How to treat pelvic inflammatory disease

Pelvic inflammatory disease is a disease that women suffer from. The pelvic cavity is closely connected with the outside world, and some bacteria and viruses can easily invade. Bacteria enter the pelvic cavity through the vagina, multiply and spread, causing pelvic inflammatory disease. However, this disease is relatively rare because the female vagina has a protective and bactericidal effect. When we feel bloating and discomfort in the pelvic area, pain in the lower abdomen, and increased vaginal discharge, we should go to the hospital for examination and treatment in time. Let us learn how to treat pelvic inflammatory disease.

1. Inspection

1. Direct smear of secretions

The sample can be vaginal, cervical, or urethral secretions, or peritoneal fluid (obtained through the posterior fornix, abdominal wall, or laparoscopy) for direct thin-layer smear, which is dried and stained with methylene blue or Gram's blue. If Gram-negative diplococci are seen in polymorphonuclear leukocytes, it is a gonorrhea infection. Because the detection rate of endocervical gonorrhea is only 67%, a negative smear cannot exclude the presence of gonorrhea, while a positive smear is specific. Fluorescein monoclonal antibody dye can be used for microscopic examination of Chlamydia trachomatis. The test is positive if a star-shaped flashing fluorescent spot is observed under a fluorescence microscope.

2. Pathogen Culture

The specimens come from the same source as above and should be inoculated onto Thayer-Martin medium immediately or within 30 seconds and cultured in a 35°C incubator for 48 hours for bacterial identification. New relatively rapid chlamydial enzyme assays have replaced traditional chlamydial detection methods. Mammalian cell culture can also be used to detect Chlamydia trachomatis antigens. This method is an enzyme-linked immunosorbent assay.

Bacteriological culture can also obtain other aerobic and anaerobic strains and serve as a basis for selecting antibiotics.

3. Posterior fornix puncture

Posterior fornix puncture is one of the most commonly used and valuable diagnostic methods for gynecological acute abdomen. The contents of the abdominal cavity or the rectouterine fossa obtained through puncture, such as normal peritoneal fluid, blood (fresh, old, clotted blood, etc.), purulent secretions or pus, can further clarify the diagnosis. Microscopic examination and culture of the punctured material are even more necessary.

4. Ultrasound examination

It mainly involves B-type or grayscale ultrasound scanning and filming. This technology has an 85% accuracy in identifying masses or abscesses formed by adhesions of the fallopian tubes, ovaries and intestines. However, mild or moderate pelvic inflammatory disease is difficult to show characteristics on B-mode ultrasound images.

5. Laparoscopy

If it is not diffuse peritonitis and the patient's general condition is good, laparoscopy can be performed on patients with pelvic inflammatory disease or suspected pelvic inflammatory disease and other acute abdominal diseases. Laparoscopy can not only make a clear diagnosis and differential diagnosis, but also make a preliminary judgment on the severity of pelvic inflammatory disease.

6. Examination of male partners

This helps in the diagnosis of pelvic inflammatory disease in women. The urethral secretions of the male partner can be taken for direct smear staining or culture of gonococci. If the result is positive, it is strong evidence, especially in those who are asymptomatic or have mild symptoms. Or a higher number of white blood cells may be detected. 2. Treatment 1. Drug treatment

Antibiotics are the main treatment for acute pelvic inflammatory disease, including multiple routes of administration such as intravenous infusion, intramuscular injection or oral administration. Broad-spectrum antibiotics should be used in combination with anti-anaerobic drugs, and attention should be paid to the adequate course of treatment. It can also be combined with traditional Chinese medicine treatment to achieve better results.

2. Surgery

Patients with lumps such as hydrosalpinx or tubo-ovarian cysts can undergo surgical treatment; patients with small foci of infection and repeated inflammation are also suitable for surgical treatment. The principle of surgery is to completely cure the disease and avoid the chance of recurrence of residual lesions. Adnexemectomy or salpingectomy is performed. For young women, ovarian function should be preserved as much as possible. The effect of single therapy for chronic pelvic inflammatory disease is poor, and comprehensive treatment is appropriate.

3. Physical therapy

The benign stimulation of warmth can promote local blood circulation in the pelvic cavity. Improve the nutritional status of tissues and enhance metabolism to facilitate the absorption and disappearance of inflammation. Commonly used methods include shortwave, ultrashort wave, iontophoresis (various drugs such as penicillin, streptomycin, etc. can be added), wax therapy, etc. Traditional Chinese medicine also has the method of treating stains with Chinese medicine wrapping.

4. Psychotherapy

General treatment relieves patients' mental concerns, enhances their confidence in treatment, increases nutrition, exercises the body, pays attention to the combination of work and rest, and improves the body's resistance.