Lumbar puncture cerebrospinal fluid drainage in th

e707004304 · Wysłany: Pią 10:51, 18 Mar 2011

Lumbar puncture cerebrospinal fluid drainage in the treatment of subarachnoid hemorrhage continued clinical observation

Words: endometriosis; ovary; hysterectomy Key words: R7l1.7l cases 1,4 O years. 4 years ago for uterine fibroids in our hospital hysterectomy surgery. Intraoperative exploration size of the normal color of both ovaries, rectal fossa, abdomen were normal. Patients without abdominal pain, abdominal distension after surgery,[link widoczny dla zalogowanych], no backache and discomfort, not referral, 3 months before the medical examination found that the left attachment zone unit mass, pelvic mass close to the hospital. Admission Fu check: vulva,[link widoczny dla zalogowanych], vagina no abnormal cervical smooth, Palace absence, hit the left side area the size of a mass 8cm in diameter, capsule sexy, ill-defined, no tenderness, poor activity, the right accessories not touched exception , non-tender nodules rectal fossa. Blood CA12532IU/ml, CEA, AFP normal, diagnosis: pelvic mass (① pelvic encapsulated fluid? ② left ovarian cyst?) Laparotomy with intraoperative see the left ovarian cyst, 6cm × 5cm × 7cm size surface brown, and bowel, omentum, pelvic adhesions tightly fixed in the rectal fossa. Peel adhesion isolated cysts, cyst rupture the separation process,[link widoczny dla zalogowanych], a thick chocolate-like fluid flow, pelvic washing, line the left side removed. Pathological diagnosis: left ovarian endometriotic cyst. Followed up for 3 months without exception. Cases of 2,49 years. 3 years ago, adenomyosis, left ovarian endometriosis in our hospital hysterectomy and left oophorectomy. Appear under more than 1 year after abdominal pain,[link widoczny dla zalogowanych], gradually worsening service painkillers, ibuprofen and other invalid. Then come to our hospital, physical examination: a mass hit the right attachment zone diameter of about 5cm, poor activity, rectal fossa tenderness apparent oral danazol for March, slightly ease the pain, requiring surgery. Preoperative right side of the attachment area of about 4cm in diameter the size of cyst, laparotomy, intraoperative see omentum like material scattered in the thick brown, right ovarian cysts, 4cm × 5cm × 4cm size, and the right side of the sacral ligament and abdominal wall close adhesion, poor activity, rectal fossa closed, the line on the right accessories removed. Pathologic: right ovarian endometriotic cysts. Gestrinone patients after oral administration of 6 months and 1 year follow-up was no discomfort, no abnormal physical examination. Discussion after hysterectomy endometriosis colonization of wood raw rare, the treatment of endometriosis is still square ripple surgery, surgical method according to lesion location, extent and fertility requirements vary, divided into conservative surgery, semi-conservative surgery and radical mastectomy. ... Required conservative surgery is mainly used for fertility patients, resection of the lesions, to retain the uterus, at least to retain the side of the annex; not required for the growth of middle-aged patients who endometriosis, the clinical use more semi-conservative surgery, ie removal of the uterus and pelvic lesions, to retain part of the normal ovaries or ovaries to prevent premature menopause symptoms; radical surgery or hysterectomy with bilateral lesions and all attachments, suitable for older, seriously ill or recurrent failure of conservative surgery, drug treatment ineffective. The success rate of conservative surgery and inversely proportional to the severity of lesions, recurrence of ovarian endometriotic cysts,[link widoczny dla zalogowanych], mostly incomplete stripping or peeling rupture of membrane during cultivation in the pelvic wall; According to theory of endometriosis cultivation theory , removal of the uterus is removed dynamic endometrial cells, which removes the source of planting, so the semi-recurrence rate after conservative surgery, reported <5% L2j. For the combined treatment of surgery and drugs, each shares the same is generally believed that lesions premedication can help reduce the limitations of the surgery, postoperative medication can control the surgical resection of lesions and occult lesions. The drugs currently used oral contraceptives, danazol, mifepristone, in the United States pass, gestrinone, GnRHa and so on. Analysis of these two cases, consider the 1st view of the normal eye surgery ovarian occult lesions may have been there, so the first 2 patients, are moderate to severe endometriosis, uterine resection of the left side of patient with recommendations Drug treatment may prevent further surgery, but hysterectomy due to uterine fibroids or subtotal hysterectomy in patients without conventional surgery, as the ovaries profile, and the possibility of postoperative adjuvant therapy is small, so for these patients The best treatment remains controversial, the other, in more complicated with the official muscle adenosis uterine fibroids, uterine fibroids were a merger of the small uterine muscle adenosis, as specimens have been lost and can not review and re-biopsy pathology biopsy .