女孩每月定期咳血竟是“大姨妈”惹的祸 The girl was monthly coughing up blood"Big aunt"To blame

　　

公开课上专家告诉你怎样避免每月的烦恼 Public class experts tell you how to avoid the trouble of a month

　　平均每个女人的一生中，要经历1800天月经来潮，正是这1800个日夜，串起了女人的一生在生命舞台上最美和最有活力的日子，让女人由内而外地焕发出柔美的性别特质。

The average woman's life,1800 days to go through menstrual cramps,It is the 1800 day and night,String a woman's life in the life the most beautiful and the most dynamic on the stage of the day,Let the woman by inside and outside coruscate gives morbidezza gender characteristics.

　　在生理上，女性用一生的绝大部分时间，为繁衍后代做准备。月经的出现，表明你被赋予了巨大的权利，从此拥有了创造生命的能力。

In the physical,Women with all the most of the time,To prepare for the breed.Menstrual appear,Show that you are given the huge rights,Since then have the ability to create life.

　　可是，也正是因为这让人纠结的“大姨妈”，也给女性带来各种各样的烦恼。

but,It is also because it makes people swirly"Big aunt",Women also bring all kinds of trouble.

　　在钱报名医公开课开场白中，浙江大学医学院附属妇产科医院医学博士吴瑞瑾，讲了自己曾经遇到的一位女孩。

In the money people for public class in the opening,Zhejiang university medical college hospital medical doctor WuRuiJin,What she had met a girl.

　　这个女孩刚20岁出头，她因一种怪病来医院就诊。女孩说自己每次“大姨妈”来访时，都会忍不住咳血。

The girl just at their early twenties,She was a strange disease to hospital.The girl said yourself every time"Big aunt"visit,Will can't help coughing up blood.

　　一听咳血，医生心中也吃惊：因为如果血来自气管或是支气管，都表明毛病已严重。幸好，女孩检查之后，并没有在气管、肺部上找到什么问题。但医生还是不放心，于是取下一小块她的支气管组织，去化验。结果发现：这小团组织的结构，与子宫内膜的腺体一模一样。

A listen to coughing up blood,The doctor in the heart also surprised:Because if the blood from tracheal or bronchial,That problem has seriously.fortunately,The girl check after,And not in the trachea/The lungs to find what is the problem.But doctors still don't trust,So take off a small piece of her bronchial organization,To test.The results showed that:The little league organization structure,And endometrial glands as like as two peas.

　　这就奇怪了，长在腹部的子宫内膜，怎么会跑到胸腔的气管里？因为胸腔与腹腔之间，人体长着一道横膈膜，把两者严密隔开。那么子宫内膜的组织，是怎么“穿越”了这个膈膜，最终在肺部扎根？并且随着女孩每月月经周期，也周期性地出血，表现出来的就是女孩每月会定期咳血，只要月经结束，也就停止咳血。

It is strange,Long in the belly of the endometrium,How can run to the chest in the trachea?Because the chest and abdominal cavity between,The human body has a diaphragm,Both close off.So endometrial tissue,Is how"through"The disc,Finally, in lung roots?And with the girl monthly menstrual cycle,Also periodically bleeding,Show a month is girl regularly coughing up blood,As long as menstruation ends,Will stop coughing up blood.

　　这其实就是一种子宫内膜异位症。

It is a kind of endometriosis.

　　它是一种激素依赖性疾病，以25~45岁女性多见，发病率为10%~15%。这位女孩发病比较早，可能与她月经初潮较早有关。

It is a kind of hormone dependence disease,In 25 ~ 45 years old women see more,Rate was 10% ~ 15%.The girl earlier onset,May and her menarche early on.

　　这堂公开课就从子宫内膜异位症开始，讲讲女性成长的烦恼。

This hall open class from endometriosis began,About women growing pains.

　　

子宫内膜“穿越”，女性就会得病 endometrial"through",Women will fall ill

　　子宫是个倒三角的空腔，在没有怀孕时，像个空的瘪气球。在“气球”内壁，覆盖着子宫内膜，它会在卵巢分泌的激素的作用下，周期性地生长、增厚、脱落。它脱落之后，会自动流出体外，形成月经。

The uterus is a nabla of cavity,There is no pregnancy,Like a empty flat balloon.in"balloon"wall,Covered with endometrial,It will in ovarian secretion under the action of hormones,Periodically growth/thickening/off.It off after,Will automatically outflow in vitro,Formation period.

