix aspiration: the obtained abdominal contents or uterine rectal fossa contents, such as normal abdominal fluid, blood (fresh, old, clotted blood, etc.), purulent secretions or pus, can make the diagnosis further clear.
4. Ultrasound and hysterosalpingogram: It can show thickening of the fallopian tubes, fluid accumulation with or without pelvic fluid and tubo-ovarian masses. Among them, imaging can show pelvic problems more clearly, such as the patency of the fallopian tubes, whether they are tortuous or not, whether they are blocked, and the degree of blockage, etc. It is helpful to have an imaging test if necessary.
5. Laparoscopy: It is highly accurate in diagnosing tubal infection and can directly take secretions from the infected area for bacterial culture. However, not all patients suspected of pelvic inflammatory disease should undergo laparoscopy. , , and
6. Blood count: In acute pelvic inflammatory disease, an increase in total leukocytes and neutrophils is seen, the latter of which is more pronounced. Elevated blood sedimentation >20mm/h, elevated CRP, etc.
There are various treatment methods for pelvic inflammatory disease.
1. Outpatient treatment.
Western medicine: mainly antibiotic treatment, for patients who can tolerate oral antibiotics in good general condition and with mild symptoms.
Traditional Chinese medicine.
(1) Chinese herbal prescriptions for symptomatic treatment.
(2) Chinese medicine enema and external application of Chinese medicine: In Chinese medicine, pelvic inflammatory disease is caused by the intersection of dampness, toxicity and heat, so the medicine is used to clear heat and detoxify the toxin, and to remove dampness and stasis by enema or external application on the lower abdomen to make the medicine reach the disease directly. There are many effective prescriptions in our department, and the specific method is chosen according to the severity of the patient’s condition.
(3) Traditional Chinese medicine: Gynecological Qianjin tablets, Gynecological Yan Kang tablets, Bao Wen Kang suppositories, etc. are also effective for internal and external use.
(4) Other: pelvic inflammatory disease treatment instrument, acupuncture and other treatments are chosen according to the condition. But it is not very convenient to use in the outpatient clinic. It is more suitable for inpatient treatment.
2. Inpatient treatment.
Western medicine.
(1) Supportive therapy: bed rest, semi-recumbent position is good for pus accumulation thus limiting the inflammation. So some patients want to do treatment during the day during the hospitalization back at night is actually not good.
(2) Antibiotic therapy.
(3) Surgery: If necessary, surgery should be performed for patients whose medication is ineffective, whose abscesses persist or rupture, or whose tubal effusion is serious. Nowadays, laparoscopic surgery is the main treatment.
Chinese medicine.
(1) Symptomatic treatment with herbal remedies.
(2) Chinese herbal enemas and external application of Chinese herbal medicine: During hospitalization, two enemas are usually performed in the morning and evening to treat pelvic inflammatory disease more effectively. And usually outpatients usually only have enemas at bedtime because of their work life and other reasons.
(3) Acupuncture treatment: including acupuncture point compresses and body acupuncture, etc., with moxa pillar warming as the main treatment.
Other treatment modalities are infrared therapy, gynecological microwave therapy, medium frequency pulse therapy, etc. The actual infrared treatment has a lot of people confused about what effect it has on pelvic inflammatory disease? In fact, infrared treatment of pelvic inflammatory disease is mainly the use of infrared light can penetrate deep into the human tissue and infrared warm effect, elevated tissue temperature expansion, capillary, promote blood circulation, enhance material metabolism, improve tissue cell vitality and regeneration capacity. Infrared treatment of chronic inflammation can improve blood circulation, increase the phagocytosis of cells, eliminate swelling and promote the dissipation of inflammation. Gynecological microwave therapy mainly uses the sterilization characteristics of microwaves, coupled with the sterilization effect of the thermal effect, so as to achieve the purpose of the anti-inflammatory.
Of course, each patient’s condition is different. It is not possible to use the same treatment plan for this patient. Therefore, if you are confused readers, please come to the hospital for consultation.
The other most important thing is: early treatment!