Endometritis

　　1. Changes in hormonal levels:As women age, the hormones in their bodies also decrease continuously. The acidity of the vagina decreases, and the cervical mucus plug gradually decreases, which is more likely to cause senile vaginitis at this time, leading to the symptoms of endometritis.

　　2. Neglecting menstrual hygiene:This is one of the common reasons for women to develop endometritis. Not paying attention to the cleanliness of the vulva during menstruation or conducting vaginal examination without strict disinfection during menstruation may allow external pathogens to invade. Similarly, it is necessary to avoid sexual activity during menstruation, and the sexual partner should also ensure health, otherwise, it is very easy to occur infection.

　　3. Unstandardized operation of uterine cavity surgery:Early rupture of the amniotic membrane during delivery, or irregular uterine cavity surgery after delivery, or gynecological examination are all prone to ascending infection. Moreover, the immune ability of women decreases after surgery, making it easier for bacteria to invade.

　　4. Uterine cavity lesions:If there are conditions such as long-term uterine bleeding, endometrial polyps, submucosal myoma, etc., the superficially covered endometrium is prone to infection, and it is easier to occur when the body's resistance decreases. At the same time, if there is inflammation in a woman's body and it is not treated for a long time, it is more likely to cause the spread of inflammation, thus triggering endometritis.

　　7. Uterine cavity pyosis: It refers to the accumulation of pus in the uterine cavity. When suffering from chronic endometritis, the cervical os is blocked, and the drainage is not smooth, leading to the retention of secretions in the uterus, which can cause pyosis of the uterine cavity.

　　6. Uterine perforation: Gynecological disease, referring to the full-thickness injury of the uterine wall caused by uterine cavity surgery, leading to communication between the uterine cavity and the abdominal cavity, or other organs. The perforation site can occur at the fundus, isthmus, or cervical canal, with the isthmus being the most common. It can also penetrate into the broad ligament, the posterior wall of the bladder, the intestinal loop, and even pull out the omentum, leading to internal hemorrhage, hematoma in the broad ligament, and secondary peritonitis.

　　5. Irregular menstruation: Endometritis patients may experience increased menstrual volume and longer menstrual periods.

　　4. Female infertility: Due to the growth of endometrial tissue in an abnormal position, it can lead to tubal occlusion, and the ovary cannot ovulate normally, reducing the chance of pregnancy.

　　5. Dysmenorrhea: Severe pain and distension may occur before menstruation, with the pain possibly extending to the anal and thigh areas, and in severe cases, chills and vomiting may occur; after menstruation, the pain may diminish or disappear.

　　6. Cyclic bladder irritation symptoms: When endometriotic lesions involve the peritoneal fold or muscle layer of the bladder, symptoms such as urgency and frequency of urination during menstruation may also occur. If the lesion invades the bladder mucosa (endometriosis of the bladder), cyclic and painful symptoms may appear.

　　7. Rectal irritation syndrome: Due to the possibility of endometrial tissue implantation in the rectal凹position, a sense of defecation may be felt during menstruation, accompanied by distension and pain in the anal and perineal areas, causing lumbar and abdominal pain, which disappears after menstruation.

　　8. Diffuse peritonitis: (Relative to localized peritonitis) is when the area of the peritoneum is almost equal to the area of the skin of the whole body. After the onset of acute diffuse peritonitis, there is a large amount of exudate, a large amount of toxic substances are absorbed, and the systemic toxic condition is also severe.

　　9. Sepsis: It refers to the entry of bacteria into the blood circulation, their growth and reproduction, and the production of toxins, causing systemic severe infection. Clinical manifestations include fever, severe toxic symptoms, rash, petechiae, enlargement of the liver and spleen, and an increase in white blood cell count.

　　10. Sepsis shock: Also known as septic shock, it refers to a sepsis syndrome (sepsis syndrome) accompanied by shock caused by microorganisms and their toxins and other products. Microorganisms and their toxins, cell wall products, and other substances in the focus of infection enter the blood circulation, act on various organs and systems of the body, affect their perfusion, leading to ischemia and hypoxia of tissue cells, metabolic disorders, dysfunction, and even multiple organ failure.

　　According to the duration of the disease, endometritis can be divided into acute and chronic endometritis.

