Uterine inflammation

　　1. Acute endometritis:The main reasons are abortion, puerperal infection, intrauterine placement of intrauterine devices, radium needles, cervical dilation, diagnostic curettage, or cervical electrocautery, laser, microwave, and other physical therapies. Urethral pathogens can also cause ascending infections. In addition, endometrial polyps and submucosal fibroids in the uterus often cause acute endometritis.

　　2. Chronic endometritis:It can be transformed from acute endometritis; it can also be caused by the spread of long-term salpingitis or severe cervicitis; the incomplete involution of the placenta residue and the placental attachment after intrauterine device insertion, childbirth, or abortion can also lead to chronic endometritis; postmenopausal women, due to the decrease in estrogen levels in the body, the endometrium and vaginal mucosa become thin, making them susceptible to bacterial invasion and chronic inflammation; in addition, submucosal fibroids and mucosal polyps in the uterus can also cause chronic inflammation of the endometrium.

　　3, Cervicitis:The occurrence of cervicitis is related to sexual life. Natural or artificial abortion, diagnostic curettage, and childbirth can cause cervical injury and lead to inflammation. Adult women should pay attention to contraception, avoid or reduce artificial abortion surgery, and pay attention to postpartum hygiene to avoid postpartum infection. Washing the vagina with some acidic or alkaline solution or inserting pessaries into the vagina can also cause cervicitis. The main pathogens are Neisseria gonorrhoeae and Mycoplasma, as well as Staphylococcus, Streptococcus, Escherichia coli, and anaerobic bacteria.

　　The proportion of infertility caused by endometritis infection accounts for 9.4% of infertility women. The causes of infertility caused by this condition include:

　　1. After the sperm enters the uterine cavity, inflammation factors such as bacterial toxins and leukocyte phagocytosis cause sperm death or reduced motility, reducing the number of sperm entering the fallopian tube, thereby affecting fertility.

　　2. The fertilized egg is not easy to implant in the inflammatory endometrium, or due to anti-endometrial body, it may cause implantation obstruction, leading to infertility.

　　3. The implantation of the fertilized egg is not stable, which is very prone to abortion, leading to infertility.

　　First, endometritis

　　1. Acute endometritis:The main manifestations are acute onset, fever, lower abdominal pain, increased leukorrhea, sometimes bloodstained, or with foul smell. Sometimes the uterus is slightly enlarged and tender. Postpartum infection may cause lochia to be muddy. Acute endometritis can further develop into myometritis, salpingitis, and pelvic inflammatory disease, which may worsen the condition.

　　2. Chronic endometritis:There are no special clinical manifestations, but when combined with a history of infection, increased leukorrhea, dysmenorrhea, and hidden pain in the pelvic region, and irregular menstruation, these symptoms are of great value for diagnosis.

　　Senile endometritis is often misdiagnosed as endometrial cancer or cervical cancer, and it is necessary to perform a diagnostic curettage to exclude it.

　　Two, acute corpus uteri inflammation

　　The clinical manifestations are the same as those of acute endometritis, but the treatment course is longer. Acute corpus uteri inflammation has symptoms such as fever, lower abdominal pain, lumbar sacral pain, prolapse, and increased leukorrhea. Pathologically, the former inflammation invades the corpus uteri, while the latter invades the endometrium.

　　Three, cervicitis

　　There are acute and chronic types. Acute cervicitis often coexists with acute endometritis or acute vaginitis, but chronic cervicitis is more common. The main manifestations are increased leukorrhea, which is sticky or purulent, and sometimes may be accompanied by blood streaks or contain blood streaks.

　　1. Acute cervicitis:The most common, and sometimes even the only symptom, is increased leukorrhea, which is often purulent. There are symptoms such as lower abdominal, lumbar sacral pain, and bladder irritation symptoms of varying degrees. Pruritus and burning sensation of the vulva caused by vaginal secretion stimulation. Symptoms such as intermenstrual bleeding and postcoital bleeding.

　　2. Chronic cervicitis:The clinical manifestations are mainly increased leukorrhea, which is milky white or faint yellow, or sticky and purulent. Sometimes it may be bloody or contain blood streaks. It is not difficult to diagnose through gynecological examination.

　　Cervical erosion is a manifestation of chronic cervicitis, which is divided into grade I cervical erosion, grade II cervical erosion, and grade III cervical erosion according to the extent of erosion.

　　1. Pay attention to contraception to avoid unnecessary abortions, cesarean sections, and uterine cavity surgeries. It is recommended to go to a regular hospital with strict sterilization to prevent direct contamination during surgery. Inadequate sterilization during surgery or delivery is an important cause of acute endometritis and should be paid attention to.

