Treatment of acute salpingo-oophoritis

In life, we always hear this sentence, that is, life is very tiring for men, because as a man we not only have to lay a solid foundation for the future, but also prepare the foundation for future life. With the changes in life, the number of women has greatly decreased, and it is difficult for men to find a wife, especially for those who have no money and no car. It is even more tragic. But then again, is it easy for women? Not only do they have to give birth to children, but women nowadays also suffer from gynecological diseases at a very high rate, so it's not easy for anyone. Well, let's get back to the topic. Next, I'm going to talk about women's gynecological diseases and the treatment methods for acute salpingo-oophoritis. I hope what I have provided will be helpful to you.

Disease treatment

General support and symptomatic treatment

Absolute bed rest or semi-recumbent position is recommended to facilitate drainage and help limit inflammation. Drink plenty of water and a high-calorie, easily digestible semi-liquid diet. People with high fever should be given fluids to prevent dehydration and electrolyte imbalance. To correct constipation, take Chinese medicine, such as senna leaves, or use saline or 1, 2, or 3 doses of enema. Those who are in pain may be given sedatives and analgesics. For patients with severe peritoneal irritation symptoms in the acute phase, ice packs or hot water bags can be used to apply to the painful area (cold or hot compresses depend on the patient's comfort). After 6 to 7 days, gynecological examination and laboratory tests of total white blood cell count and erythrocyte sedimentation rate confirm that the condition has stabilized and infrared or shortwave diathermy therapy can be used instead (see chronic salpingo-oophoritis for details).

Infection Control

Appropriate antibiotics can be selected based on the smear examination or bacterial culture and drug sensitivity results of the uterine discharge fluid. Since this type of inflammation is mostly caused by mixed infection, and the pathogens in my country are mostly Escherichia coli and Bacteroides, especially Bacteroides fragilis, while gonorrhea or chlamydia infections are rare, gentamicin 80,000 U can be used, injected intramuscularly 2 to 3 times a day, or 240,000 U can be used by intravenous drip, such as metronidazole 0.4 g 3 times a day. Gentamycin is more effective against Escherichia coli, while metronidazole is particularly effective against anaerobic bacteria, has low toxicity, strong bactericidal power, and is inexpensive, so it has been widely used. In severe cases, broad-spectrum antibiotics such as cephalosporin, amikacin, chloramphenicol, etc. can be given intravenously. The treatment must be thorough, and the dosage and application time of antibiotics must be appropriate. Insufficient dosage will only lead to the production of drug-resistant strains and the continued existence of lesions, which will develop into a chronic disease. The sign of effective treatment is gradual improvement of symptoms and signs, which can usually be seen within 48 to 72 hours, so do not change antibiotics easily.

In addition to antibiotics, corticosteroids are often used for severe infections. Adrenal cortical hormone can reduce interstitial inflammatory response, increase the concentration of antibiotics in the lesions, fully exert its antibacterial effect, and has antipyretic and antitoxic effects. It can reduce fever quickly and absorb inflammatory lesions quickly, especially for cases with weak response to antibiotics. Administer dexamethasone 5-10 mg dissolved in 500 ml of 5% glucose solution intravenously once a day. When the condition stabilizes slightly, switch to oral prednisone 30-60 mg per day, and gradually reduce the dose to 10 mg per day for 1 week. After discontinuation of adrenal cortical hormones, antibiotics still need to be continued for 4 to 5 days.

Local puncture of the abscess and injection of antibiotics

After an abscess forms, systemic antibiotics are not effective enough. If the fallopian tube-ovarian abscess is close to the posterior fornix and vaginal examination shows that the posterior fornix is ​​full and fluctuating, posterior fornix puncture should be performed. After confirmation of pus, the posterior fornix can be incised and drained, and a rubber tube can be placed for drainage; or the contents can be sucked out first, and then 800,000 U of penicillin plus 160,000 U of gentamicin (dissolved in saline) can be injected through the same puncture needle. If the pus is thick and difficult to draw out, it can be diluted with saline solution containing antibiotics so that it gradually becomes a bloody serum-like substance that is easier to draw out. Generally, the abscess will disappear after 2 to 3 treatments.

Perforation of pelvic abscess into the abdominal cavity

If a pelvic abscess perforates into the abdominal cavity, there are often changes in the systemic condition at the same time. Immediate infusion and blood transfusion should be given to correct electrolyte imbalance and shock, including intravenous antibiotics and dexamethasone and other drugs. While correcting the general condition, laparotomy should be performed as soon as possible to remove the pus and, if possible, the abscess. After the operation, silicone tubes were placed on both sides of the lower abdomen for drainage. After the operation, gastrointestinal decompression and intravenous infusion of broad-spectrum antibiotics were applied, dehydration and electrolyte imbalance were continued to be corrected, and blood transfusion was performed to improve the body's resistance.

Effective treatment

1. Puncture of ovarian endometrioid cyst under B-ultrasound: For cases of recurrence after surgical dissection or laparoscopic puncture, ultrasound puncture and drug treatment can be considered.

2. Radiotherapy: Although radiotherapy has been used for endometriosis for many years, it uses heavy drugs and surgery to achieve very high efficacy and usually does not damage ovarian function. The effect of radiotherapy for endometriosis is to damage ovarian production, thereby inhibiting the influence of ovarian hormones. External radiotherapy can also be used to damage ovarian function and achieve the treatment goal.

3. Radical surgery: For patients approaching menopause, especially those with severe disease and recurrence, total hysterectomy and bilateral adnexectomy should be performed. During surgery, the ovarian endometrial cyst must not be ruptured. When the cyst fluid flows out, it should be sucked out immediately. If endometriosis occurs in the abdominal wall or perineal incision, it should be completely removed, otherwise it will recur.

4. Laparoscopic surgery: Laparoscopic examination can provide accurate diagnosis, and specially designed knives, scissors, forceps, etc. can be used to promote the removal of lesions and separate adhesions. Under laparoscopy, co2 laser or helium-neon laser can be used to cauterize the lesion, that is, make a second incision 2 cm above the pubic symphysis, then inject 5 to 10 ml of anhydrous ethanol, aspirate it after 5 to 10 minutes, and finally rinse it with saline and aspirate it out. [2]

The above are the treatments for acute salpingo-oophoritis. I think you all understand them now. Finally, I wish all men and women in the world good health.