　　子宫内膜是一种很有生命力的组织，有些人的内膜在子宫内部不安份，会“跑”到外面去。这一部分内膜组织一旦“穿越”出去，长在子宫肌体以外的其他部位，就会引起一系列麻烦，产生一系列病症，总结成一个名称，称之为“子宫内膜异位症”，简称内异症。

Endometrial is one of the dynamic organization,Some people in the womb lining of internal unrest,will"run"Go outside.This part of endometrial tissue once"through"out,Long in other parts of the body other than the uterus,Will cause a series of problems,Produce a series of disease,Summary into a name,called"Endometriosis",Referred to as different disease in.

　　子宫内膜异位症的细胞特性，和肿瘤细胞特性很相似，它会长到子宫腔以外的其他地方。异位子宫内膜可以侵犯全身任何部位，但绝大多数位于盆腔内，其中子宫直肠陷凹及卵巢，是为最常见的侵犯部位，通过B超检查就能发现。

Endometriosis cell characteristics,And tumor cell characteristics are very similar,It will grow to uterine cavity outside of the other places.Endometriosis may violate any part of the body,But the vast majority in located in pelvic cavity,The uterus and ovaries rectal pouch,For the most common infringement of parts,Through the B ultrasonic inspection can be found.

　　那么通常子宫内膜，是通过什么途径“跑”出去的？

So usually endometrium,By what way"run"out?

　　子宫内膜先是经过输卵管流到盆腔里去，再流到腹腔里去；如果走得更远，就会穿过横膈膜，到胸腔。

Endometrial first after tubal flows into the pelvic cavity,To flow to the abdominal cavity;If go further,Will through the diaphragm,To chest.

　　它非常有活性，可以在任何部位粘附、侵袭、种植，但它又十分依懒激素，所以会随着女性激素水平的波动而起伏，在月经周期完成一个生长到衰败的过程。

It is very active,Can be in any part of the adhesive/hit/planting,But it is in accordance with the lazy hormone,So the female hormone level fluctuation and ups and downs,In the menstrual cycle to complete a growth process of decline.

　　

痛经不要忍，“内异症”要早诊早治 Dysmenorrhea don't endure,"Different disease in"To early treated early

　　不少女孩在来月经的时候，或是来月经前一两天，会肚子痛。有些人会疼痛到大汗淋漓，恶心、呕吐，需要吃止痛片，甚至一天要吃好几片。

Many girls in the period of time,Or to a day or two before menstruation,Will upset stomach.Some people will be pain to sweat,nausea/vomiting,Need to eat painkillers,Even a day to eat several tablet.

　　这与“穿越”的子宫内膜生长的位置有关。它长在身体的不同部位，就会引起不同部位的疼痛。

this"through"The position of the endometrium growth related.It is long in different parts of the body,Will cause different parts of the pain.

　　除了疼痛，有些人还会月经失调和不孕。

In addition to pain,Some people will menstrual disorders and infertility.

　　因此，痛经要早诊早治，如果总是抱着熬一熬就过去的想法，最终可能会导致不孕不育。现在发现，不孕不育的人中，有30%~40%曾有严重痛经，患有内异症。

so,Dysmenorrhea to early treated early,If you always hold a boil boil the idea,May eventually leads to sterility.Now found,Among the sterility,30% ~ 40% had severe dysmenorrhea,With different disease in.

　　内异症的治疗有药物和手术两种方法。目前来说，以腹腔镜确诊，通过手术治疗，后续再加上药物，可以达到相对来说比较理想的治疗效果。

Different disease in the treatment of drug and surgical two kinds of methods.For now,Laparoscopic diagnosis in,Through the surgical treatment,Subsequent plus drug,Can achieve a relatively ideal treatment effect.

　　内异症的病人，如果伴有不孕症，通过手术处理，清除异位的内膜和囊肿，盆腔清洗以后，可以怀孕。

Different disease in patients,If the associated with infertility,Through the surgical treatment,Clear ectopic endometrial and cyst,Pelvic cavity after cleaning,Can be pregnant.

　　对于内异症比较轻微的患者，术后一年内受孕的概率为33%~35%，中度为33%~31%，重度为29%左右。

For different disease in patients with a minor,After a year of conception probability is 33% ~ 35%,Medium is 33% ~ 31%,Severe is about 29%.

