Chronic pelvic inflammatory disease

　　The causes of chronic pelvic inflammatory disease include:

　　1, Postpartum or post-infection infection: The postpartum woman is physically weak, the cervical os has residual blood and turbid fluid flowing out and not closed in time, there is a placental detachment surface in the uterine cavity, or the birth canal is damaged due to delivery, or there is residual placenta or amniotic membrane, or sexual intercourse is too early after childbirth, pathogens can easily invade the uterine cavity, causing infection; the vaginal bleeding time is too long during spontaneous abortion or medication-induced abortion, or there is residual tissue in the uterine cavity, or the aseptic operation is not strict during artificial abortion, etc., can cause post-abortion infection.

　　2, Infection after intrauterine surgery: Such as the placement or removal of intrauterine contraceptives, curettage, tubal hydrotubation, hysterosalpingography, hysteroscopy, submucosal resection, etc., due to preoperative sexual activity or inadequate surgical disinfection or inappropriate preoperative indication selection, the original chronic inflammation of the reproductive tract, after surgical interference, can cause an acute attack and spread; also, some patients do not pay attention to personal hygiene after surgery, or do not follow the doctor's advice after surgery, which can also cause ascending infection by bacteria, causing pelvic inflammatory disease.

　　3, Poor menstrual hygiene: If menstrual hygiene is not paid attention to, using unclean sanitary napkins and pads, bathing in the bath during menstruation, and sexual intercourse during menstruation can all allow pathogens to invade and cause inflammation.

　　The most common direct spread of inflammation to adjacent organs is when, due to their proximity to the female internal reproductive organs, inflammation can spread directly to cause pelvic inflammation; when suffering from chronic, inflammation can also spread through the lymphatic circulation, causing pelvic adhesion peritonitis.

　　1.Chronic pelvic inflammatory disease can cause infertility

　　Chronic pelvic inflammatory disease is often refractory, often forming adhesions and masses of the fallopian tubes and ovaries, and they are adherent to the surrounding tissues, making it difficult for anti-inflammatory drugs to enter, thus not easy to be completely cured. It often has an acute attack when the body's resistance decreases or when it is overworked.

　　2.Chronic pelvic inflammatory disease can cause ectopic pregnancy

　　Chronic pelvic inflammatory disease can cause pathological changes in the fallopian tubes and directly affect the peristalsis, patency, and egg collection by the fimbriae of the fallopian tubes, thereby directly affecting the normal function of the fallopian tubes and becoming an important factor in the occurrence of ectopic pregnancy.

　　3.Chronic pelvic inflammatory disease can cause peritonitis and tubo-ovarian abscess.

　　Severe pelvic inflammatory disease can spread to the pelvic peritoneum, uterus, and para-uterine tissues, eventually leading to hardening and decreased mobility of these organs and tissues, especially the fallopian tubes losing their soft and蠕动ing physiological function, becoming rigid and twisted, with the lumen completely blocked, reaching an incurable degree.

　　1.Enhance physical fitness

　　Guide the patient to arrange their daily life, avoid overexertion, encourage the patient to continue exercising, such as jogging, walking, practicing Tai Chi, etc., to enhance physical fitness.

　　2.Medication care

　　Inform the patient of the dosage, method, and precautions for taking medication. Antibiotics should not be used for a long time, and when desamethasone needs to be discontinued, the dosage should be gradually reduced.

　　3.Symptom care

　　When the patient has abdominal pain or lumbar pain, pay attention to rest and prevent catching a cold. If necessary, follow the doctor's advice to take sedative analgesics to relieve symptoms. When the patient has poor sleep, they can take a hot foot bath before going to bed, turn off lighting facilities, keep the room quiet, or perform massage before going to bed. If necessary, follow the doctor's advice to take sedatives.

