- 期刊
骨盆感染與骨盆腔炎症之老病精華
Pelvic Infection and Pelvic Inflammatory Disease: Old Disease Essence
摘要
婦女常見疾病骨盆感染，包括有下生殖道感染，如外陰炎、陰道炎、子宮頸炎，上生殖道感染稱為骨盆腔炎症如子宮內膜炎、輸卵管炎、卵巢炎、子宮旁炎、腹膜炎、輸卵管卵巢膿瘍。多數骨盆腔炎症經由性傳染而稱為性傳染病，最常見病原淋菌與披衣菌由下上升經黏膜傳染。然而，非性傳染，經下生殖道菌落上升傳染的病原如由腸道菌、雜菌或由呼吸道而來，可以混合感染。有症狀的典型骨盆腔炎症為急性下腹或骨盆疼痛、骨盆器官壓痛、生殖道炎症表現，可以細微和非特異性的；症狀較嚴重後可能合併全身症狀如發燒而可能為腹膜炎；影像評估以超音波檢查仍是最常應用者。骨盆腔炎症治療原則基於病原考量，對付最常見病原。陰道炎常見症狀為分泌物、有異味、搔癢、刺激、紅腫等；常見診斷為外陰陰道念珠菌病、陰道滴蟲病、細菌性陰道症；外陰炎有多樣化外陰病變除皮膚炎外，感染常見的念珠菌病、尖形濕疣、單純皰疹；依診斷分別處置。須要強調預防性傳染病給予行為之諮詢介入。
並列摘要
Pelvic infection includes lower genital tract infection, such as vulvitis, vaginitis, and cervicitis; upper reproductive system infection called pelvic inflammatory disease (PID) includes endometritis, salpingitis, oophoritis, parametritis, peritonitis, and tubo-ovarian abscess. PID is mostly sexually transmitted, and the most common etiological pathogens, Neisseria gonorrhoeae and Chlamydia trachomatis. Symptomatic classical PID is characterized by an acute lower abdominal or pelvic pain, pelvic organ tenderness, and evidence of inflammation of the genital tract. The most important imaging assessment is by ultrasonography. The principle of management is to treat against the common pathogens. Common symptoms of vaginitis include vaginal discharge, odor, pruritus, and/or discomfort; common diagnoses are candida vulvovaginitis, trichomoniasis and bacterial vaginosis. A wide variety of vulvar lesions represent vulvitis and dermatitis, and some common infections as candidiasis, condyloma acuminata, and herpes simplex. Vulvar and vaginal infections are treated accordingly. Behavioral counseling interventions to prevent sexually transmitted infections are emphasized.