　　

经期不要剧烈运动，防止经血逆流 Period not to strenuous exercise,Prevent blood flow

　　体检做妇科B超，有很多女性发现有“巧克力囊肿”，这种囊肿包裹着，像块巧克力。其实，这也是一种子宫内膜异位症。

Medical do gynecological B ultrasonic,There are a lot of women have found"Chocolate cyst",This kind of cyst parcel,Like a piece of chocolate.In fact,This is also a kind of endometriosis.

　　我们知道，子宫内膜会长在卵巢上，因为卵巢每个月会排卵，排卵后就会在卵巢上有一个排卵孔，即一个破口。子宫内膜有时候会种在那个破口上，然后在雌激素的作用下，长在卵巢上的子宫内膜每个月也会生长、脱落，但是这些血液无法流出体外，就会滞留在卵巢里。

We know that,Endometrial President in the ovary,Because ovarian oviposit every month,After ovulation in ovarian has a ovulation hole,Is a breach.Endometrial sometimes in that the breach,Then under the action of estrogen,Long in the ovary endometrium each month will also grow/off,But these blood can't outflow in vitro,Will be trapped in the ovary.

　　囊肿反复的出血、吸收，就形成了一层包膜，里面都是流不出来的经血，颜色成为褐色，像巧克力一样。所以，长在卵巢上的子宫内膜异位症，俗称为“巧克力囊肿”。

Cyst repeated hemorrhage/absorption,Form a layer of envelope,There is flow not to come out of blood,Color as the brown,Like chocolate.so,Long in the ovarian endometriosis,Commonly referred to as"Chocolate cyst".

　　这种囊肿往往手术切了又会长出来，十分顽固。据统计，手术后5年，有将近一半的内异症病人会复发。

This kind of cyst surgery often cut out and President,Very stubborn.According to the statistics,Surgery after five years,Nearly half of the different disease recurrence in patients.

　　而预防子宫内膜异位症，要做到经期注意保健，经期不要剧烈运动，比如快跑、跳高等，防止经血逆流；同时，育龄妇女要选择好的避孕方法，减少人工流产的次数；女性还要在月经来潮的最初一两天，避免性生活。

And prevention of endometriosis,To do period attention to health care,Period not to strenuous exercise,Such as run/High jump, etc,Prevent blood flow;At the same time,Women of child-bearing age should choose good contraceptive method,To reduce the number of abortion;Women also in menstruating first for a day or two,Avoid sex.

　　问：子宫肌瘤到底需不需要处理？

ask:Uterine fibroids really need not to need to deal with?

　　答：这个需要根据病人的具体情况来看。病人的年龄，有没有生育要求，有没有月经增多或是其他压迫症状，瘤子长在什么部位，有多大，有多少个等，都是我们医生需要考虑的。对于45岁以上靠近绝经年龄的妇女，如果肌瘤不大，不影响月经，我们会选择不处理，要求她3个月到6个月来医院做一次妇科检查、B超检查等。对于肌瘤较小、症状轻，或是有全身性疾病(比如心脏病)的病人，我们采取药物治疗。对于子宫肌瘤长得很大或者数量很多，月经过多甚至贫血，或者大的肌瘤压到直肠、膀胱，以及瘤子短期内长得特别快的病人，还有药物治疗完全无效的病人，我们就会考虑对其进行手术。(记者 王蕊 通讯员 张雨佳 孙美燕 整理)

a:This need according to the patient's specific situation.The patient's age,Have fertility requirements,Have profuse menstruation or other compression symptoms,Tumors long in what place,How much,How many, etc,Are our doctors need to consider.For over 45 years of age of menopause women near,If fibroids is,Do not affect menstrual,We will choose not to deal with,Ask her to 3 months to 6 months to a hospital doing a gynaecological check-up/B ultrasonic inspection.For fibroids smaller/Symptoms light,Or systemic disease(Such as heart disease)patients,We take the drug therapy.For uterine fibroids grow large or there are many,Menorrhagia and anemia,Or big fibroids pressure to the rectum/bladder,Tumors in the short term and the long quickly patients,And drug therapy completely invalid patients,We will consider the surgery.(Reporter WangRui correspondent ZhangYuJia SunMeiYan finishing)