　　4.Psychological care

　　Carefully listen to the patient's description of their concerns and provide timely answers. Discuss and analyze the patient's condition together with the patient, choose the best treatment plan, and enhance the patient's confidence in overcoming the disease.

　　5.Surgical care

　　Provide routine preoperative and postoperative care for surgical patients.

　　1.Blood routine examination　Blood cells, 10x10^9/L, with an increase in neutrophils as the main component.

　　2.Medical history diagnosis　Most patients with pelvic inflammatory disease have risk factors that can cause pelvic inflammatory disease, such as a history of gynecological or obstetric surgery in the recent past, including delivery, cesarean section, induced abortion, and placement or removal of intrauterine devices. There is a history of sexual intercourse during menstruation or a history of unclean sexual activity. Accompanied by inflammation of the lower genital tract and inflammation of adjacent organs.

　　3.Gynecological examination　The cervix may be congested, with a large amount of purulent smelly discharge; the cervix is congested and swollen. If purulent discharge is observed coming from the cervical os, it indicates acute inflammation of the cervical canal mucosa or uterine cavity.

　　1.Avoid spicy, fried, and hot foods. Spicy and fried items include chili, pepper, fennel, Sichuan pepper, star anise, onion, fried dough sticks, roasted lamb, electric roasted chicken, fried quail, fried pork chops, and fried chicken wings, etc.; hot foods such as beef, mutton, and dog meat, as well as various cooked snacks like roasted sunflower seeds, roasted peanuts, and roasted chestnuts, all of which can cause heat and inflammation, exacerbating vaginal inflammation and congestion. Therefore, it is advisable to avoid these foods.

　　2.忌海鲜发物。海虾、河虾、带鱼、螃蟹、梭子蟹、黄鳝、蛏子、毛蚶、银蚶、牡蛎、鲍鱼等水产品，多属发物，食后将加重阴部搔痒，不利于炎症消退，故忌食。

　　3.忌甜腻厚味。过于甜腻的食物如糖果、奶油、巧克力、奶油蛋糕、糯米糕团、八宝饭、猪油及肥猪肉、羊脂羊膏、鸡蛋黄，鸭蛋黄，以上这些食物有助湿的作用，会增加白带的分泌，降低治疗效果。

　　4.忌烟、酒。烟、酒及含酒食品如酒酿圆子、人参酒，鹿茸酒等，食后会加重炎症充血，不利于本病的治疗，故忌食。

　　5.药物禁忌：因本病由湿热之邪所引起，故患病期间，禁止使用具有温里补阳作用的药物，如红参、附子、干姜、吴茱萸、丁香、细辛、荜拔、高良姜、鹿茸、补骨脂、菟丝子、巴戟天、淫羊藿、牛鞭子、仙茅、黄狗肾、锁阳、蛤蚧、肉苁蓉等，中成药如十全大补丸、右归丸、金匮肾气丸等。

　　The treatment for acute pelvic inflammatory disease and chronic pelvic inflammatory disease is different. The main treatment for acute pelvic inflammatory disease patients is to rest more, and if possible, they can be hospitalized for treatment. They should also pay attention to eating more high-protein and nutritious foods, and pay attention to the balance of electrolytes, supplementing water, and the most important thing is to use some anti-inflammatory antibiotics. The use of antibiotics should be carried out after the vaginal secretion bacteria culture and drug sensitivity test before the use of antibiotics, and the most suitable drug should be selected through the drug sensitivity test. It should be noted that the dosage must be sufficient and the time must be long enough. Clinically, some patients stop taking medication after a few days because the symptoms disappear, which is easy to cause recurrence and even lead to the occurrence of chronic pelvic inflammatory disease. Therefore, the treatment must be thorough. In addition, traditional Chinese medicine can choose to use treatments such as clearing heat and detoxifying, resolving phlegm, and promoting blood circulation to remove blood stasis according to the symptoms of the patients, and the combination of traditional Chinese medicine and Western medicine antibiotics also has a good curative effect.