Chronic adnexitis

　　一、病因：

　　可由多种原因造成，暂无定论。

　　二、发病机制：

　　慢性附件炎虽然是指输卵管和卵巢的炎症。但输卵管、卵巢炎常常合并有宫旁结缔组织炎、盆腔腹膜炎，且在诊断时也不易区分，这样，盆腔腹膜炎、宫旁结缔组织炎，就也被划入附件炎范围了。在盆腔器官炎症中，以输卵管炎最常见，由于解剖部位相互邻近的关系，往往输卵管炎、卵巢炎、盆腔腹膜炎同时并存且相互影响。

　　(1)分娩或流产后由于抵抗力下降，病原体经生殖道上行感染并扩散到输卵管、卵巢，继而整个盆腔，引起炎症。

　　(2)在宫内节育器广泛应用的同时，患者不注意个人卫生或手术操作不严格而引发。

　　(3)未经严格消毒而进行的宫腔操作，如吸宫术、子宫输卵管碘油造影、子宫颈管治疗，以及消毒不严格的产科手术感染等。

　　(4)不注意经期卫生，月经期性交或不洁性交等。

　　(5)身体其他部位有感染未经及时治疗时，病原菌可经血行传播而引起输卵管卵巢炎，多见于结核性疾病。

　　(6)盆腔或输卵管邻近器官发生炎症如阑尾炎时，可通过直接蔓延引起输卵管卵巢炎、盆腔腹膜炎，炎症一般发生在邻近的一侧输卵管及卵巢。

　　(7)性传播疾病如淋病，感染后淋病双球菌可以沿粘膜向上蔓延，引起输卵管、卵巢炎症。

　　1.并发宫腔感染

　　慢性炎症反复发作，迁延日久，使盆腔充血，结缔组织纤维化，盆腔器官相互黏连。患者出现下腹部坠胀、疼痛及腰骶酸痛等症状，时轻时重，并伴有白带增多、腰疼、月经失调等，且往往在经期或劳累后加重。

　　2.引发不孕症

　　尤其是输卵管的慢性炎症，时间久了可导致输卵管纤维化、增粗且阻塞不通，还可与周围组织黏连。如输卵管两端闭塞，可形成输卵管积水，积水穿入到黏连于一起的卵巢中，就会形成输卵管儿巢囊肿。这是造成婚后不孕或宫外孕的主要祸端。.

　　3.影响女性第二性征

　　患有慢性附件炎会出现与急性附件炎程度不同的腹痛，或小腹坠胀和牵扯感，时轻时重，伴有白带增多、腰疼、月经失调等症状。

　　Chronic adnexitis has different degrees of abdominal pain, chronic inflammation recurs, persists for a long time, causing pelvic congestion, fibrosis of connective tissue, and adhesion of pelvic organs. Patients may experience symptoms such as lower abdominal distension, pain, and lumbosacral pain, which are mild or severe, accompanied by increased leukorrhea, back pain, and menstrual disorders, and often worsen during menstruation or after fatigue. Gynecological examination may show tenderness and thickening in both or one side of the adnexal area, or the appearance of painful masses, with an increase or normal level of white blood cells.

　　It is especially worth noting that some symptoms of adnexitis are not very obvious. However, due to the close proximity of the fallopian tube and ovary, it is not easy to distinguish when inflammation occurs. Especially the chronic inflammation of the fallopian tube, if it persists for a long time, can lead to fibrosis, thickening, and obstruction of the fallopian tube, and can also cause adhesion with surrounding tissues. If the ends of the fallopian tube are occluded, hydrosalpinx can form, and if the hydrosalpinx penetrates into the ovary adhered together, it can form a fallopian tube ovarian cyst. This is a major cause of infertility or ectopic pregnancy after marriage.

　　Palpation and thickening are found in the adnexal area during physical examination.

　　1. Eliminate adnexitis in the acute stage. Chronic adnexitis is usually left over from acute adnexitis or pelvic inflammatory disease, which includes sexually transmitted diseases. Failure to treat, incomplete treatment, or intermittent treatment will lead to chronic disease.