　　2、卫生预防。产后或流产手术后注意个人卫生，不使用不洁卫生纸巾，卫生巾及时更换，并且禁止房事；一般妇女平时也应该注意个人卫生，阴道有出血时绝对禁止房事。

　　3、有感染可能性的妇女应进行预防性的抗炎治疗。

　　4、产后注意。产后过早同房，很容易将细菌带进妻子的生殖器官，引起子宫内膜炎或盆腔炎，轻者或治疗及时，尚可完全恢复，但不少人却因此招致子宫内膜破坏或输卵管闭塞而造成终生不孕症，甚至因急性期，细菌从创面侵入，随血流扩散成败血症而危及生命。

　　5、定期妇科检查，以便及时发现宫颈炎症，及时治疗。

　　6、平时应保持心情舒畅，注意营养，劳逸结合，增强自身的抵抗能力，提高身体素质。

　　1、子宫内膜炎的病理检查

　　内膜间质内有很多浆细胞及淋巴细胞浸润。值得指出的是，较多的浆细胞出现对诊断极为重要。炎症时间较久者可见纤维母细胞及毛细血管增生。老年性子宫内膜炎呈现血管壁厚、硬化，有时有钙化。病变严重时局部有溃疡形成。内膜腺体萎缩时，表面上皮可有鳞状化生，当鳞状化生广泛时有大片的鳞状上皮覆盖整个子宫腔内壁，称为子宫鱼鳞癣。流产后子宫内膜炎应注意有否绒毛、蜕膜等存在，特别是流产较久，绒毛可高度退化，甚至找不到绒毛，但常在血管的周围可找到散在的片块状蜕膜组织。

　　2、诊断性刮宫

　　可明确发病原因及排除恶性病变。术前应控制炎症三天，术后继续给予抗生素消炎。术中操作应轻柔，因感染的宫壁脆弱，易致子宫穿孔。老年性子宫内膜炎其内膜菲薄，刮取时更应注意。流产后子宫内膜炎可能残留胚胎组织，应仔细全面刮取进行检查，往往可同时起到治疗作用。

　　一、营养食谱

　　1、淡菜煮韭菜

　　[用料]生油15克，韭菜120克，淡菜60克，黄酒适量。

　　[制作]将生油倒入锅内烧熟，快速倒入韭菜炒拌，然后投入洗净的淡菜，加水适量，煮至淡菜熟透，放入适量黄酒，即可服用。每天1剂，7天为一个疗程。

　　[功效]补充营养，适用于白带多者。

　　2、莲子枸杞灌汤

　　[用料]莲子、枸杞子各30克，鸡蛋2个，猪肠一段。

　　[制作]将莲子、枸杞子浸润洗净，用鸡蛋拌匀，加适量调味品后，灌入洗净的猪肠内，两端用线扎紧，放入锅内加清水煮熟，切成片后服食；每天l剂，10天为一个疗程。

　　[功效]补养肝肾，适用于肝肾亏虚型患者。

　　3、银杏豆浆饮

　　[用料]银杏10枚，豆浆300毫升。

　　[Preparation] After the ginkgo seeds are peeled, they are crushed and poured into soy milk, then boiled for 1 hour and it can be drunk. Take once a day, and 7 days make up a course of treatment.

　　[Effect] To supplement nutrition, suitable for patients with increased leukorrhea.

　　Second, what is good for chronic endometritis

　　1. Strengthen nutrition, eat more high-protein and vitamin-rich foods, such as chicken, lean meat, shrimp, milk, tofu, beans, etc.

　　2. Eat more fibrous vegetables and fruits, such as bananas, sweet potatoes, celery, etc.

　　3. For those with increased leukorrhea, more leeks, dolichos, millet, tofu, lotus seeds, walnuts, white sesame seeds, etc. can be eaten.

　　4. Pain relief can be achieved by eating horseshoe crabs, red crabs, lobsters, sea asparagus, sea cucumber, tiger fish, beetroot, mung beans, radishes, chicken blood.

　　Third, what food should not be eaten for chronic endometritis

　　1. Avoid spicy and刺激性 foods and beverages such as chili, Sichuan pepper, green onions, garlic, white wine, etc.

　　2. Avoid seafood and river fish: seafood such as sea fish, crabs, shrimps, clams, hairy clam, oysters, abalone, etc. are all stimulants, which are not conducive to the regression of inflammation.