　　Acute endometritis:

　　1. The onset is acute, with mild fever, a feeling of坠胀 pain in the lower abdomen, which is usually persistent.

　　2. There is a significant increase in leukorrhea, which may be purulent, bloody, or watery, with a foul smell. Abnormal endometritis during the puerperium often presents with persistent lochia and an unpleasant smell, which is usually caused by Escherichia coli and anaerobic bacteria. If Streptococcus hemolyticus or Staphylococcus aureus infection is present, the lochia is usually less and there is no obvious smell, but it is easy to spread through the lymphatic system.

　　3. Endometrial congestion and edema, infiltration of inflammatory cells. The cervix has purulent leukorrhea, cervical tenderness, and mild uterine body tenderness. White blood cell count is elevated, and neutrophils are increased.

　　Chronic endometritis:

　　1. Low fever, lumbar muscle pain, and marked lower abdominal pain or a sense of坠胀.

　　2. Increased leukorrhea, showing a thin watery, pale yellow, or purulent and bloody discharge. There may also be prolonged menstruation, dysmenorrhea, amenorrhea, or irregular vaginal bleeding.

　　3. The uterus increases in size and becomes soft, presenting a spherical shape with tenderness. Bloody or purulent discharge may be released.

　　Acute endometritis often occurs after abortion or childbirth, related to retrograde bacterial infection of the uterine wound. Therefore, active treatment of reproductive tract inflammation before childbirth, attention to personal hygiene after abortion and childbirth, can play a certain role in preventing the occurrence of acute endometritis.

　　1. Pay attention to menstrual hygiene:Sanitize menstrual pads, avoid sexual activity and taking a bath during menstruation. Avoid gynecological examinations and operations, such as various vaginal surgeries, tubal patency tests, and intrauterine device placement surgeries, to prevent ascending infection of pathogens.

　　2. Strengthen prenatal health care:Prepregnancy comprehensive gynecological examination should be conducted to detect and treat acute and chronic inflammatory diseases of the reproductive tract in a timely manner, preventing bacterial ascending infection after childbirth. Regular checks during pregnancy are necessary to detect various complications during pregnancy and to facilitate timely treatment. It is important to enhance nutrition and vitamin intake during pregnancy. Pay attention to prenatal hygiene, and bathe and change clothes frequently. After the eighth month of pregnancy, due to the gradual relaxation of the cervix, avoid taking a bath in a bathtub and excessive sexual activity to prevent infection.

　　3. Choose a regular hospital for delivery:In the process of delivery, strict aseptic operation should be performed to avoid unnecessary rectal and vaginal examinations, handle the labor process, prevent the labor process from being too long, ensure the rest and nutrition of the pregnant woman. After the placenta is delivered, check carefully, and remove any residual tissue in time to reduce postpartum hemorrhage. Early rupture of the amniotic membrane should be treated with antibiotics in time.

　　4. Pay attention to personal hygiene after childbirth:Do not use unclean toilet paper, change sanitary napkins in time, and prohibit sexual activity. Pay attention to diet and nutrition after childbirth, eat easily digestible, protein-rich, and vitamin-rich foods to maintain good physical condition. Take a semi-recumbent position more often when lochia has not been completely discharged to facilitate the discharge of lochia.

　　5. Do not have an illegal abortion:Some women, in order not to let others know they are pregnant, resort to illegal abortion by finding 'doctors' or their own family members. This is extremely dangerous. Often, it not only fails to induce labor but also causes infection in the mild case, organ damage in the severe case, and can lead to sepsis, tetanus, and even death. Therefore, this dangerous method should never be adopted.

　　1. Diagnostic curettage:It can clarify the cause of the disease and exclude malignant lesions. Before hysteroscopy, inflammation should be controlled for three days, and antibiotics should be continued after surgery to prevent infection. The operation should be gentle because the infected uterine wall is fragile and prone to uterine perforation. Senile endometritis has thin endometrium, so extra attention should be paid during scraping. Endometritis after abortion may have residual embryonic tissue, so it should be carefully and thoroughly scraped for examination, which often has a therapeutic effect. The total white blood cell count and neutrophils increase.

　　2. Ultrasound examination:Use ultrasound for preliminary diagnosis of uterine condition, and combine the results with clinical symptoms and laboratory results to diagnose endometritis.