　　2. Treat inflammatory foci such as vaginitis and cervical erosion. For more serious cervical erosion, electrotherapy is better. It can be cured once and for all.

　　3. Keep clean and healthy.

　　4. Throw away jeans and synthetic underwear.

　　5. Do not wash the internal part of the vagina randomly.

　　6. Do fewer abortions.

　　7. Oppose dieting to become a 'skeletal woman', letting body fat account for 22% of body weight.

　　8. Strengthen the body.

　　9. Early diagnosis and treatment of infertility. Try to have the first child before the age of 30.

　　10. Discover symptoms in a timely manner and do not take random drugs for chronic adnexitis.

　　The following examinations can be performed to confirm the diagnosis:

　　Chronic salpingo-ovarian inflammation can cause lower abdominal tenderness, thickening and tenderness of the uterus on pelvic examination, and sometimes palpable, fixed, cystic masses.

　　Generally, B-ultrasound examination does not show any abnormalities, unless there is hydrosalpinx or formation of fallopian tube ovarian cysts, in which case ultrasound examination can detect masses.

　　Dietary adjustment items for adnexitis patients:

　　1. Eat more high-fiber foods: Ensuring an adequate intake of high-fiber foods can effectively increase the magnesium content in the blood, regulate menstruation, and have a calming effect on the nerves. Foods high in fiber include vegetables, fruits, oatmeal, and brown rice.

　　2. Take vitamins: Surveys show that women with dysmenorrhea caused by adnexitis can improve their symptoms by taking a certain amount of vitamins or minerals each day. Therefore, it is recommended that patients with adnexitis take vitamins under the guidance of a doctor.

　　3. Supplement minerals: Women with adnexitis may experience a decrease in resistance. It is recommended that women eat more meat, eggs, and legumes before and during their menstrual periods to increase the intake of calcium and magnesium, as calcium and magnesium can help alleviate dysmenorrhea caused by adnexitis.

　　4. Do not eat spicy and irritating foods: Foods such as chili, pepper, and alcoholic beverages are irritating and can worsen inflammatory symptoms and affect body recovery.

　　5. Avoid consuming caffeine: Caffeine is present in coffee, tea, and cola, which can make people's nerves tense and worsen discomfort during menstruation. Patients with adnexitis should avoid drinking these beverages.

　　The use of only antibiotic drugs is not effective for chronic adnexitis. The treatment of chronic adnexitis requires a long-term supportive therapy, which is to increase nutrition and improve the body's immunity. The most important way to increase body immunity is to exercise, which can improve the body's immunity on the one hand and also make the body and mind happy on the other hand.

　　Physical therapy can be combined, and the effect of physical therapy can disperse local edema, soften scars, promote peristalsis, promote blood circulation, and improve local lesions.

　　1. Supportive Treatment: Patients can increase their nutritional intake and appropriately engage in physical exercise to enhance the body's resistance and strengthen the ability to resist diseases.

　　2. Drug Treatment: Under the guidance of a doctor, some traditional Chinese medicine can be used. When taking such drugs, patients must follow the treatment course and should not discontinue or reduce the medication arbitrarily when they feel that the symptoms have been relieved, as this not only affects the effectiveness of treatment but may also lead to recurrence of the disease.

　　3. Physical Therapy: When the effect of drug treatment is not very ideal, physical therapy can be combined, such as using laser, microwave, and iontophoresis treatment, etc. Physical therapy can promote local blood circulation, improve the nutritional status of human tissues, enhance the body's metabolism, and thus is conducive to the absorption and regression of inflammation. It should be especially reminded that after acute adnexitis, it is necessary to carry out active and thorough treatment to prevent the disease from lingering and becoming chronic adnexitis. At the same time, the frequency of sexual intercourse should also be reduced, so that the pathogen is reduced and the inflammation will improve faster. While actively treating acute and chronic adnexitis, it is also necessary to actively treat lower genital tract infections, because vaginitis and cervicitis are both possible causes of ascending pathogens. If the patient has an intra-abdominal intrauterine device, it should also be considered to remove the intrauterine device.