　　3. Avoid sweet and greasy foods: foods that are too sweet and greasy, such as candy, cream cakes, eight-treasure rice, glutinous rice cakes, lard, and fatty pork, sheep fat, egg yolk, these foods have the effect of promoting dampness, which will reduce the therapeutic effect and make the disease difficult to treat.

　　4. It is not advisable to eat greasy, cold, sticky foods. Such as fatty meat, crab,螺蛳, preserved meat products, etc.

　　5. Strictly prohibit the consumption of spicy and刺激性 foods such as cigarettes, alcohol, strong tea, etc.

　　First, endometritis

　　1. General therapy

　　Acute endometritis should rest in bed, preferably in a semi-recumbent position, which is conducive to the limitation of inflammation and the drainage of endometrial secretions; abdominal heat compress can be applied to promote the absorption of inflammation and relieve pain; bowel movements should be kept smooth to reduce pelvic congestion and facilitate the excretion of toxins; excessive gynecological examinations should be avoided to prevent the spread of inflammation; physical cooling can be used when feverish; diet should be easy to digest, with high calories, high protein, and a variety of vitamins, such as liquid or semi-liquid foods; for those who cannot eat, intravenous nutrition and water should be supplemented, and attention should be paid to correcting electrolyte imbalance and acidosis.

　　When treating chronic endometritis, it is first necessary to consider whether there are any triggering factors, such as retained placenta, intrauterine devices, etc. How to treat chronic endometritis? Removing these triggers, chronic endometritis will recover quickly. Otherwise, simply anti-inflammatory will not be significant. The intrauterine device should be removed, and chronic endometritis caused by postpartum or post-abortion should be treated with careful curettage to remove the degenerated placental tissue left behind; endometrial polyps should be removed; if submucosal uterine fibroids or endometrial cancer are found, active treatment should be carried out according to the situation; for senile endometritis, the cervical os can be dilated to facilitate the outflow of blood or secretions.

　　2. Drug treatment

　　Antibiotics: Generally, penicillin 4 to 8 million units intravenously per day, gentamicin 240,000 units intravenously per day, and treatment should continue until symptoms completely disappear. It can be changed to intramuscular injection for about 1 week and then stop taking the medicine. Metronidazole 0.4g can be taken orally, three times a day, or effective antibiotics should be chosen according to symptoms, nature of secretions, bacterial culture, and drug sensitivity.

　　Chronic cases can take dienestrol 1mg orally once a day for a month. There may be therapeutic effects; if combined with appropriate antibiotics such as penicillin, streptomycin, erythromycin, gentamicin, etc., the efficacy can be improved. However, it must be used under the guidance of a doctor.

　　For senile endometritis, dienestrol 0.25-0.5mg can be taken orally once a day for 1-2 weeks, and appropriate antibiotics should be selected for treatment for 5-7 days. At the same time, treatment for senile vaginitis should also be carried out.

　　3. Removal of Uterine Cavity Residue and Other Foreign Bodies

　　Endometritis occurring after childbirth or abortion. If there is a suspicion of placental tissue residue, it should be removed immediately while using antibiotics, but it is advisable to gently protrude the uterine cavity residue, try not to curettage, and only perform curettage surgery after the antibiotics reach a certain dose and the inflammation is controlled to prevent the spread of inflammation. If there is active bleeding in the uterus, the uterine cavity can be cleaned up under the condition of using a large amount of antibiotics. For women with intrauterine contraceptives, they should also be removed as soon as possible to eliminate the primary lesion and control the spread of inflammation.

　　4. Dilatation and Drainage of the Uterus and Estrogen Therapy

　　For chronic endometritis and senile endometritis, the method of dilating the cervical canal can be used in conjunction with treatment to facilitate the drainage of uterine cavity secretions and remove the etiological factors.

　　Second, Cervicitis

　　1. Medication Therapy:The treatment methods are as follows:

　　(1) Vaginal irrigation: Potassium permanganate solution at a concentration of 1:5000 can be used to irrigate the vagina before medication.

　　(2) Local Application: Silver nitrate, potassium dichromate solution, Derialin (Ibuprofen) suppository.

　　2. Physical Therapy

　　It is a widely used treatment method with the advantages of short treatment course and good efficacy. It is suitable for cases with severe inflammation and deep inflammation infiltration, and common methods include electrotension, laser treatment, or cryotherapy. However, the disadvantage is a high recurrence rate.

　　(1) Electrotension: This method is relatively simple and suitable for cases with severe erosion and large erosion area.

　　(2) Cryotherapy: It is advisable to select an appropriate cryoprobe that can fully cover the lesion and slightly exceed its range by 2-3mm.