　　Even without obvious symptoms, an internal scan can be performed. By examining the patient with a scanner, the treatment method can also be determined at the same time.

　　3. Laboratory examination:Blood and uterine cavity secretion bacterial culture and drug sensitivity test can be performed to make an accurate diagnosis and provide reference for treatment medication.

　　4. Endoscopic examination:Endoscopic examination shows a large amount of purulent or dirty, smelly, bloody vaginal discharge. During bimanual examination, the cervix is painful. The uterine body is enlarged and soft due to congestion and edema, with marked tenderness.

　　Patients with endometritis should enhance their nutrition, consume more dietary protein and vitamins, such as chicken, lean meat, shrimp, milk, tofu, beans, etc.; reduce fat and sugar intake; keep the taste light and reduce salt. Those with increased leukorrhea can eat more chive, mung bean, millet, tofu, lotus seed, walnut, white fungus, and other foods.

　　Avoid spicy, smoky, alcoholic, and other irritant foods and seasonings. These foods can cause congestion of the organs and increase vaginal blood flow.

　　Nutritious Recipe

　　1. Boil sea mustard with chive.

　　[Ingredients] 15g of vegetable oil, 120g of chive, 60g of sea mustard, and appropriate amount of yellow wine.

　　[Preparation] Pour some cooking oil into the pot and heat it, then quickly pour in chopped chives and stir-fry, then add cleaned mussels, add appropriate amount of water, and boil until the mussels are tender. Add some yellow wine and it can be served. Take one dose a day, and 7 days make up a course of treatment.

　　[Efficacy] Supplement nutrition, suitable for those with excessive leukorrhea.

　　2. Lotus Seed and Chinese Wolfberry Stewed Soup

　　[Ingredients] Lotus seeds and Chinese wolfberry each 30 grams, eggs 2 pieces, pork intestines one piece.

　　[Preparation] Soak and clean lotus seeds and Chinese wolfberry, mix with eggs, add appropriate seasoning, and then stuff into cleaned pork intestines, tie both ends with thread, and cook in a pot with water. After cutting into slices, serve. Take one dose a day, and 10 days make up a course of treatment.

　　[Efficacy] Nourish the liver and kidney, suitable for patients with liver and kidney deficiency.

　　3. Ginkgo Biloba Soy Milk Drink

　　[Ingredients] Ginkgo biloba 10 pieces, soy milk 300 milliliters.

　　[Preparation] After removing the shell of the Ginkgo biloba, crush it and mix it with soy milk, then boil it in water for 1 hour and it can be drunk. Take once a day, and 7 days make up a course of treatment.

　　[Efficacy] Supplement nutrition, suitable for patients with excessive leukorrhea.

　　The treatment of endometritis should first distinguish between cold and heat, and deficiency and excess. For those with heat and excess, it is urgent to clear heat and detoxify, promote diuresis and stop leukorrhea, and resolve blood stasis and relieve pain to prevent the disease from progressing further; for those with cold and deficiency, it is necessary to warm the kidneys and assist Yang, dispel cold and dampness, and resolve blood stasis and relieve pain to benefit the healthy and expel the pathogenic factors. In terms of specific therapies, internal medicine decoction, external application, acupuncture, enema, and other methods can be selected according to different conditions and applied in combination.

　　Acupuncture Therapy:

　　(1) Body Acupuncture: Main points, Guanyuan, Qihai, Sanyinjiao. Auxiliary points, Qichong, Ligou, Zusanli, Yinlingquan, generally perform moderate stimulation, do not retain needle or retain needle for 15 minutes.

　　(2) Ear Acupuncture: Take the uterus, ovaries, and endocrine points, needle embedding or magnetic particle application and pressure.

　　Enema Therapy:

　　(1) Take 30g of Dandelion, Lonicera japonica, Spatholobus suberectus, Patrinia scabiosaefolia, Houttuynia cordata, 15g of Angelica sinensis, Persica, 三棱, 莪术, add 1000ml of water, boil down to 100ml, retain enema, once a night, suitable for acute and chronic endometritis.

　　(2) Take 30g of Salvia miltiorrhiza, Spatholobus suberectus, Forsythia, 15g of赤芍, 丹皮, 三棱, 莪术, add 1000ml of water, boil down to 100ml, take once a day, and retain enema.