Are pelvic inflammatory disease and metritis the same thing?

We know that the uterus is located in the lower abdomen, and the pelvic cavity is also located in the lower abdomen. Therefore, many women think that the uterus is the pelvic cavity. In fact, the uterus is just a female reproductive organ in the pelvic cavity. The pelvic cavity also includes other organs such as ovaries and fallopian tubes. Pelvic inflammatory disease is an inflammation of the organs in the pelvic cavity. It is not just the inflammation of the uterus that is called pelvic inflammatory disease. Inflammation caused by other organs can also be called pelvic inflammatory disease.

Pelvic inflammatory disease refers to inflammation of the female internal reproductive organs (including the uterus, fallopian tubes, and ovaries) and their surrounding connective tissue and pelvic peritoneum. Severe cases may be limited to one part, or several parts may be affected at the same time. According to its pathogenesis and clinical manifestations, it can be divided into acute pelvic inflammatory disease and chronic pelvic inflammatory disease. Acute cases are critical and have severe symptoms, which can lead to sepsis and be life-threatening. Chronic cases have symptoms that vary in severity and recur repeatedly, affecting the patient's physical and mental health.

Metritis is a common type of pelvic inflammatory disease in women. A general term for inflammation of the entire uterus and its surrounding tissues, including endometritis, perimetritis and parametritis. It generally refers to endometritis and cervicitis. Perimetritis and parametritis refer to inflammation involving only the serosa or uterine ligaments. These two diseases are mainly secondary to severe endometritis. Endometritis is inflammation of the lining of the uterus. According to the length of the disease course, it can be divided into acute endometritis and chronic endometritis; cervicitis can be divided into acute cervicitis and chronic cervicitis.

2. Treatment of pelvic inflammatory disease

The treatment of acute pelvic inflammatory disease emphasizes the combination of traditional Chinese and Western medicine. Timely, reasonable and sufficient use of antibiotics is necessary to quickly control the infection and avoid sepsis, septicemia, septic shock and the formation of pelvic abscesses. However, antibiotics all have certain side effects. Traditional Chinese medicine can not only alleviate these side effects, but also synergize and enhance their anti-inflammatory effects, so that the patient's condition can be quickly controlled and recover soon.

For chronic pelvic inflammatory disease, traditional Chinese medicine treatment has greater advantages than Western medicine treatment. Traditional Chinese medicine emphasizes multi-channel comprehensive treatment, including oral Chinese medicine water and pills, Chinese medicine retention enema, Chinese medicine external application, intravenous drip of Chinese medicine preparations, Chinese medicine foot bath, acupuncture treatment, etc. Generally speaking, oral Chinese medicine alone is not as effective as comprehensive treatment.

3. Treatment of metritis

1. General treatment

Patients with acute endometritis should rest in bed, preferably in a semi-recumbent position, to help limit the inflammation and drain the uterine secretions; hot compresses can be applied to the lower abdomen to promote the absorption of inflammation and relieve pain; bowel movements should be kept open 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 for high fever; a diet of liquid or semi-liquid, easily digestible foods containing high calories, high protein, and multiple vitamins is recommended. Those who cannot eat should receive intravenous nutrition and water supplements, and pay attention to correcting electrolyte imbalances and acidosis.

When treating chronic endometritis, the first thing to do is to see if there are any causing factors, such as retained placenta, intrauterine contraceptive device, etc. If these causes are removed, chronic endometritis will heal quickly. Otherwise, simply reducing inflammation will not have significant therapeutic effects. The intrauterine contraceptive device should be removed. For chronic endometritis caused by delivery or abortion, a careful curettage should be performed to remove the residual degenerated placental tissue. Endometrial polyps should be removed. If submucosal uterine fibroids or endometrial cancer are found, active treatment should be given according to the situation. For senile endometritis, the cervix can be dilated to facilitate the outflow of blood or secretions.

2. Drug treatment

Antibiotics: Generally, 4 to 8 million U of penicillin are given by intravenous drip per day, and 240,000 U of gentamicin are given by intravenous drip per day, which must be continued until the symptoms disappear completely. It can be changed to intramuscular injection for about 1 week and then stopped. At the same time, 0.4g of metronidazole can be taken orally 3 times a day, or a strong antibiotic can be selected according to symptoms, nature of secretions, bacterial culture and drug sensitivity.

For chronic cases, take 1 mg of diethylstilbestrol orally daily for 1 month. It can have therapeutic effects; if appropriate antibiotics such as penicillin, streptomycin, erythromycin, gentamicin, etc. are added, the efficacy can be improved. But it must be used under the guidance of a doctor.

For senile endometritis, 0.25-0.5 mg of diethylstilbestrol can be taken orally once a day for 1-2 weeks, and appropriate antibiotics can be used for treatment for 5-7 days. At the same time, treatment is provided for senile vaginitis.

3. Clear uterine cavity residues and other foreign matter

If endometritis occurs after delivery or abortion and there is suspected placental tissue residue, it should be removed immediately while using antibiotics. However, it is advisable to gently protrude the residue in the uterine cavity and try not to perform a curettage. Curettage can only be performed when the antibiotic dose reaches a certain level and the inflammation is under control to prevent the spread of inflammation. If there is active uterine bleeding, the uterine cavity can be cleaned with the use of large amounts of antibiotics. For those who have contraceptive devices in their uterus, they should be removed as soon as possible to eliminate the primary lesion and control the spread of inflammation.

4. Uterine dilation and drainage and estrogen therapy

For chronic endometritis and senile endometritis, the method of dilating the cervix can be used in conjunction with treatment to facilitate the drainage of uterine secretions and eliminate the inducement.